[00:00:00] Welcome to Think Oral

[00:00:06] Where we connect the unconnected between oral and physical health

[00:00:10] I'm your host Dr. Jonathan Levine

[00:00:13] And I'm your host Maria Filipova

[00:00:15] Let's get at it

[00:00:23] Hi Jonathan, I am so excited about our podcast today

[00:00:27] You know why? Do you know why I'm excited?

[00:00:29] Why are you excited?

[00:00:31] You know how every episode we keep telling our guests

[00:00:35] Keep this as if you're talking to somebody who is a non-insider

[00:00:40] Stay away from the jargon, keep it as accessible as possible

[00:00:45] But I'm kind of excited about getting into the science at all

[00:00:48] We've got to put your knowledge to work

[00:00:50] And we have a fellow scientist like you on the podcast today

[00:00:53] So I'm excited to get into it

[00:00:55] I want to learn all about methods and modes of action

[00:00:58] I want to learn about innovation, technology and science

[00:01:01] So I can wait

[00:01:03] Jonathan, why are you excited about today's topic?

[00:01:06] Yeah, I'm really excited

[00:01:08] You know Maria Ryan, she's a force in the industry

[00:01:11] She's at the clinical head of Colgate

[00:01:14] The multinational, the largest 200 years old

[00:01:18] Oral Health company

[00:01:20] And they do great things

[00:01:22] They do think really innovative

[00:01:24] The kind of company that you know when you're around 200 years

[00:01:28] You know how important the people are

[00:01:31] I'm excited about the equation

[00:01:33] I'm really excited also to dig into you know Maria Ryan

[00:01:36] As a researcher, scientist, background, academic

[00:01:39] And also as living now in large corporation

[00:01:43] And navigating that world

[00:01:45] Really exciting to dive into the siloing between medicine and dentistry

[00:01:49] And how do we break down the walls

[00:01:51] And what's Colgate doing about it

[00:01:53] Because they are doing some great, great things

[00:01:55] I think it's going to be a lot of fun

[00:01:57] I can't wait, let's get to it

[00:01:59] Let's get tailored, all right

[00:02:00] Hey everyone and welcome to another exciting episode

[00:02:03] Of the Think Oral Health podcast

[00:02:06] As usual I'm joined by my co-host, Dr. Jonathan Levine

[00:02:10] And we are privileged to have an amazing visionary

[00:02:14] And a leader joining us today

[00:02:16] We are speaking with Dr. Maria Ryan

[00:02:20] Who leads, she's the chief clinical officer

[00:02:23] At the Colgate Pomoliff Company

[00:02:25] She leads dental and dermal clinical organizations

[00:02:29] And she's a knowledge management and scientific communications team

[00:02:32] Maria is an accomplished leader

[00:02:35] And as I said, created visionary

[00:02:38] She served as a professor and chair of the department of oral biology

[00:02:41] And pathology at Stunning Brook

[00:02:43] She was the past president of the American Association

[00:02:46] For dental, oral and craniofacial research

[00:02:49] She's received numerous awards

[00:02:51] And I'd love to acknowledge her award

[00:02:53] Around the NIH National Research Service Award

[00:02:56] And the Physician Scientist Award

[00:02:58] As I said, she's a visionary

[00:02:59] She's a creative problem solver

[00:03:01] She's a troublemaker

[00:03:02] But she comes at it from a perspective of evidence-based science

[00:03:07] And that's what we love about Maria

[00:03:09] We love the energy that she brings into the conversations

[00:03:12] And we love the topics that Maria loves to talk about

[00:03:15] The importance of oral health as part of overall health

[00:03:18] And also the role that dental teams, dental practitioners

[00:03:22] Can play in delivering of care

[00:03:24] So these are only some of the topics that we will cover today

[00:03:27] I am so privileged to welcome Maria Ryan to our podcast

[00:03:32] Welcome, Maria

[00:03:33] Thank you, Maria and Jonathan

[00:03:35] For having me on your podcast

[00:03:37] It's exciting for me to be here with you

[00:03:39] It's great to have you here, Maria

[00:03:41] Let's open it up a little bit

[00:03:43] When the question of Holgate

[00:03:46] Has been around for many, many years

[00:03:49] A leader in...

[00:03:51] Over 200 years, Jonathan

[00:03:53] Well, to be exact, over 200 years

[00:03:56] How do you keep it fresh?

[00:03:58] You're the chief scientific officer

[00:04:00] Innovation is the energy of the day

[00:04:04] How does Colgate keep it new, exciting,

[00:04:08] Refresh, reinvented in today's world?

[00:04:12] Yeah, you know, Jonathan

[00:04:14] It's our purpose really

[00:04:15] Reimagining a healthier future for all people

[00:04:19] Their pets and our planet

[00:04:21] And when we talk about all people

[00:04:24] It is in the areas of oral care

[00:04:27] We're the leader in oral care

[00:04:29] And Maria mentioned the work that we're doing

[00:04:31] In skin health and personal care

[00:04:33] Which certainly during COVID

[00:04:35] We worked with the WHO to ensure that people

[00:04:38] Use the proper mitigation strategies

[00:04:40] But I would say the innovation that we look for

[00:04:44] Is the four Ps that really move forward

[00:04:48] Precision medicine is...

