[djtango]

I can't remember where (maybe here) that you shouldn't use mouthwash after working out because of the effects on your oral microbiome. That fact shocked me just like this article does because it was unintuitive that your oral microbiome could have such an impact on your physiology.

The effect may actually be a similar one because nitrates do sound familiar...

[christophilus]

You shouldn’t use mouthwash at all ever. It’s a nuke to the microbes in your mouth. There was a long, rambling discussion with a functional dentist on the Primal Podcast[0] that goes into this.

[0] https://m.youtube.com/watch?v=jNrm-9sp-RQ

[Aurornis]

> long, rambling discussion with a functional dentist on the Primal Podcast

I don’t know what a “functional dentist” is, but the term “functional medicine” is used to describe alternative medicine doctors. They traditional misinterpret studies and exaggerate their impacts, focusing on small studies in mice or theoretical in vitro studies and then extrapolating those to treatment decisions.

[kaleinator]

In my own personal experience (chronic pain), "Real Doctors" seem to want to shove pills down your throat because "they work", or give things like steroid shots which have negative long term effects. Whereas "Functional Doctors" are willing to try more traditional things because historically they have seemed to produce good results and are typically less intrusive (but may require more effort from the patient).

So I can see "Functional Dentist" being more like a dentist that is willing to try more ways to save teeth & gums by using more traditional methods (eg. Balancing the oral microbiome, suggesting softer foods more often), rather than a "Real Dentist" suggesting extractions or root canals without ever mentioning the hardness of foods or oral microbiome.

[Aurornis]

> "Real Doctors" seem to want to shove pills down your throat because "they work", or give things like steroid shots which have negative long term effects. Whereas "Functional Doctors" are willing to try more traditional things because historically they have seemed to produce good results and are typically less intrusive (but may require more effort from the patient).

This is the functional medicine fallacy: That “real doctors” are “shoving pills” that are secretly bad for the patient, while functional medicine doctors are also “shoving pills” but they’re a laundry list of supplements and traditional remedies.

In my experience, the functional medicine practitioners push far more pills and unnecessary tests than anyone else, but they’re given the benefit of the doubt because they’re operating under the alternative medicine fallacy that primary care doctors are the ones doing the bad things.

> (but may require more effort from the patient).

This is another concept used to justify the ineffective alternative medicine treatments; If they don’t work, it’s the patient’s fault for failing to do some effort. Another common explanation for when they don’t work is to “discover” yet another thing that needs to be treated. The additional demands of the patient are also designed to create buy-in which amplifies any placebo effect. The more rituals and supplements you can get a patient taking, the more they believe it’s going to work.

[djtango]

It's unpopular to voice anti-science sounding sentiments about medicine but it's worth noting that there is often a disconnect between known and practiced medicine.

Optimal outcomes at the aggregate don't always translate to optimal outcomes for the individual.

This can mean that strategies like effective triage and prioritization lets people fall through the cracks of conventional medical treatment. This is especially true for both public healthcare and separately chronic issues which are often too hard to treat vs acute medicine.

Then in private medicine it can be a bit of a crapshoot of practitioners who are incentivised to upsell or recommend preferred treatments.

I think this has soured people's opinions of conventional medicine.

My own personal anecdote to offer on the subject is a friend who suffered from severe eczema and over their life and was just put on progressively higher doses of steroids until that stopped working. The last advice from the doctor was "we give up - our next recommendation is chemotherapy to shock your body. Maybe you would like to consider alternative medicine first"

They went to try traditional Chinese medicine and for the first time in their life got control of their eczema.

Given alternative medicine is a dirty word here what I'd say is missing these days is the family doctor who has excellent holistic patient history and is willing to provide a mixture of therapy and lifestyle guidance eg exercise or nutrition intervention.

Some people might claim a GP should do this but the reality is that GPs often aren't allowed to provide this kind of care due to capacity constraints or top down strategic planning.

Ironically you see the gap being bridged from the other direction with therapists increasing their scope - eg someone close to me went to an osteopath for neck issues to get diagnosed (correctly!) that the root cause was sleep apnoea

[chemmail]

If you look at the US healthcare system, it is 100% about fixing after the fact rather than prevention. Insurance would touch anything preventative.

