#9 Saliva, Mastication, and Oral Sex

By now, we have all seen the “Hawk Tuah” girl. So why don’t we talk about saliva and what it does for you? Just so we’re all on the same page: saliva does a lot more than you think. In this episode, Dr. Mike and Dr. Rusty talk about all things saliva: the good, the bad, and the ugly. They finally answer the question that’s on everyone’s mind (apparently, because we’ve received SO many messages in our inbox about this): “Can my dentist tell when I’ve performed oral sex?”. Okay, maybe the questions are worded differently than that, but you get my point. Tune in to today’s episode to figure out if we can tell.

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Transcript:

Welcome to DM Adentist, your friendly neighborhood podcast where Dr. Rusty and Dr. Mike are here to make dental care approachable for everyone because everyone deserves a healthy smile without the fear. Welcome back to another episode of DM Adentist, I’m Dr. Mike and I’m Dr. Rusty. Today’s episode is going to get into a little bit of a spicy topic if you couldn’t tell from the title of our episode. Our topic today will be for a bit of an older audience so make sure the little ones ears are closed. It’s not per se inappropriate but you know 18 and up would be great. Yeah, we’ll be talking about a few different topics, some things ranging from saliva and then we’ll get into things like swap and spit and even oral sex at the end so be sure to stick around for the big finish. We wanted to break down a couple basics of what saliva is made up and then follow that up with the question we get pretty frequently which is can my dentist tell that I’ve given oral sex? If you guys ask me that one more time, I swear. We definitely got that question a lot, I know there’s been some videos that have gone around tick-tock and Instagram and stuff that say your dentist can or cannot so we’ll definitely dive into that but we don’t want to be too premature here so let’s start from the beginning, Mike. Yeah and it’s important to start from the beginning so like in Genesis 1-1 in the beginning God created the heavens in the earth. Okay, okay. The very first sin was a woman who ate. Oh my god, come on back to the podcast please. Okay, so let’s start with the basics, right? We know everyone has saliva, right? And it’s so it must be important because evolutionarily we’ve not gotten rid of it. So what makes up saliva? Well evolutionarily or when you’re just talking about Genesis in the beginning so. Do not catch me in a lie. Either way, saliva has stuck around and it’s very important. What do you think makes it so important, Mike? It has a couple of key ingredients, Rusty and I think those key ingredients are what makes it important. So let’s talk about what makes up saliva. So saliva is made up of mostly water and proteins and salt and electrolytes. Look at you guys. That’s probably the most of of what it’s made up of. So I would say it’s how much of how much of that do I make per day? You make anywhere between a half a liter to one and a half liter per day on average for most people, that’s the amount of saliva that you’re going to be making. So you know, like imagine a two liter or a thing of soda or whatever, not quite one of those all the way somewhere between one quarter to three quarters of that full of saliva a day. Again, most of that like 99% of that is going to be water. But there’s a bunch of other stuff mixed in it with the water that’s super important as well. So mostly water, but there’s some proteins floating around. Yeah, I mean, there’s definitely a lot of protein in saliva too. I think there’s over a thousand different individual types of protein that are in saliva and they all have different important functions and purposes. I mean, they’re all there for a reason and they all contribute and do things. So what are some of the proteins that you can find in saliva? Yeah, so that’s important. The majority of, thanks for asking, Resty. The majority of proteins in saliva are a type of protein called an enzyme. Okay, so going back to bio 101 here. Correct. Enzymes are proteins and they’re a type of protein that breaks stuff down. So we have a lot of that in our saliva and that’s important because why? What type of stuff? You said these proteins in saliva are called enzymes. Yeah. Inzymes break stuff down. So what type of stuff are they going to be breaking down in saliva? So we have things. So when you start to chew, you have things that break down carbohydrates. You have things that break down fats. So you have amylase in your saliva which breaks down carbs and then you have lipase which breaks down fats. So that’s kind of the start of your digestion in your mouth because of saliva. Okay, wow. So digestion doesn’t just happen in the stomach. No, it happens in the mouth. It starts. It definitely starts in the mouth and I like you were saying chewing it up is the first step right? Yeah, so like digestion starts in the mouth with mastication. Oh, mastication. Yes, that’s