Healthy Living Blog: Your Oral Microbiome Is Wrecking Your Heart, Brain, and Hormones: What Your Dentist Isn’t Testing with Dr. Sanda Moldovan

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If you’ve been doing everything right — eating clean, exercising, managing stress, optimizing your hormones — and you still feel like something is off, I want to ask you something: when was the last time someone looked at your oral health as a whole-body issue?

For most of us, the answer is never. And that was me too, until I went down this rabbit hole around the oral microbiome and realized how much I had been missing. I thought I had covered everything. Gut health, hormones, toxic load, mold, breast implants — I had been on a deep health detective journey for years. But the mouth? I had largely treated it as a separate thing. Keep your teeth clean. See the dentist twice a year. That was it.

Then my trusted colleague Laura Frontero, who I call The Gut Genie, said something that stopped me cold. She told me the oral microbiome may actually be more important than the gut microbiome. That the mouth is where everything starts.

That is when I knew I had to bring Dr. Sanda Moldovan to Midlife Conversations.

Dr. Sanda is a double board-certified periodontist and nutritionist, the founder of Beverly Hills Dental Health and Wellness, creator of the Orasana oral probiotic line, and author of Heal Up. She has spent decades studying how the oral microbiome connects to the rest of the body, and what she shared in our conversation genuinely changed the way I think about my health.

If your mouth has always felt like a separate department from the rest of your wellness, this is going to reframe everything.

Your Mouth Is the Gateway to Your Entire Body

Most of us never think of the mouth as part of the digestive system. But it is literally where digestion begins. The mouth is the opening of the entire GI tract, and it is the one place in the whole digestive system where foreign materials — metal fillings, crowns, bacteria hiding under restorations — can quietly sit for years, creating health problems you would never connect back to your teeth.

Dr. Sanda explained that the mouth houses over 700 species of bacteria. Some of them are genuinely beneficial. They support healthy blood pressure, aid in digestion, and help the body produce nitric oxide, a critical compound for cardiovascular health. But other species are pathogenic, and when those get out of balance, they do not just cause cavities and bleeding gums. They are directly linked to heart disease, brain fog, Alzheimer’s, Parkinson’s, metabolic issues, and certain cancers.

The idea that gum disease links to heart disease is not new. You have probably heard that. But here is what most people do not understand: you do not have to have visible symptoms to have a serious problem. I did not have bleeding gums. My teeth looked fine. I did not have cavities. But when my husband and I both took an oral microbiome test, we both came back with markers including a significant marker for heart disease. Wild.

What Is the Oral Microbiome and How Do You Test It?

The oral microbiome is the ecosystem of microorganisms living in your mouth. The balance of that ecosystem is what determines whether you are supporting your health or working against it.

Testing the oral microbiome is done through a saliva test, and Dr. Sanda uses two primary approaches. The first is the OralDNA test, which has been available for about 15 years and identifies 11 specific types of bacteria linked not just to gum disease but to heart disease, dementia, Parkinson’s, and metabolic conditions. The second is a newer European test called the Oral Fitness Test, which measures inflammation in real time to show what is actively happening in the gums right now.

The reason these tests are not standard of care comes down to two things: education, because most dental schools do not teach it, and historically, practitioners did not know what to do with the results. That is changing, but slowly.

One thing the test revealed that genuinely surprised me: the specific bacteria are transmissible. Through kissing, you can pass pathogenic bacteria to your partner, and they can live in the biofilm of someone’s mouth and create the same issues. If one partner tests positive, both need to be treated. Otherwise you will just keep passing them back and forth.

What Your Bleeding Gums Are Actually Telling You

When you floss and see blood, most of us either ignore it or assume we just need to floss more. But Dr. Sanda explains that chronic, consistent bleeding in a specific area is a sign that something is actively wrong. Bleeding from the gum pocket means the lining inside that pocket has broken down, creating what is essentially an ulcer. This is typically caused by aggressive, disease-producing bacteria that live deep in the gum tissue and will not resolve with flossing alone.

And the numbers your dentist reads out loud during charting? They are only part of the picture. A pocket can measure three or four millimeters and still be healthy if it is not bleeding. But a two-millimeter pocket that consistently bleeds is telling you something important. The number alone is not the full story. The microbiome is.

Why Your Mouthwash May Be Making Everything Worse

This was one of the most surprising things I learned in this conversation, and I think a lot of you are going to feel exactly the same way.

Antibacterial mouthwashes — including Listerine and even many natural alternatives like tea tree oil — destroy the oral microbiome indiscriminately. Yes, they kill bad bacteria. But they also wipe out the good bacteria your body depends on to produce nitric oxide, regulate blood pressure, and maintain immune balance.

Studies have actually shown that regular use of antibacterial mouthwash is associated with higher blood pressure, precisely because it destroys the bacteria responsible for nitric oxide production. Nitric oxide is a vasodilator — it is critical for healthy blood flow and cardiovascular function. When you kill off the bacteria that produce it, you lose that benefit entirely.

Dr. Sanda’s position is clear: we cannot kill our way to a healthy oral microbiome. We are outnumbered ten to one by the bacteria in and on our bodies. The goal is not sterilization. It is balance.

The one exception she noted is a product called Dentalcidin, which is appropriate for someone actively treating periodontal disease — but as a targeted, temporary intervention, not a daily mouthwash replacement.

The Three Steps to Reset Your Oral Microbiome Tonight

Dr. Sanda keeps her foundational protocol refreshingly simple, and it is something you can start implementing immediately.

