18 Aug You Swallow 6 Cups of Bacteria a Day: Oral-Gut Connection Linked to 57 Diseases with Dr. Elmira Shojai and Lora Hooper
Have you ever done everything right and still felt like your body was working against you? You eat clean, you move your body, you track your HRV, you take your supplements, you do the cold plunge and the sauna. And yet something still feels off. Joint pain that won’t resolve. Brain fog that won’t lift. Inflammation you can’t explain no matter how many labs you run.
I want you to ask yourself something most of us have never even considered: when was the last time anyone tested your mouth?
Not cleaned it. Not scraped it. Not polished, drilled, or filled it. Tested it. Because your mouth isn’t just where digestion starts. It’s the second largest microbiome in your entire body, and it may be one of the biggest missing pieces in your health journey.
🦷Special offer for you on your own oral testing kit: https://get.theurbanmonk.com/oral#why-it-matters
Why I Brought This Topic To You
If you’ve been listening to me for a while, you know my whole health journey has been about becoming my own health detective. I’ve talked openly about my heart health, about pulling old root canals, about explanting breast implants that I believe were quietly driving inflammation in my body for years. I share all of it because I want you to see that even when you think you’ve done the work, there’s usually one more layer to uncover.
That’s exactly why I brought on Dr. Elmira Shojai and Lora Hooper. Dr. Shojai has been practicing dentistry for nearly two decades, and she got tired of the endless cycle of fixing cavities without ever asking why they kept coming back. Lora is a hygienist of over 30 years who has spent more than half of her career working directly alongside physicians and functional medicine doctors, including as the first hygienist in the country to work inside a cardiology practice. Together they specialize in something almost nobody in traditional dentistry is trained to look at: your oral microbiome.
I did a consult with them on my own mouth, and honestly, what I learned shocked me. I felt amazing. No symptoms, no visible inflammation, nothing standing out. And yet my bacterial levels came back elevated on the exact strains most linked to systemic disease. If it can happen to me after years of cleaning up my health, it can happen to you too, no matter how good you think your habits are.
I’m not here to scare you. I’m here to help you understand your own body a little better, the same way I always try to do. Whether you’re dealing with a chronic illness you can’t explain or you feel completely healthy and just want to stay ahead of things, this episode is for you.
The Second Largest Microbiome You’ve Never Tested
Most of us are familiar with the gut microbiome at this point. We know about probiotics, we know about fiber, we know leaky gut is a real thing. But the oral microbiome rarely gets the same attention, even though it’s larger than every other microbiome in your body except your gut.
Here’s why that matters so much. Your mouth is the front door to your gut, your heart, and your brain. Everything you eat, drink, breathe, and swallow passes through it first. And you’re swallowing far more than food. On average, you swallow around six cups of your own saliva every single day, and that saliva carries whatever bacteria is living in your mouth straight down into your gut and into your bloodstream.
If the bacteria living there is balanced and healthy, that’s not a problem. But if it’s not, you are essentially re-infecting your own body over and over again, no matter how clean your diet is or how many supplements you take.
Peer-reviewed research has now linked oral pathogens to 57 different systemic diseases, including cardiovascular disease, Alzheimer’s, and a long list of autoimmune and chronic inflammatory conditions. That’s not a small connection. That’s a front door most of us have never bothered to check.
Why Killing Every Germ In Your Mouth Might Be Backfiring
I think most of us grew up believing that a clean mouth meant a sterile mouth. Mouthwash that burns, antibacterial rinses, anything labeled antimicrobial. If it kills germs, it must be good for us, right?
Not exactly. When you wipe out almost all the bacteria in your mouth with harsh antimicrobial products, you’re not creating a blank, healthy slate. You’re creating an opening. The healthy bacteria that would normally keep things in balance gets wiped out right alongside everything else, but a small percentage of highly resistant, aggressive bacteria survives. With the good bacteria gone and nothing left to compete with, those resistant strains multiply quickly and take over.
This is the same pattern we’re starting to understand in soil health and in the gut microbiome. Constant sterilization doesn’t create health. It creates an imbalance that lets the most aggressive organisms win. Products like this absolutely have a place for short-term use, if you cut your mouth or have an acute flare-up, for example. But research from as far back as 2008, and again in 2021, shows that chronic daily use of harsh antimicrobial products is associated with exactly the kind of bacterial imbalance that feeds disease.
Where Oral Bacterial Imbalance Actually Comes From
One of the most fascinating parts of this conversation was learning that oral dysbiosis, meaning an unhealthy imbalance of bacteria in the mouth, tends to come from three main sources.
The first is how your oral microbiome was seeded in the first place, starting before you were even born. A mother’s oral microbiome is nearly identical to the microbiome found in the placenta, meaning bacteria can cross over and begin shaping a baby’s microbiome in utero. Add in how you were delivered, whether you were breastfed, and every close contact and kiss throughout your life, and you start to see how much of this was set in motion long before you ever picked up a toothbrush.