right. I’m chewing. Mastication. Oh, mastication. Mastication. Chewing. I know we’re getting into something later on in the episode but mastication is chewing that breaks down your food into smaller pieces. Then the enzymes in your saliva, the lipase, the amylase, break down those fats and carbohydrates a little bit more. So then your body is ready to digest it in the stomach intestines blah, blah, blah. So it kind of breaks it up into smaller particles and makes it much more digestible and even actually starts the digestion process before you even swallow your food and it goes to the stomach. Correct. That’s pretty cool. So our listeners would love to know more about this riveting topic, Rusty. I know. What else to saliva do? Well, you’re probably wondering what the other functions of saliva are apart from just listening. I know it’s such exciting. But we do have a lot of purposes of our saliva apart from just breaking down food and starting that digestion process. We talked a little bit in the past about how it can help prevent cavities and help fight that off. And so the main way that it does that is through buffering. So buffering is basically like making acidic things less acidic and making it a more neutral area. You guys remember when Rusty talked about he’d rather you drink a liter of soda in one sitting versus a liter of soda over the course of the entire day. This is why. That’s because of that acid. Again, if your mouth is always acidic, then your saliva isn’t going to have time to buffer that acid. And again, the acid is what’s going to cause cavities for people. So yeah. So, saliva has different chemicals in it. They’re called bicarbonates that neutralize that acid. So that’s just a fancy way of saying it’s going to make the mouth less acidic and less likely for you to cause cavities. And then the saliva can put your mouth in more of a protective state where your teeth can actually remineralize or heal a little bit. Wow. So, your saliva breaks down food, right? So your body can digest it easier. But also it seems to buffer or help with the pH of your mouth to prevent cavities and remineralize the teeth. Correct. Is that what you’re saying? Correct. Wow. That’s exactly right. That’s remarkable. I know. Make your cheeks and lips and tongues moist so that you can speak and move around and make disgusting noises like that. But it also has other important benefits, particularly with the immune system. So there’s a bunch of different types of immune cells that can be found in the saliva. That’s correct. So what type of stuff in that regard can you find in that? So in your saliva you’re going to find white blood cells and other antimicrobial agents. And that’s important because I know we talked about saliva being 99% water, right? But it’s also the first, it’s one of the openings to your body, right? So you have this oral cavity. It’s where things enter. You need some sort of like stop agent. You need something to protect you there. So you have immune cells in the saliva that protect your body from these various attacks and they attack being like viruses, bacteria, things like that. So your saliva contains these important cells to help protect your body, which is great. So it gives you a chance to fight off infection before it even interests the body. It’s kind of like that. One of the first lines of defense or like a barrier that your body has, as I applied off these, you know, small bacteria viruses, these little diseases that can lead to causing a lot of stuff. And you know, obviously it’s a barrier that you have or that everyone has. And so that’s a good first line of defense to help fight off those bacteria, those viruses, things that can lead to specific, you know, things. And you know, one interesting thing that a lot of people don’t know is that if you let people into your barrier, into your mouth through things like swap and sweat, kissing or even oral sex, right? So there’s things that we do with our mouths with other people that you can swap not only the spit or the saliva, but your swap and everything that’s in there. So these proteins, wait, wait, wait, wait, wait, wait, wait, you’re saying kissing, swapping spit, tons of hockey, whatever you kids are calling it these days, spreads things around other than spit. It does. It does. So any bacteria or viruses that are in your mouth, you’re having the potential to spread that to whoever you’re kissing too. So you’re saying I can spread the bacteria that causes cavities? Definitely. So if you have that bacteria, you can be spreading that. No. Not only just the ones that cause cavities, but bacteria that contribute to cavities, gum disease, even potentially like oral STDs. You can be spreading all of that through things like kissing, swapping, oral sex, all of that. So if you see an eye kiss, I can give him parodontoses if I have it. I mean, theoretically, you’re not going to be exchanging the disease directly though. And I think that’s an important point to me. So you