[00:04:50] And applying it to oral care

[00:04:52] Is to be preventive

[00:04:53] Which we have always been the leader in prevention

[00:04:56] And we continue to innovate in that area

[00:04:58] To be predictive, to be personalized

[00:05:02] And to have people participate more in their care

[00:05:05] So people to be more participatory

[00:05:07] And so these are areas that we are focusing

[00:05:10] A lot of our efforts, Jonathan

[00:05:12] To really move forward with innovations

[00:05:16] In our company

[00:05:17] Love that

[00:05:18] And there will be a quiz on the four Ps

[00:05:20] So please take note for those of us listening

[00:05:22] For our listeners

[00:05:23] Maria, let's double click on the prevention part

[00:05:26] There's the most, as Jonathan and I talk a lot about

[00:05:29] The most widely spread preventable chronic disease

[00:05:33] Carey is still a topic of discussion

[00:05:36] We still use pretty crude treatment methods

[00:05:39] Like a filling for that disease

[00:05:41] So what are you doing

[00:05:44] In the area of prevention around careies

[00:05:47] And I would lean on Dr. Jonathan

[00:05:49] Moving here as well to dig into that topic a little bit

[00:05:52] Sure

[00:05:53] Well, of course, you know, fluoride has been

[00:05:56] Our standard of care for many, many years

[00:05:59] It does help in preventing carries

[00:06:02] And the studies show that fluoride can reduce

[00:06:06] Risk of developing carries by about 25%, right?

[00:06:09] And all over the world

[00:06:11] We see fluoride used in different levels

[00:06:14] In different countries

[00:06:16] And professionally we use high doses of fluoride

[00:06:20] In higher risk individuals

[00:06:22] And we have many, many products

[00:06:24] On the professional side and the consumer side

[00:06:27] But clearly as you mentioned, carries still remains

[00:06:29] A very, very significant issue

[00:06:31] So we have continued to look into

[00:06:34] What else can be done

[00:06:36] And since the 1960s, our solution

[00:06:39] To prevention of carries has been

[00:06:42] Based on fluoride treatments

[00:06:44] And so we have come to recognize

[00:06:47] That there is a natural protective agent

[00:06:50] In saliva to help prevent carries

[00:06:53] And that is an amino acid called arginine

[00:06:56] And in fact, in people who have a lot of cavities

[00:06:59] Their levels of arginine and the saliva are very low

[00:07:02] And in people who don't have cavities

[00:07:06] Their arginine levels are much higher

[00:07:08] And even if you look and, you know

[00:07:10] In our companion animals, we have hills, pet food

[00:07:13] And nutrition, etc.

[00:07:15] Many of us know that our dogs can get periodontal disease

[00:07:18] But they don't get cavities

[00:07:20] And we now know that in the saliva of a dog

[00:07:23] They have very, very high arginine levels

[00:07:25] So even in our companion animals

[00:07:27] We see that arginine plays a major role

[00:07:30] In prevention of carries

[00:07:32] So we have a number of products

[00:07:35] Which we have developed

[00:07:37] Some containing arginine and fluoride

[00:07:39] With arginine alone

[00:07:41] And we have now initiated studies

[00:07:45] In the U.S.