Step one: Brush. Use a toothpaste with calcium hydroxyapatite rather than fluoride. Calcium hydroxyapatite actually rebuilds and strengthens enamel by remineralizing it, and it is especially important during perimenopause and menopause when dry mouth becomes more common. It works even if you have veneers or crowns, strengthening the natural tooth at the margins where restoration meets enamel.

Step two: Water floss. The science on this one is genuinely compelling. Studies conducted at USC’s Center for Biofilms showed that three seconds of water pulsation at a medium setting removes 99.9% of plaque, including classified plaque. You cannot say that about string floss. Floss has been around since the 1850s. It is technique-sensitive, and most people do not use it correctly. Water flossing is more effective and more accessible. For each space between teeth, aim for a full three seconds. Use medium power unless your gums are resilient, in which case you can go higher.

Step three: Chewable oral probiotic. This was new to me, and I think it is going to be new to a lot of you too. We think about gut probiotics. We even think about vaginal probiotics. But oral probiotics are a completely separate need that most of us have not considered. Dr. Sanda recommends a chewable probiotic taken after brushing at night, when the mouth is driest and the probiotic can do the most work. After chewing or dissolving it, she recommends using your tongue to coat the outer surfaces of your teeth and cheeks. If you wake up with a white-coated tongue, that is a sign the microbiome is off, and consistent use of an oral probiotic will often resolve it over time.

What Menopause Does to Your Mouth

Here is something I genuinely did not know before this conversation: menopause significantly changes the oral microbiome, and most women have no idea it is happening.

As estrogen drops during perimenopause and menopause, saliva production decreases. The salivary glands begin to atrophy. And saliva is not just about keeping your mouth moist. It is one of the primary ways your body mineralizes and protects enamel. When saliva decreases, plaque sticks more aggressively to teeth. Enamel becomes more vulnerable. And the collagen fibrils inside the gum tissue thin out, just like they do in your skin and hair, which means gums recede more easily, especially in women who already had thinner gum tissue to begin with.

The result is that many women in midlife notice more gum recession, more plaque, more sensitivity, and drier, stickier mouths than they ever experienced before. This is hormonal. It is real. And it is largely not being addressed by conventional dentistry.

Two things that specifically support gums during this phase: collagen peptides, which help maintain the structural integrity of gum tissue, and avoiding overbrushing, which accelerates recession when gums are already thin and vulnerable.

The Four Pillars of Integrative Oral Health

Dr. Sanda shared the framework she uses with every patient, and I found it incredibly clarifying as a way to think about priorities.

The first pillar is the oral microbiome. Before anything else, you want to know what you are working with. A healthy terrain is essential for anything else you do to actually work. This is why she recommends resetting the microbiome before doing any major dental work — the same way a good gardener prepares the soil before planting.

The second pillar is healthy jaw bones. This means no cavitations and no infected root canals. Cavitations are holes in the jawbone at sites where teeth were previously extracted or root canals were performed. They are filled with microorganisms — not just bacteria, but in some cases parasitic activity as well. They cannot be diagnosed on a regular x-ray. They require a cone beam CT scan to properly identify, and even then, only practitioners trained to read them will catch them. Treatment involves a small incision, ozone sterilization, and the use of platelet-rich fibrin from the patient’s own blood to support healing.

The third pillar is healthy teeth — meaning no metal restorations and no mercury. Replacing old amalgams with biocompatible ceramics reduces the toxic burden on the immune system.

The fourth pillar is sleep. Poor oral health, particularly underlying infections or structural issues, can directly interfere with sleep quality. Addressing the first three pillars often improves sleep as a result.

Root Canals: The Conversation Nobody Wants to Have

I have been very public about my own experience with root canals, and this is a topic that generates a lot of strong reactions. Dr. Sanda laid out the science clearly.

Root canal treated teeth contain up to 50 times more bacteria than a healthy tooth. Published research in the Journal of Endodontics shows that patients with root canal treated teeth are three times more likely to have heart attacks. The issue is not the procedure itself — when done perfectly, a root canal can last for years. The problem is what happens over time: the bacterial load builds, the tooth is essentially dead tissue, and for someone whose overall toxic bucket is already full, a root canal can be one more factor pushing the immune system past its threshold.

Dr. Sanda is not dogmatic about this. Her practice is to give every patient the honest pros and cons of every option and let them decide what aligns with their intuition and health goals. She is clear that she cannot guarantee someone will feel dramatically better after removing a root canal tooth. The body is complex. Results vary. But for patients who are already dealing with a heavy toxic burden, removing an old root canal can reduce the immune load and create conditions for improvement.

If a tooth is turning black, producing a smell on the floss, or sitting in a meridian that corresponds to organs you are already having trouble with, those are all signals worth paying attention to even if the tooth is technically pain-free.

Choosing the Right Practitioner

Dr. Sanda ended with advice that I think is genuinely useful regardless of where you are in this process: interview your dentist. Ask how they feel about fluoride. Ask if they use ozone. Ask what materials they use for restorations. And most importantly, ask how they think about the oral microbiome in relation to the rest of the body.

If their answer is that the mouth is completely separate from systemic health, you have your answer. That is not the practitioner who is going to help you connect these dots.

A good integrative periodontist or biological dentist will be thinking about your mouth as the first chapter in your overall health story, not a standalone concern.

You can learn more about Dr. Sanda’s work and her oral probiotic line at beverlyhillsdentalhealth.com or listen to her podcast, the Holistic Dentistry Show, on all major platforms. You can also find her on Instagram at @dr.sanda.

 

 

The contents of the Midlife Conversations podcast is for educational and informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider. Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links mentioned on this podcast.

 

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