won’t say I have a cavity and I kiss somebody. I’m not going to be spreading that cavity directly to them because cavities aren’t directly a contagious disease. Okay. So you’re spreading the bacteria that has the possibility of causing a cavity? Correct. Exactly. Exactly. Exactly. You can be spreading it through to gum disease or STDs, cavities, a whole bunch of stuff. And good bacteria too, right? There’s good bacteria that live in your mouth. Yeah. You’re going to be switching that around to anytime you’re kissing people or, and it’s not just kissing. There’s other things you do, you know, things like sharing straws, taking a drink after somebody, sharing a cigarette or a joint or something. A cigarette? You’ve made it so edified. A cigarette. I did just find out that I am Italian by birth, so that’s exciting. Anywho? To change back? So maybe you should say cigarette. A cigarette? Yeah, there you go. So basically, Rusty, what you’re saying is a single kiss, which we found from research, can actually transmit tens of millions of bacteria, colony forming units. So it’s essentially individual bacteria that have the possibility to cause a certain disease. Correct. Why can pass that on to whoever I’m kissing? Correct. Or smoking after or sucking straws after or whatever. Anything. Yeah, wow. It’s not just the kissing. And that’s also how, you know, children from a young age get these bacteria introduced to them is oftentimes, unfortunately, it’s from mom or dad, Antarong, Goliath, you know, everyone kisses babies. Everyone’s kissing the baby. I love meeting the baby and they want to kiss all over it. And that’s how they’re introducing these cavity forming things. And so a lot of times, we ask people ask me, hey, is our cavity’s genetic or is it hereditary? And there’s not a genetic direct link to cavities. But the bacteria are certainly passed on from individuals within families. And if mom and dad have a bunch of cavity causing bacteria and they’re kissing all over baby, then baby is going to have a high bacterial load of that too and may have an uphill battle to prevent cavity formation. Fair. Yeah. Yeah, side note, in the future, if you feel like you’re getting more cavities than you showed you take care of your mouth and resting up talked about this before, ask your dentist to do a bacteria swab or something. So that’s important. But you have to realize you need to be doing all the other things first, brushing, flossing. And I mean, you know, internalize that, figure that out if you’re actually not doing it, do that first. But that’s a caveat. So it can sound kind of gross to think about it from, you know, microscopic level when you think about all the things that are insoliva, you’re swapping that around. Ten millions of bacteria. Yeah. And again, majority of those are probably going to be good, healthy, normal things that you’re going to have in your mouth anyway already. But you know, the people that you interact and associate with the most are going to have the most similar kind of microbial composition of their mouth, their body, their hands, their skin, their skin. Still yucky. Yucky. Mike is so gross. I don’t love like wet things. Wet things are gross to me. Wet things like saliva. I don’t particularly love saliva. I wouldn’t say I love saliva. You got into the wrong. Rusty’s like, oh, you’re a dentist because you love saliva. No, I don’t love saliva. I don’t, I wouldn’t say I love it either. I’m happy with its existence, but I’m not dying to have more of it. Yeah. You know, it’s like when you pull something out of a patient’s mouth and it has a drool of saliva behind it. That doesn’t make me super happy. No, I wouldn’t say that I’m jumping for joy. But that’s good for the patient because they have all these protective things, right? Digest. Yeah, no. I’m happy that we have it. I just don’t particularly love it. That’s life. So saliva is really important. It does a lot of positive things for patients and everyone’s mouth and it has a lot of benefits. People that have no or little saliva have a lot more problem problems. Yeah. It’s important. So for what you’ve all been waiting for, the topic of discussion that’s for older ears. Yeah. We’ll get into other things you can do with your mouth since we’re talking about saliva and kind of segue into oral sex. Again, one of the questions we get repeatedly. We’ve had several DMs and even some of our friends have asked us directly this question. Can your dentist tell if you’ve given oral sex? So Dr. Mike, what do you think in your tail? Well, this time we’d like to thank Timothy for asking that question. And yeah, the answer to can my dentist tell if I’ve given oral sex is sometimes. And Rusty, let’s dive into why? So sometimes, yeah, I mean, why only sometimes? How can you tell what is it exactly that you’re looking for? Yeah. Walk us through that process. So it’s important to know, like Rusty said last a couple episodes ago is everybody is different literally, right? So some people can give oral