[00:07:46] We have a nine-center study

[00:07:48] Where we are looking at the impact of arginine alone

[00:07:52] In carries prevention

[00:07:54] And last year at the International Association

[00:07:56] For Dental Research Meeting in Columbia

[00:07:58] We presented the results of a study

[00:08:00] In 6,000 kids in China

[00:08:04] Where we were able to show that arginine

[00:08:07] Is equivalent to, if not better

[00:08:10] Based on some of the higher doses of it

[00:08:12] Than 1450 ppm fluoride

[00:08:15] So this is not to say we should replace fluoride

[00:08:18] But we now have another active

[00:08:21] Which is very exciting

[00:08:23] Just like you had aspirin before

[00:08:25] And then you had Tylenol

[00:08:27] And then you had Motrin

[00:08:29] And then you had naprason

[00:08:31] And all of these things can be used separately

[00:08:33] Together to address pain

[00:08:35] We have now in dentistry a new active

[00:08:38] Which we have shown in studies

[00:08:40] Can reduce carries risk by 50%

[00:08:43] When you combine it with fluoride

[00:08:45] And we know it's at least as good

[00:08:48] As fluoride when used alone

[00:08:50] So it's very exciting

[00:08:52] That's very exciting on the preventive strategy

[00:08:54] Marina has an amino acid

[00:08:56] So it's so fascinating as an amino acid

[00:08:59] What are you considering

[00:09:00] And what are the scientists like yourself

[00:09:02] Considering as the mode of action

[00:09:04] How has that synergistic effect

[00:09:06] Potentially with fluoride occurring

[00:09:09] As you think about this

[00:09:11] Or from the science that is getting eliminated

[00:09:14] Jonathan, we actually had a special issue

[00:09:17] In the Journal of the American Dental Association

[00:09:19] Which goes into the mode of action

[00:09:22] Which has been studied for many years

[00:09:24] By many great scientists at Stony Brook

[00:09:26] Where I came from

[00:09:28] At the University of Florida

[00:09:30] Bob Bernie who was funded by the NIH

[00:09:32] Our scientists at Colgate

[00:09:34] And we know that fluoride strengthens the tooth

[00:09:37] So it makes it harder

[00:09:38] Makes it more resistant to the acids

[00:09:41] That break down the tooth structure

[00:09:43] So that's how fluoride works

[00:09:45] Arginine actually works

[00:09:48] By modulating the bacteria around the teeth

[00:09:52] And what we know is that

[00:09:55] Everyone is born really

[00:09:57] Without those bacteria that will cause carries

[00:10:00] And with time you have a change

[00:10:03] From those protective bacteria

[00:10:06] Because they're actually good bacteria there

[00:10:08] We call them the commensals

[00:10:10] To those pathogens like strep mutans

[00:10:13] Which help to produce a lot of acids

[00:10:16] Make the tooth more prone to breaking down

[00:10:20] And will drive the development of cavities

[00:10:24] Arginine actually supports the commensals

[00:10:28] The good bacteria

[00:10:30] And it leads to a more basic environment

[00:10:32] So the tooth is less prone to break down

[00:10:34] Because the bacteria are not generating all these acids

[00:10:37] And so it's a completely different mechanism

[00:10:40] Than fluoride

[00:10:42] And you can imagine how the two of them

[00:10:44] Work very well together

[00:10:45] By keeping the good bacteria at high levels

[00:10:48] And getting the bad ones at very low levels

[00:10:51] And then also strengthening the tooth

[00:10:54] But we do find that either one alone

[00:10:57] Can work very well

[00:10:58] And in fact besides the nine center study

[00:11:01] We're looking to do a pediatric safety study

[00:11:03] Because since arginine is naturally

[00:11:06] In a mother's breast milk and baby bottle formula

[00:11:09] It actually helps with neurological development

[00:11:12] But it helps to prevent carries

[00:11:14] We could be applying this six months old

[00:11:17] Into a child's mouth to really drive prevention

[00:11:20] So that's very exciting to think about

[00:11:23] That from the time the first tooth erupts

[00:11:26] We can have some impact on trying to

[00:11:29] Reduce the risk for developing cavities

[00:11:32] Very exciting stuff

[00:11:33] And there's also a nutritional implication here

[00:11:35] Right?

[00:11:36] Food which would be high in arginine

[00:11:39] Potentially could be introduced into the baby's diet

[00:11:42] At appropriate times

[00:11:44] So that there becomes this increase

[00:11:46] Of these good bacteria

[00:11:48] The commensals versus the pathogens

[00:11:50] That are causing decay

[00:11:52] And it's so interesting

[00:11:54] So how long has Kogate been working on this

[00:11:57] And do you think that you will be the lead player

[00:12:00] Of this to create this unique value proposition

[00:12:03] For the consumers?