[red-iron-pine]

what does "chinese medicine" mean? was he huffing ground up rhino horn?

most chinese medicine is hokum, utter BS, but that doesn't mean they can't use plants whose utility have not been fully explored by modern science.

and even if it does work, that doesn't mean it didn't utterly ravage his liver -- but hey, at least his skin looks a lil better

[specialist]

Same.

I went to Swedish Hospital's Pain Services Clinic. https://www.swedish.org/services/pain-services Transformative.

Funny thing: the techniques and skills they teach work, even if you don't think they will.

I think most (all?) new age stuff -- naturopathy, chiropractics, reiki, whatever -- is BS. But I can't argue with my lived experience of using tai chi, mindfulness, education, and other new skills to proactively manage my disease.

This is my first time hearing (reading) the phrase "functional doctor". WebMD defines them as specialists in digging deeper, seeing the whole picture. Perfect.

--

YMMV. Consult your doctor, etc. Most treatments don't help with treatment resistant conditions. Beware adverse effects. Yadda, yadda.

[Ey7NFZ3P0nzAe]

Not every doctor works in a country where there pay depends on the treatment they give. Research is produced internationaly.

[giantg2]

There are situations where mouthwashes are beneficial, such as with injuries... Just not the stuff you buy at the store. The best mouthwash for those situations is just warm salty water.

[morkalork]

I'll just add that chlorohexadine mouthwash is probably the most vile thing I've ever put in my mouth; like gargling essence of hospital.

[rickydroll]

Being that guy: Chlorhexidine is the correct spelling. It is what Nate the hoof guy uses when cleaning cow hoof wounds.

https://www.youtube.com/results?search_query=nate+the+hoof+g...

[Beijinger]

You should definitely use mouthwash. For healthier teeth and problems like Alzheimer might also be correlated:

https://expatcircle.com/cms/how-to-clean-your-teeth-and-save...

[thenaturalist]

Erythritol and Xylitol do have a strong correlation with severe coronary diseases and risk of strokes under certain preconditions according to newer studies though.

Also not really advisable for people with Irritable Bowel Syndrome.

[canucker2016]

What are your sources?

Peter Attia has a blog entry about the weak xylitol-cardiovascular disease research. For Xylitol, see https://peterattiamd.com/xylitol-and-cvd/

  The problem with interpreting these results as a condemnation of xylitol consumption is that diet isn’t the only source of circulating xylitol. This compound is also produced by our own bodies through a process known as the glucuronate pathway, one of the pathways by which we metabolize glucose. So how did the authors ensure they were investigating the relationship between dietary xylitol intake and MACE risk?

  They didn’t. ...

Attia also brings up something the study authours noted:

  The rapid rate of xylitol excretion observed in healthy volunteers with return to near baseline (fasting) levels within hours following ingestion of a significant dietary exposure suggests that the plasma levels observed in our observational (validation) cohort represent variations in endogenous production/levels and not food intake.

[Beijinger]

This is true but how much will your body absorb via a mouthwash?

Erythritol is commonly found in sugar-free or keto-friendly products like beverages, desserts, and snacks. A single serving of an erythritol-sweetened product (e.g., a sugar-free soda, keto ice cream, or protein bar) often contains 10–30 g of erythritol.

Studies, such as the 2023 Nature Medicine study, used a 30 g dose in intervention experiments to simulate typical consumption (e.g., one sweetened beverage or dessert). This dose raised plasma erythritol to 5–7 mM within 30 minutes, a level linked to increased platelet reactivity and clotting risk.

[Melatonic]

Pretty sure you're not supposed to swallow the mouthwash !

[Beijinger]

Why the downvote? The evidence is strong. I rinse daily with sugar alcohols.

[lurking_swe]

there are mouthwashes that don’t nuke everything in your mouth. Just FYI in case you’re unaware. They are not popular but they exist. The added benefit is it doesn’t burn either lol.

Example: Tom’s of Maine Whole Care Natural Fluoride Mouthwash.

It’s extra beneficial if you live in a state / country that doesn’t add fluoride to drinking water.

[DuzAwe]

Alcohol or just fluoride?

I have an aversion to the alcohol washes after reading years ago that the change to your mouth biome may lead to the issues that they are meant to stop.

[ta988]

fluoride with no kind of antibacterial is fine (careful with thymol etc). Check your toothpaste for anti bacterial as well. you want to remove food and plaque, not good bacteria.

[justinator]

But fluoride IS antibacterial.