sex and we’ll have no idea, right? But the reason we can see this is we’re not necessarily looking for it. But when we do an oral cancer screening and we’re looking at all the parts of your mouth, we can see bruising in the back of your throat. And that is a sign that you’ve done something. Potentially oral sex related. But there’s other things it could be, right? Right, right. And I mean, we’re not just going in specifically looking for for this individual thing either. It’s part of both of our comprehensive exams for every patient. We’re looking around it. All the stuff in your mouth, both hard and soft. All the stuff in there. We’re looking for anything, any abnormal pathology, right? Yeah, anything abnormal. Any sort of like what I tell my patient, lumps, bumps or things that are growing in there that shouldn’t be. So when we’re doing that sort of exam, we’re looking everywhere. And I don’t necessarily bring up like what we call this palatal particular, right? Which is just bruising of the palate, small bumps up there. Because it’s not like a lesion that typically goes into something that’s cancerous, right? It’s more of a trauma to the palate, which can tell us that you’ve done something. Whether that’s what, it can be oral sex, it can also be. I mean, it can be like really vigorous coughing. So if you have like respiratory infection or strep throat, if you have anything, you know, dramatically hitting the roof of your mouth, like sucking on a lollipop a little too hard, could be a lollipop. Could be anything, right? So we don’t make assumptions and we don’t judge. Again, we just see what we see as we’re looking around. And if we see anything that’s concerning or abnormal, we’re going to talk to our patient about it. And it’s concerning. If it’s something that’s very minor, a lot of times this is something we don’t even necessarily bring up because it’s part of normal living. And if it’s not something that’s concerning, it’s not something that necessarily is going to always be brought up. But if a patient’s asking me about it, definitely happy to have that discussion. And again, so you had kind of mentioned the name of them, again, they’re called palatal peticia. And what would this look like? Like say someone was just interested. Like they look at them. They could see it on themselves. Where would they look for? What are they looking for? So if you go to the mirror and you open your mouth and you tilt your head back and you look back there, you can see towards the little dangly thing in the back of your throat, the uvula. The uvula as Nicki Minaj would say differently. Near that area, you’ll see what’s called palatal peticia, which is if you were to bruise your arm, it’s essentially the similar thing, right? It’s just like bruising of the palate. They’re kind of like little small pinpoint bruises that can be around the uvula, the soft palate, or even sometimes for the forward on like the hard palate. Yeah. And we don’t care. I mean, I literally have never brought this up to someone unless they ask. I’ve had people that ask and they’re like, hey, I had a good night last night and I want to know if you can tell and they like, well, like, we’ll discuss it in detail. And then we’ll discuss it in detail. But other than that, I don’t bring it up because it’s not a concern. What do you do? I put it up a couple of times with patients the only time once was in dental school and I was unsure what it was exactly. So it was anything abnormal had to bring it up to the instructor and we kind of had the discussion and found out that’s what it was from. I could have awkward as a dental student. Yeah, don’t worry. And then another time was one of my hygienists had brought it up and she was unsure of what she was looking at as well and then brought it up with the patient. And so then I come into the room and the patient had been pretty concerned about it because the hygienist was talking about it and just wasn’t sure what it was. And so, hey, the way she had phrased it was, hey, there’s something here on the roof of the mouth, I’m not sure what it is. We’ll have Dr. Take a look and she had taken some intral photographs of it and so the patient was a little bit concerned about, hey, what is this weird bump or lump or thing growing in my mouth? What is this? I would think my hygienist is setting me up. I mean, then again, maybe she wasn’t sure. I know she knows. This was a pretty severe case of palatal pituitia, I will say. It was pretty large bruising in this case and so it was a little abnormal but again, further discussion with the patient, they had had owned up to, hey, I was doing that last night and yep, that happened and good, that’s all that was from and all was well. Usually people are not uncomfortable about it. Right. As long as it’s something that’s not scary and there’s a reason for it, there’s an explanation for it, that’s what’s important. So to answer the question, yeah, your dentist can sometimes tell if you’ve given oral sex. Are there other