[00:12:04] What do you think everybody else is going to jump

[00:12:06] On the bandwagon and we're going to have

[00:12:08] That beautiful competition

[00:12:10] Occuring between the marketing powers

[00:12:13] Of the oral health and the oral care companies

[00:12:16] We've been working on this for 15 years

[00:12:19] Since we licensed the technology

[00:12:21] From Stony Brook University

[00:12:23] Which actually came from

[00:12:24] And Kogate has done an awesome job

[00:12:27] Of developing this technology

[00:12:29] Not only for caries but for sensitivity

[00:12:32] It was first introduced into the market for sensitivity

[00:12:35] And in fact there is a product in the US market

[00:12:38] For sensitivity, Tom's instant relief

[00:12:41] Which is 8% arginine

[00:12:43] And so it is approved for sensitivity

[00:12:46] And we look forward to the approval

[00:12:48] In the US and other parts of the world

[00:12:51] For caries prevention as well

[00:12:53] We have used it in the past

[00:12:55] In addition to fluoride

[00:12:57] But never as a standalone

[00:12:59] And so these studies that we have done

[00:13:02] Looking at arginine as a standalone

[00:13:04] Really proved that it in and of itself

[00:13:08] Is a preventive agent

[00:13:10] And you know it's interesting what you say Jonathan

[00:13:12] You know in the diet etc

[00:13:14] You can consume arginine

[00:13:16] And there have been studies done

[00:13:18] Looking at chews, candies

[00:13:20] With arginine in it

[00:13:22] To help prevent caries and young people

[00:13:24] And I think that Kogate will be the leader

[00:13:27] Because we have put the most time, effort

[00:13:30] And work into it

[00:13:32] And are doing the hard studies

[00:13:34] That need to be done

[00:13:35] And I give the company credit

[00:13:37] And I really appreciate working at a company

[00:13:40] That's willing to invest

[00:13:42] What it takes to drive this forward

[00:13:44] But I do believe Jonathan down the road

[00:13:46] It will be like fluoride

[00:13:48] Everyone will accept that this is a new agent

[00:13:50] So there'll be others who will join us

[00:13:53] In trying to prevent caries

[00:13:55] Across the world

[00:13:57] So I think it's very exciting

[00:13:59] To be taking the lead in this

[00:14:01] And also have an active that doesn't have

[00:14:04] The potential so-called

[00:14:06] Let's call it public facing

[00:14:08] Side effects

[00:14:10] That the fluoride is garnishing

[00:14:12] From a standpoint of

[00:14:14] What is out in the consumer world

[00:14:16] Whether it's true or false

[00:14:18] Perception is my tenth of the lot here

[00:14:21] And people perceive that fluoride

[00:14:24] Has a negative impact at certain levels

[00:14:28] Could you comment on that

[00:14:30] And how does Kogate educate the consumer

[00:14:33] To the good side of fluoride

[00:14:35] Because as a professional

[00:14:38] We deeply understand the motive actions

[00:14:41] And how it works both in up tank

[00:14:43] And the developing tooth

[00:14:45] To create that fluoropathy molecule

[00:14:47] And also topically as you were describing

[00:14:49] To create that improved surface on the tooth

[00:14:52] But how does Kogate think about that

[00:14:54] Messaging, that important messaging

[00:14:56] To the consumer so that

[00:14:58] You can dispel the myths out into the market

[00:15:01] Yes, I mean fluoride as we know

[00:15:03] Is very safe used in toothpaste

[00:15:05] They're also very highly regulated

[00:15:07] By the regulatory agencies

[00:15:10] So of course we comply with all of that

[00:15:12] And so we know it works

[00:15:14] We know that it's safe

[00:15:15] We share the information with people

[00:15:17] But as you say, unfortunately

[00:15:19] It's probably one of the biggest issues

[00:15:21] We face in science

[00:15:23] Is misinformation going out

[00:15:26] And unfortunately we do see

[00:15:29] A growing market of people using

[00:15:32] Fluoride 3 products

[00:15:34] Which increases the risk

[00:15:36] For what we talked about in the beginning

[00:15:38] With L'Oreal which is the incidence of disease

[00:15:41] Will rise, right?