The second is the overuse of harsh antimicrobial products we just talked about, which wipes out protective bacteria and allows resistant, aggressive strains to dominate.
The third is something most people have never connected to their mouth at all: how you breathe. If you’re a mouth breather rather than a nose breather, especially at night, you lose out on nitric oxide production, which your body makes in two ways. One is through nasal breathing. The other is through healthy oral bacteria. A dry mouth from chronic mouth breathing creates the perfect environment for aggressive, harmful bacteria to thrive, while the beneficial, nitric oxide producing bacteria simply cannot survive in that dry environment.
The Root Canal Question I Get Asked Constantly
This is one of the most controversial topics in the functional health space, and I wanted real answers. I’ve shared before that I had two root canals done about 30 years ago. When my MPO marker showed up elevated on recent bloodwork, that was enough to send me to get a cone beam scan, where I discovered the beginning of an infection at the site of one of them. I had it properly extracted with a biological dentist, and my MPO has come down significantly since.
Here’s what I learned. The root canal itself isn’t necessarily the villain. The real issue is whether it was done properly in the first place, ideally by a trained endodontist using modern tools like lasers and microscopes to fully disinfect the tiny nerve canals branching off the main root, canals that are easy to miss with older or less thorough techniques. When those small canals aren’t fully cleaned, bacteria, including a common but far from harmless species found in failed root canals, can remain trapped in the bone. Sometimes practitioners will interpret stable, symptom-free x-rays as evidence that everything healed fine, when in reality the infection may simply be sitting quietly, waiting.
This is exactly why testing matters more than guessing. In my own case, testing actually reassured me that my second, older root canal doesn’t currently show signs of the same issue, which means I don’t need to rush into removing it. The goal isn’t fear-based extraction of every root canal you’ve ever had. The goal is understanding what’s actually happening in your body instead of assuming.
The Gut and Oral Connection Nobody Talks About
I’ve done entire episodes and webinars on gut health, and I still didn’t fully understand this piece until this conversation. So many of us have gone gluten free, cleaned up our diets, loaded up on probiotics, and still haven’t seen the results we expected. One major reason may be leaky gut caused by something called LPS, a byproduct of harmful bacteria, and a significant source of LPS is the oral microbiome itself.
In other words, you can do everything right for your gut and still be reinfecting it every time you swallow, if the bacteria living in your mouth is out of balance. The mouth and the gut aren’t two separate systems to treat independently. They’re one continuous lining running from your mouth all the way through your digestive tract, and they influence each other constantly. Some bacteria even start in the gut and travel up into the mouth, which is why looking at both together, rather than treating one and ignoring the other, gives such a clearer picture of what’s really going on.
What Testing And Treatment Actually Look Like
If this is resonating with you, you’re probably wondering what you’re actually supposed to do about it. The process starts with salivary testing, which uses PCR technology to identify not just which bacteria are present in your mouth, but how much of each one. This turns treatment from a guessing game into something highly personalized.
If elevated levels of aggressive bacteria show up, treatment isn’t as simple as taking an antibiotic and calling it done. Antibiotics alone won’t solve the problem, because these bacteria live inside a protective biofilm that can fully reform within just four hours. Real treatment involves preparing the gut first, then properly disrupting that biofilm through deep cleaning combined with laser therapy and precisely timed antibiotic use, and finally rebuilding a healthy, balanced oral microbiome so the harmful bacteria doesn’t simply repopulate.
This isn’t about becoming afraid of your own mouth. It’s about finally having real data instead of guesswork, and a genuine path toward sustainable healing rather than another cycle of fixing the same problem over and over again.
🦷Special offer for you on your own oral testing kit: https://get.theurbanmonk.com/oral#why-it-matters
Where I’m At In My Own Journey
I want to be transparent with you because that’s how I try to show up in every part of my health journey. Even after explanting, removing an infected root canal, and feeling genuinely great, my testing showed elevated levels of some of the more aggressive bacterial strains linked to systemic inflammation. My husband Brooks and I are now going through this entire testing and treatment process together, because if only one partner addresses it, you simply keep re-exposing each other.
I’m not sharing this to alarm you. I’m sharing it because I think this is one of the most overlooked pieces of the midlife health puzzle, especially when it comes to hormones, cardiovascular health, and chronic inflammation that so many of us are quietly dealing with. I’ll be updating you as I go through this process myself, and I genuinely can’t wait to share what changes.
If you’ve been doing all the right things and still feel like something is missing, this might be it. Your mouth has been trying to tell you something. It might finally be time to listen.
🦷Special offer for you on your own oral testing kit: https://get.theurbanmonk.com/oral#why-it-matters
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.