things besides, okay, so patients, oral sex, whatever, who cares? But are there other things that we can see like STDs? Yeah, yeah, there are some STDs that can manifest in the mouth for sure and that’s one of the bigger, I guess, risks of performing oral sex, especially if it’s with new partners, unfamiliar partners, things like that because STDs can spread through oral sex and I think Mike, you’ve seen a couple of specific cases, right? The one that stands out in my mind is I had a patient come in and they had this thing on their cheek which honestly, if I was doing a head of neck exam, I like wouldn’t, I think it was like, they were just biting their cheek but it was something that wasn’t going away for them and they’d been seeing many providers over and over and over and we looked at it and then just, it looked like something familiar, it comes to find out it was syphilis. Oh, really? In the mouth. Wow. And this was growing on the person’s cheek? On the person’s cheek. Okay. Yeah, so it didn’t really hurt them, they just noticed it and what was sad about the story is that it ended up being like the patient didn’t realize that their partner was cheating on them and that’s how they found out it was a whole thing. Oh my goodness. But, yeah, I mean, I’ve seen a couple of STDs in the mouth and I did not realize I’d have to deliver that news to the patient so that was exciting for me. And typically, how are you going to, like, with that syphilis case, how did you find out it was syphilis? Did you know looking at it directly? We do more testing. Okay. So we send the patient to their primary care or to like quest agnostics, get some blood work drawn and like figure out what that is. We could also biopsy it but there’s, I don’t biopsy all the time. It just kind of depends. Dang. So syphilis. Wow. Wow. Yeah, so syphilis happens in the mouth. STDs can you see in the mouth? Climidia, gonorrhea, herpes. Herpes I’d say is probably the most common. Yeah. Yeah, you want to talk about herpes? Yeah, since that’s probably the most… That means you probably don’t want that. Happily, happily. I will say it is probably the most common STD that you’re going to have or that we’re going to see in the most common manifestation of herpes is just going to be a cold sore on people’s lips. It is so common. I mean, people worry about it. Right. I mean, I don’t think it should be a big… You have it. Don’t worry about it. Right. But, I mean, can people see their dentist for herpes? Absolutely. Herpes is something you definitely can see your dentist for and people may not know but your dentist can actually prescribe medication. You know, Valtrac, a cyclovier is a type of medication you can get from your dentist to prevent herpes. Yeah, we also use our laser. Oh, yeah. There’s laser treatment. If they come in and they’re like, “Hey, I feel this, we call the pro-dromal phase.” Yeah. When it starts to tingle near the lip before that sore comes out, we can use the laser and then you won’t get as much of an impact on your lip, which is great. And that’s great. Yeah. And that’s great. That’s when you notice it is, like Mike said, the pro-dromal phase. That’s kind of that, if you ever had a cold sore, it’s that like tingling or burning or itching sensation that you get right before the actual blister forms on the lip. And if you take the medication or can get to see someone to laser it off before, it’s going to make it way less severe of an impact and way happier, way healthier to heal a lot. And I felt that at night and the next day, I would be calling a dentist to see if I could get in because in that pro-dromal phase is when you can treat it and like prevent the visual aspect of it. Treat is probably the wrong word, but treat the symptom, not necessarily the herpes itself. Right. And because there’s also the over-the-counter creams and stuff that are great, but those are going to be more symptomatic treatment and introduce the length of treatment, not so much preventing the actual sore from forming. But like you said, the herpes virus, it’s crazy, it lives in your nerves of your intradreminal nerve is where it lives. And it’s with you forever, certain things like stress, sunlight, heavy alcohol use, things like that can cause it to break out. A lot of patients get it after dental care too. So if you have trauma or manipulation of the soft tissue, that can cause an outbreak of herpes. And also like if you have one cold sore here, a lot of dentists, a lot of times will defer the patient if it’s right in that kind of really outbroken phase because you can cause it if you have the lips but open right by the cold sore and then getting around other areas when you’re doing normal dental work, that can cause that to spread. Yeah, so you don’t want that spread. So it is important that as dentists, we look at more than just teeth, right? Yeah. So we look at things that are just like soft tissue, which is just the lips, cheeks, things like that. Right. Speaking of teeth, I’ve had this question