[00:15:43] And there are some countries in the world

[00:15:45] Where 50% of the market

[00:15:47] Is fluoride free like China

[00:15:49] Where we did the study with Arginine

[00:15:52] And so I think it's really important

[00:15:54] That people have choice

[00:15:57] But certainly fluoride

[00:15:59] It's very safe

[00:16:01] I mean think of the millions and millions

[00:16:03] And millions of people

[00:16:05] Who are using fluoride toothpaste

[00:16:07] In the world

[00:16:08] And it is very effective

[00:16:10] But now we have another tool

[00:16:13] And I think we can make it even more effective

[00:16:16] By adding it in

[00:16:18] And for those people for whatever reason

[00:16:21] Who choose to take the fluoride free route

[00:16:24] Which we know does absolutely nothing for carries

[00:16:27] I mean there are many many papers written

[00:16:29] So if anybody thinks you're using a fluoride free toothpaste

[00:16:31] And it's taking care of your carries, you're wrong

[00:16:34] Those studies have been done

[00:16:36] But now we may have any tool

[00:16:39] So we have a new active

[00:16:41] That can help if you chose not to use fluoride

[00:16:44] So I think this addresses a potential

[00:16:47] And a looming public health issue

[00:16:49] As the numbers of people who use fluoride free products

[00:16:52] Does grow and it gives them another option

[00:16:56] But you are right Jonathan

[00:16:58] We need to continue to educate people

[00:17:00] About the fact that fluoride is very safe

[00:17:02] And I do want to make sure that for those listeners

[00:17:04] On the podcast today for those parents

[00:17:07] Whose kids are being offered silver diamond fluoride

[00:17:10] As an anti-carry treatment

[00:17:12] That there's appropriate consent

[00:17:14] And there's appropriate conversation

[00:17:16] Because there are different tools

[00:17:18] For different parts of the mouth

[00:17:20] Or the tooth structure

[00:17:22] And so if you're using STF

[00:17:24] Or the front teeth of the child

[00:17:26] And there's some staining down the road

[00:17:28] You don't want to be surprised

[00:17:30] So there's efficacy, there's appropriate use

[00:17:32] Of the right tool in the appropriate situation

[00:17:34] And I think that's what Maria you're getting at

[00:17:36] Is that innovation needs to be

[00:17:38] In that specific part

[00:17:40] Big market, big opportunity

[00:17:42] For caries

[00:17:44] Let's make sure that we have an abundance

[00:17:46] Of different treatment options

[00:17:48] Or prevention options in this case

[00:17:50] And that's amazing, that's the power of innovation here

[00:17:52] So have a conversation with your dentist

[00:17:54] All about all the available options

[00:17:56] The piece that I really appreciate

[00:17:58] About this conversation in addition to the richness

[00:18:00] Of the science behind it

[00:18:02] Is the opportunity Maria to take

[00:18:04] This new technology

[00:18:06] And this new potential product

[00:18:08] And the fact that Arginine

[00:18:10] Is in the mother's breast milk

[00:18:12] And in certain foods opens up

[00:18:14] Conversation where the dental team

[00:18:16] Is now part of the pediatric team

[00:18:18] Or the OBGYN

[00:18:20] Or for pregnant moms

[00:18:22] Or new moms who just had their first baby

[00:18:24] To have the conversation

[00:18:26] Around oral health with their pediatrician

[00:18:28] So in this future state

[00:18:30] Where you have a product on the market

[00:18:32] That's with proven efficacy

[00:18:34] And it's ready to be launched

[00:18:36] What is the dream optimal model

[00:18:38] Of care delivery

[00:18:40] Between the medical teams and the dental teams

[00:18:42] In your view

[00:18:44] Obviously your mouth is connected

[00:18:46] To the rest of the body

[00:18:48] And we have known for many many years

[00:18:50] That the infection

[00:18:52] And inflammation in the oral cavity

[00:18:54] Can have an impact on the rest of the body

[00:18:56] And so for many years

[00:18:58] I was involved in doing research

[00:19:00] In a general clinical research center

[00:19:02] At stonybrook where we looked

[00:19:04] At the impact of

[00:19:06] Oral health on people with diabetes

[00:19:08] On risk for cardiovascular disease

[00:19:10] On adverse pregnancy outcomes

[00:19:12] Respiratory diseases

[00:19:14] There's so many where we know

[00:19:16] That oral health

[00:19:18] Is so important to overall health

[00:19:20] And well-being

[00:19:22] But having gone to

[00:19:24] Dental school

[00:19:26] Like jonathan and in a school

[00:19:28] Where we went with the medical school

[00:19:30] There's a recognition that

[00:19:32] The physicians and other health

[00:19:34] Care providers do not get a lot

[00:19:36] Of education about oral health

[00:19:38] And so it's very important

[00:19:40] That we share

[00:19:42] The data, the knowledge

[00:19:44] About the connections between

[00:19:46] Oral health with overall health

[00:19:48] And so in working in this

[00:19:50] GCRC it was really interesting

[00:19:52] To see that when you work side by side

[00:19:54] With other clinicians

[00:19:56] That is knowledge that we share

[00:19:58] And then begin to work together on

[00:20:00] And so you're starting to see

[00:20:02] Dentistry coming closer