a couple of times where like we’ll do an extraction on a patient and they’re like, so when can I get back to normally scheduled activities? And then they’re deciding in terms of activities as adult activity. Do you have any sort of like post-op instructions for patients that are like, hey, I had a tooth extracted? I’d like to get back to the normally scheduled programming. Yeah, right, right. I think I’m catching your attention. Okay. I’m thinking about every week. Let’s see. One piece of advice I always tell my patients after a surgery, after an extraction is, is I don’t want you doing anything that gets your heart rate up for a day or two. No. No, no. Literally nothing. Pumping, you know? At the gym or at home? Okay. No pumping. You heard him. For at least 24 hours. At least a day or two. At least a day or two. Nothing that gets our heart rate really thumping. Again, you want that blood to clot. Yes. And if that can be bad. But for real. Other instructions that revolve around this sort of topic as far as tooth extractions and surgery, right? We always are concerned about dry socket after after we pull teeth. So dry socket is when you lose the blood clot from the site and you get some exposed bone. And what are the really painful? Five S’s to a boy. The five S’s. Yeah, that’s something. I always tell my patients it’s easy to remember. After a surgery, especially a tooth extraction, none of the five S’s. So no smoking, no straws, no swishing, no spitting and no sucking. None of the five S’s. And what does that include, Rusty? Everything. Everything. Everything. No, no sucking on straws or lollipop or candy or cough drops or lozenges or anything else you may want to suck up. So to break that down further. Eyes tell patients, no oral sex for seven days. After a tooth extraction. Seven days. Yep, yep. Rusty, can I have oral sex after four days? Nope. You said seven, Doc. Seven. You said seven. Please. Also, you know, there are stitches in there. Stuff is healing. I mean, I get it. If you’ve got a high libido and you want to do it, but just wait. Please. Just wait. Let your stuff heal. Let the stitches heal. We bring this up because this question comes up far too often. Yep. And also, no vigorous, you know, tonsil hockey, like might call it earlier for three days, you know? Yeah. At least, please. Some packing, some kissing. She’ll love your partner, do what you need to do. But, you know, let your mouth heal. It’s a very delicate area where there was some very small stitches a lot of times, some grafting, all sorts of stuff can be going on in there. I don’t think people realize when we say, like, suction in the mouth is what causes the disruption of the blood clot. So if you have a tooth extracted, even if it was just a cut on your arm, any sort of movement on that’s going to disrupt the blood flow, things like that. You’re healing a scab. Your mouth’s trying to get a scab. Any suction is going to be problematic. Right. So we say no straws. So then, you know, kissing causes suction. Yeah. So just don’t do that. Anything that causes your cheeks to kind of literally suction in, you want to avoid that. So straws and smoking are going to be the biggest things, but swishing, spitting, sucking of any kind can cause all sorts of dry soccer problems, problems with healing, everything. Yep. So just avoid it. Take it easy. Cut on your arm or an injury on your arm. You’re going to wrap it up, bandage it, put it in a cast. You can’t really do that on your mouth because you’ve got to speak and function in chew and live your life, but certain things you can avoid just take it easy and not the area heal. Cause, you know, dry sockets know fun. No, I’ve had it. It’s awful. It’s just better to let it wait. Let it heal. Wait the seven days. Yeah. Even two weeks, you know, as far as like none of the five S’s, I tell my patients minimum two weeks for that and hope that they’ll do 10 days, but correct. You know, minimum two weeks is really what I tell people. And I have one patient recently. He’s like, Hey, I’m going to use this as an excuse to quit smoking. I’ve been trying to. Yeah. So fingers crossed for him that he can actually hold true. And if you guys need help, we can also do tobacco cessation. We can go in that into another podcast. Yeah, but we talked about that a lot last last week actually tobacco nicotine. Oh, we did. Yeah. If you need help with that, we can help. Yeah. On that note, you know, protection is the best form of prevention. I do want to say that real quick. That’s true. It’s important to use protection. So we’ll go from there. But yeah, we hope this podcast was helpful. Yeah. On that note, stay safe out there and keep those questions coming. Bye. Bye. Thank you for listening to today’s episode of DM Adentist brought to you by dose of dental. And thank you for your interest in improving your oral health. If you’d like your questions answered by Dr. Rusty and Dr. Mike, visit us at doseofdental.com or DM us on Instagram @YourDailyDoseOpDental. [MUSIC]