[00:20:04] With primary care

[00:20:06] Being provided in FQHCs

[00:20:08] Federally qualified health centers

[00:20:10] And that kind of connection

[00:20:12] I think is very important

[00:20:14] For us to work together

[00:20:16] And one of the people that I know

[00:20:18] Is a doctor

[00:20:20] To work together and one of the people

[00:20:22] That I worked very closely with

[00:20:24] At that time a guy named Jerry Quirk

[00:20:26] Who was the head

[00:20:28] Of obstetrics and gynecology

[00:20:30] Wrote the first basically

[00:20:32] Position paper

[00:20:34] In the state of New York

[00:20:36] Telling obstetricians that

[00:20:38] It was important that their

[00:20:40] Patients have good oral health

[00:20:42] And that poor oral health

[00:20:44] Could have an adverse effect

[00:20:46] On their pregnancy

[00:20:48] On the birth of their child

[00:20:50] And that dentists needed

[00:20:52] To provide care to people

[00:20:54] Who had periodontal disease

[00:20:56] Even during pregnancy

[00:20:58] And that waiting till the end

[00:21:00] Was not the answer

[00:21:02] So those types of connections

[00:21:04] Drive the

[00:21:06] Sharing of knowledge

[00:21:08] And getting it out into the communities

[00:21:10] And so

[00:21:12] I'm happy to see it's happening

[00:21:14] More than it did in the past

[00:21:16] It's important that we work very closely together

[00:21:18] The other reason we put

[00:21:20] Our dental chairs in the middle

[00:21:22] Of a hospital to do this

[00:21:24] Research is that we notice

[00:21:26] That even getting people to leave

[00:21:28] From the physician's office

[00:21:30] And come to the dental office

[00:21:32] They didn't often make the trip

[00:21:34] So if we were next door they came

[00:21:36] So I think putting us together

[00:21:38] Is a very good thing

[00:21:40] And I think that when you look at

[00:21:42] The overall health of people

[00:21:44] Working together

[00:21:46] To improve on health

[00:21:48] Is essential

[00:21:50] And so I'm happy to see a bit

[00:21:52] More of it in our communities

[00:21:54] And certainly

[00:21:56] I know in the dental profession

[00:21:58] We reach out to our medical colleagues

[00:22:00] All the time

[00:22:02] And now with some of the

[00:22:04] EDC that we're seeing

[00:22:06] That is joint where you actually

[00:22:08] Have medical and dental information

[00:22:10] In electronic data capture

[00:22:12] That can communicate even

[00:22:14] More easily

[00:22:16] I think that's very important too

[00:22:18] Because you can start to see the impact

[00:22:20] Of the care we give in the

[00:22:22] Dental office

[00:22:24] Medical parameters and dental

[00:22:26] Parameters and the physician can see this

[00:22:28] As well so I think that's

[00:22:30] Going to only facilitate this more

[00:22:32] So I'm giving a talk down

[00:22:34] At Nova University where

[00:22:36] They're talking about medical

[00:22:38] Dental integration

[00:22:40] And that's a new area for us

[00:22:42] But if you think about it

[00:22:44] It may be new today but years ago

[00:22:46] Dentistry was like a

[00:22:48] Subspecialty in medicine and so

[00:22:50] It was at a certain point

[00:22:52] In time where we kind of became

[00:22:54] Separate but we're not separate

[00:22:56] We were there to begin with

[00:22:58] Because it's part of your overall health

[00:23:00] We're lucky to talk about Mariano's

[00:23:02] Book and she talks about the mouth

[00:23:04] Is connected to the rest of the body

[00:23:06] And 58 systemic inflammatory diseases

[00:23:08] Are connected to inflammation in the mouth

[00:23:10] As we know and there's this new

[00:23:12] Division of oral systemic medicine

[00:23:14] That you're describing so if we took

[00:23:16] A snapshot and we said today

[00:23:18] Where are we today? The truth is

[00:23:20] That the physicians don't really know

[00:23:22] What to look for in a patient's

[00:23:24] Mouth. If you ask the physician

[00:23:26] What do you look for? I look for some redness

[00:23:28] And if you ask the dentist what are you looking at

[00:23:30] Are you looking at blood pressure

[00:23:32] Are you looking at A1C, are you looking at pulse

[00:23:34] Socks, what do you look at

[00:23:36] And you're really doing that. Right.

[00:23:38] So where do we start? You've mentioned

[00:23:40] Nova University, I'm a big fan of

[00:23:42] Nova and their dedication to

[00:23:44] Innovation and unbelievable

[00:23:46] Educated. Head of Prostitonics, Alexander

[00:23:48] Bendine down there is amazing work.

[00:23:50] Fantastic. He does, yeah.

[00:23:52] Doesn't it start in the dental

[00:23:54] School? Isn't this concept

[00:23:56] Of oral systemic medicine needs to

[00:23:58] Be a division in the

[00:24:00] Medical and dental schools

[00:24:02] If they learn the same thing

[00:24:04] Very fortunate. At first two years we were in medical school.

[00:24:06] Farver, the only dental

[00:24:08] School in the country that

[00:24:10] Integrates dentistry and medicine all under one root

[00:24:12] Dental school is part of medical school

[00:24:14] And I don't want to go back to 1840

[00:24:16] In the old Grand Rebuke when

[00:24:18] The physician said no you cannot join our

[00:24:20] Medical school, you have to open up your own

[00:24:22] Dental school. That was 1840.

[00:24:24] Here we are in

[00:24:26] 2024. Not much has changed

[00:24:28] But a company like Colgate

[00:24:30] The global impact of Colgate

[00:24:32] What you all can do to start a bit of a revolution here

[00:24:34] How do we get

[00:24:36] This oral systemic health medicine

[00:24:38] Knowledge it's 20 years out

[00:24:40] Since the silent killer was on the cover

[00:24:42] Of Time Magazine by the

[00:24:44] Surgeon General of Satchar at that time

[00:24:46] How do we change this

[00:24:48] 20 years later when the

[00:24:50] Oral now, you know it came out the

[00:24:52] Report and you know why it was thicker

[00:24:54] But it was the same conversation from

[00:24:56] 20 years earlier. How do we

[00:24:58] Make this change. Change has to be coming

[00:25:00] For this. How do we

[00:25:02] You know one of the things is breaking down

[00:25:04] Silo's right so

[00:25:06] Really to make progress

[00:25:08] We recognize you have to

[00:25:10] Have academia

[00:25:12] And industry and government

[00:25:14] And the profession

[00:25:16] And the researchers

[00:25:18] All working together instead

[00:25:20] Of their own little silos. I think a lot of

[00:25:22] People are trying to make progress but

[00:25:24] We are trying to do it

[00:25:26] Individually in various

[00:25:28] Sectors right and certainly

[00:25:30] I agree with you Jonathan you know

[00:25:32] I was 20 years in academia that

[00:25:34] You need to start in the

[00:25:36] Academic setting but to be

[00:25:38] Quite frank a less reimbursement

[00:25:40] Really pushes some of this forward

[00:25:42] We're not going to see that

[00:25:44] And I will tell you at Colgate we are

[00:25:46] Working with insurance carriers

[00:25:48] To do the hard work

[00:25:50] To show that

[00:25:52] The investment in oral

[00:25:54] Health will show dividends

[00:25:56] Not only in improving

[00:25:58] On the oral health of

[00:26:00] Someone but also

[00:26:02] On the medical side of it and many

[00:26:04] Insurance carriers have both sides they

[00:26:06] Have both the dental and the medical and

[00:26:08] They can clearly see the impact

[00:26:10] Of people actually

[00:26:12] Using their dental insurance

[00:26:14] When they have it and sometimes

[00:26:16] They don't use it for various reasons

[00:26:18] Or giving them dental

[00:26:20] Insurance when they didn't have it

[00:26:22] Before and they felt that they

[00:26:24] Had the care that they needed so

[00:26:26] I think that's a very

[00:26:28] Important part of it is the

[00:26:30] Reimbursement side and that goes

[00:26:32] The other way too for the medical side

[00:26:34] You know I have met with

[00:26:36] When I was in academia with

[00:26:38] Insurance carriers who were

[00:26:40] Reimbursing dentists for taking

[00:26:42] Blood pressure, for doing

[00:26:44] BMI's, for looking at

[00:26:46] Blood glucose levels because

[00:26:48] We can screen for these

[00:26:50] Diseases where they may be

[00:26:52] Reimbursement side and get people in

[00:26:54] Earlier which is going to save money

[00:26:56] As well so it goes both ways

[00:26:58] But I think that we all have to

[00:27:00] Work together in order to make that

[00:27:02] Work but I have to tell you

[00:27:04] I gave a talk at a global oral

[00:27:06] Health conference down in Merida, Mexico

[00:27:08] And I had the good fortune

[00:27:10] Of meeting Steve Beshear

[00:27:12] Who was the former governor

[00:27:14] Of Kentucky and

[00:27:16] He made significant

[00:27:18] Changes in access

[00:27:20] To health care and including dental

[00:27:22] Care in his state of Kentucky

[00:27:24] And the only way that he was able

[00:27:26] To actually change laws and get

[00:27:28] Things integrated was to give

[00:27:30] The economic rationale for it

[00:27:32] So he said you know you all sound

[00:27:34] Very frustrated you have all this data

[00:27:36] But nothing's happening so like how do you

[00:27:38] Make it happen and so Steve said

[00:27:40] You know work with Deloitte work

[00:27:42] With these people who can help

[00:27:44] You to really

[00:27:46] Put the data together for

[00:27:48] The economic argument so at

[00:27:50] At Colgate we joined the

[00:27:52] World Economic Forum and I

[00:27:54] Sit on the global health equity

[00:27:56] Network which is within

[00:27:58] The world economic form and

[00:28:00] We actually created an

[00:28:02] Oral Health Affinity Group because

[00:28:04] Oral Health was being left out of

[00:28:06] The discussion as usual right

[00:28:08] And so they had

[00:28:10] Actually put together a plan for

[00:28:12] Companies for a zero health

[00:28:14] Gaps pledge to have

[00:28:16] The numbers of companies signed that

[00:28:18] They were taking care of their

[00:28:20] Employees health and concerned

[00:28:22] About the health of the communities

[00:28:24] That they serve and

[00:28:26] When you looked at the zero health

[00:28:28] Gaps pledge there was nothing in it

[00:28:30] About Oral Health the plan

[00:28:32] The pledge the whole thing so

[00:28:34] I said where's Oral Health

[00:28:36] And they said you know what we forgot

[00:28:38] So I said let's

[00:28:40] Create a

[00:28:42] Oral Health Affinity Group and to

[00:28:44] The W E F allowed us

[00:28:46] To create this group and we have

[00:28:48] A white paper coming out Marco

[00:28:50] Wujisek from the ADA

[00:28:52] Is the primary author on it

[00:28:54] And we have brought

[00:28:56] Together all of the data

[00:28:58] That supports that if you

[00:29:00] Improve on Oral Health

[00:29:02] If you have preventive

[00:29:04] Strategies that it

[00:29:06] Is helpful to not

[00:29:08] Only the economics of your company

[00:29:10] But to the world's economy

[00:29:12] When you look at misdays of work

[00:29:14] Misdays of school for kids

[00:29:16] Where their parents have to take

[00:29:18] Offer of work to take care of them

[00:29:20] All for Oral Health issues

[00:29:22] And so I think that

[00:29:24] That was an awakening for me

[00:29:26] Is that we can have all this

[00:29:28] Data and all this interest

[00:29:30] But without the economic argument

[00:29:32] We're not getting very far

[00:29:34] So we're now continuing to promote

[00:29:36] That. I love it you know Maria

[00:29:38] You come from this healthcare

[00:29:40] Around this whole concept

[00:29:42] Of a wellness model versus a

[00:29:44] Sickness model proving it

[00:29:46] Economically to the insurance companies

[00:29:48] That are driving a lot of the decision making

[00:29:50] Would you weigh in on this from a healthcare

[00:29:52] Perspective? I love it this is

[00:29:54] The topic that's near and dear to my heart as well

[00:29:56] And I've been

[00:29:58] Saying this for quite a few

[00:30:00] Forums now including an

[00:30:02] Article and Forbes that came out that said

[00:30:04] Oral Health is the missing piece

[00:30:06] In healthcare because

[00:30:08] We believe that in healthcare

[00:30:10] We have been calculating total

[00:30:12] Cost of care wrong

[00:30:14] Because we haven't been factoring

[00:30:16] In the cost on the dental side

[00:30:18] And how what

[00:30:20] We do or fail to do on the

[00:30:22] Dental side impacts

[00:30:24] Our medical cost the

[00:30:26] Number of pre-term

[00:30:28] Births that we would have

[00:30:30] And we know that a single pre-term

[00:30:32] Birth the cost of mom and baby

[00:30:34] To get out of the new queue is

[00:30:36] A single pre-term labor

[00:30:38] And so to me

[00:30:40] There is this misconception

[00:30:42] Around dental is what you do

[00:30:44] For the oral health and then medical

[00:30:46] Is what you do for total cost of care

[00:30:48] And that's the first bias

[00:30:50] And then Maria you

[00:30:52] We can't you know emphasize what you're describing

[00:30:54] Enough because the famous

[00:30:56] Quote by Howard Schultz

[00:30:58] That Starbucks spends more

[00:31:00] Money on healthcare

[00:31:02] Than on coffee beans

[00:31:04] This puts in perspective how

[00:31:06] The important healthcare costs

[00:31:08] Are for the bottom line

[00:31:10] Of the businesses right

[00:31:12] And you pick any of the largest

[00:31:14] Employers like Walmart they spend

[00:31:16] Two billion dollars to take care

[00:31:18] Of their employees and their dependents

[00:31:20] These are not insignificant amounts

[00:31:22] And clinically

[00:31:24] Scientists like both of you have

[00:31:26] Proven that there is a credible

[00:31:28] Connection between oral health

[00:31:30] And overall health the business model

[00:31:32] For the delivery of care needs to

[00:31:34] Catch up to the science

[00:31:36] And I'm so incredibly

[00:31:38] Grateful to have you Maria

[00:31:40] Working on this at the highest possible

[00:31:42] Levels influencing the decision makers

[00:31:44] Because the other myth I would like

[00:31:46] To disperse is this

[00:31:48] Conversation we're having is not

[00:31:50] A conversation for the clinicians

[00:31:52] Or a conversation for the Santas

[00:31:54] It's a C-suite conversation

[00:31:56] It's a conversation for the business

[00:31:58] Leaders because that becomes

[00:32:00] A business conversation not about

[00:32:02] Only about your bottom line but how

[00:32:04] Are you differentiating yourself

[00:32:06] As an employer relative

[00:32:08] To other employers what are your benefits

[00:32:10] How do you take care of your own employees

[00:32:12] And so that's the conversation

[00:32:14] That we need to have rather than

[00:32:16] To say oh do you have three cleanings

[00:32:18] A year or four cleanings a year

[00:32:20] And dental benefits are just the thing

[00:32:22] That you put in the bottom of the food now

[00:32:24] So that's where this is near and

[00:32:26] Here to my heart I also

[00:32:28] Would put in here is

[00:32:30] This conversation has been so

[00:32:32] Amazingly insightful

[00:32:34] But also not from so many levels

[00:32:36] But also we were able to elevate the importance

[00:32:38] Of treating caries because

[00:32:40] Untreated caries oral health

[00:32:42] Is one of the only areas where

[00:32:44] By the time you feel pain

[00:32:46] It's too late and so

[00:32:48] You could have very significant

[00:32:50] Outcomes adverse outcomes

[00:32:52] From untreated caries

[00:32:54] I mean just recently we saw

[00:32:56] A 36 year old NFL player

[00:32:58] Who died because

[00:33:00] He had infection in the mouth

[00:33:02] Multiple caries, roots that were

[00:33:04] Untreated and then left in

[00:33:06] And he had an adverse somebody

[00:33:08] Died. And so one of the

[00:33:10] Things that I would love to also

[00:33:12] Disperse as a myth is the fact that

[00:33:14] When you have time we'll deal with your caries

[00:33:16] That's not acceptable

[00:33:18] We still have to think about

[00:33:20] Prevention. What a great way to wrap it up

[00:33:22] What a great way to maybe

[00:33:24] I should say begin the conversation Maria

[00:33:26] We're hoping that number one

[00:33:28] You share with us amazing resources

[00:33:30] Some of the things that you were referring to

[00:33:32] About publications and articles

[00:33:34] When the white paper with

[00:33:36] Mako Fujicic and your team

[00:33:38] For the World Grammy Forum is available

[00:33:40] Please let us know. I would like to share

[00:33:42] With our audience and we'd like to have

[00:33:44] You back, absolutely.

[00:33:46] I'd love to. I think

[00:33:48] You know educating the public

[00:33:50] About oral health is very important

[00:33:52] I think we've tried to do things from the top

[00:33:54] Down but we need advocates

[00:33:56] Through the consumers

[00:33:58] And the people and the more they understand

[00:34:00] It, the more they can advocate

[00:34:02] And there's a lot more of them than there are

[00:34:04] Of us, right? And so

[00:34:06] We have a program called know your

[00:34:08] OQ, know your oral health quotient

[00:34:10] Which is educating people

[00:34:12] About oral health like you know

[00:34:14] Your IQ or EQ. What do you know about oral

[00:34:16] Health and it's like 10 quick questions

[00:34:18] And to be quite frank Maria

[00:34:20] We've learned that some people don't even know

[00:34:22] That caries or cavities is a disease

[00:34:24] So like the football player probably

[00:34:26] Didn't think well what do I have to take care of this for

[00:34:28] So if you don't know it's a disease

[00:34:30] You're going to have issues, right?

[00:34:32] And so we have to educate people

[00:34:34] About these connections

[00:34:36] Between their oral health and their

[00:34:38] Overall health. So I think

[00:34:40] You know that's very important as well

[00:34:42] And being part of Colgate

[00:34:44] We have the opportunity being in 60%

[00:34:46] Of all homes to actually

[00:34:48] Educate people about it which is very exciting.

[00:34:50] Absolutely. It was great to have you on the show

[00:34:52] That's why we have sync oral health

[00:34:54] Is to raise the awareness and having people

[00:34:56] Like you sharing your

[00:34:58] Experiences, your wisdom and really the vision

[00:35:00] Of where Colgate is having a huge impact

[00:35:02] Has been really great for our listener

[00:35:04] I know. Thank you so much, Maria

[00:35:06] Thank you. Thank you. Thank you for having me

[00:35:08] Doxon, till next time.

[00:35:10] Thanks for listening to the

[00:35:12] Think Oral Podcast

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[00:35:21] Think Oral Podcast

[00:35:23] For the show notes and resources from

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