Dr. John Sorrentino started his practice in 1991 with a commitment to patient care through education. He believes that with proper care everyone can maintain their teeth for a lifetime. Dr. Sorrentino grew up in the Hudson Valley. He received his Bachelor's degree from the State University of New York at Binghamton and his Doctor of Dental Medicine degree from the University of Connecticut School of Dental Medicine. In 2003 he was awarded a Fellowship in the Academy of General Dentistry. The fellowship is symbolic of Dr. Sorrentino's commitment to life long learning and bringing the highest quality dental care to his patients.
He is a member and past president of the Dutchess County Dental Society. He is also a member of the New York State Society of Forensic Dentistry and was actively involved in the identification of victims of the World Trade Center disaster and Flight 587
Lately he has been researching the history of decay and formulating strategies to eliminate it.
AUDIO-DUwHF #1106 John Sorrentino, DMD, FAGD
VIDEO-DUwHF #1106 John Sorrentino, DMD, FAGD
Howard: It's just a huge honor for me today to be podcast interviewing Dr. John Sorrentino who started his practice in 1991 with a commitment to patient care through education he believes that with proper care everyone can maintain their teeth for a lifetime. He grew up in the Hudson Valley, he received his bachelor's degree from the State University of New York at Binghamton and his doctor dental medicine DMD degree from the University of Connecticut School of Dental Medicine. In 2003 he was awarded a fellowship from the Academy General Dentistry the fellowship is symbolic of Dr. Sorrentino's commitment to lifelong learning and bringing the highest quality dental care to his patients. He is a member and past president of the Dutchess County dental Society, he is also a member of the New York State Society of forensic dentistry and was actively involved in the identification of victims of the World Trade Center disaster and flight 587. Lately he has been researching the history decay and formulating strategies to eliminate it. Dr. Sorrentino thank you so much for coming on the show today.
John: It's my pleasure Howard like I said a big fan.
Howard: Oh thank you so much, so I invited you you didn't invite yourself I wouldn't get you on. It seems like you know what we should do first there's 9 specialties in dentistry and everybody always talks about oral surgeons and perio and ortho but they don't really talk about public health and it seems like the mission of dentistry should be primarily to prevent disease instead of drill fill and Bill. Instead of sitting on an assembly line just do an MOD composite spur from age 25 to 65. How could we prevent more cavities than we do today?
John: Very simple we need to look at the past to go to the future, for example let me start by asking you a question, how many wild animals living on their natural diet get tooth decay?
Howard: Winnie the pooh eating honey.
John: That's about it the answer is none. So there's a biological mismatch that if humans are getting tooth decay I acert we're not eating a species-appropriate diet and I've done a deep dive because I have a background most dentists don't and that's an area in anthropology and human origins and you know I have a good friend who has a PhD in anthropology and teaches and you know he when he was working on his PhD at Stony Brook he took me into the bone room now this is a 1990 Im only a few years younger than you. I was a newly minted dentist and he showed me all these Paleolithic skulls and it amazed me but and it left an impression that none of them had decay and I'd ask how old is this one they say fifteen thousand years I think we had stuff that was 45,000 years old and keep in mind that a toothbrush wasn't even invented until three thousand years ago. So the bottom line is people are eating things that they shouldn't and you look at the fossil record you first starting to see decay in the Middle East notably Mesopotamia 12,000 years ago or 10,000 BC and it comes with the age of Agriculture and I made the observation that dentistry is just not doing it right and it took me two or three years to figure out number one how to do it right and the part that dentistry got so wrong and it seems to me that we spend a lot of teeth that in dentistry what we've done is we've conflated normality okay with that we think decay is normal. Okay it's not normal it's a disease and the way to do it to get rid of it is to return to well my term species-appropriate diet.
Howard: and what and when you were looking at these Paleolithic skulls they also like malocclusions correct?
John: Correct in fact less than five percent of Paleolithic skulls demonstrate malocclusions and the ones that do you've got like a couple incisors overlapping that's it.
Howard: So do you think the diet also changed the malocclusion?
John: I think the diet affected the growth and development and that again I meant to say before we're conflating commonality with normality, none of this is normal.
Howard: Well put commonality with, so it just becomes the new norm everybody just eats packaged food and drinks soda and we just think that it's just normal for every two-year-old to come in with cavities.
John: Yes and I'll tell you exactly why it happened is that dental schools in medical schools for that matter do not teach evolutionary biology nor do they require it as a prerequisite for admission. All we'd have to do to fix this is every dental school Dean sit down with some anthropologists from their local college and have them explain it to them and then teach it.
Howard: I was very lucky our Anatomy teacher at University of missouri-kansas a was Bernard Butterworth and he was I remember the first time I asked him a question he said well I can't answer any better than this book and he gave enemy his own copy of the book the naked ape by Des Amorous and that was my first turn onto anthropology and it was just amazing. So what do you think is the appropriate species human diet for Homo Sapien?
John: That is a great question and it's a somewhat long-winded answer first of all ok let's get a few terms straight humans have been walking the earth for 2.5 million years. Homo sapiens have been walking the earth for between 200 and 300 thousand years we were defined as human by our genus not our species. So when I say humans I'm generally referring to the two and a half million year number. It depends we're on the planet we are and when I say we're on the planet the latitude we evolved in the equatorial zone in East Africa and then are you familiar with the or you listeners familiar with the Out of Africa Theory?
Howard: Review it for them and also the latest finding they found a nine point six million year old tooth in a German cave that kind of was very surprising.
John: Yeah so there's a couple of oddities out there and that's certainly one of them, basically the Out of Africa theory it's the current model of human planetary domination we left Africa crossing from the east Horn of Africa into Yemen okay during two ice ages ago when our water levels were much lower and then we followed the water waves around the earth okay first into Mesopotamia then India. So a species appropriate diet for humans has to take in a look on a seafood when I say seafood I don't just mean fish I mean sea vegetables what we need commonly call seaweed you have the the enzymatic engine to digest this sort of thing also some of the first hunting and gathering we did is it didn't take these tribes long to figure out that the tide reversed every six hours. So if you had a net you'd go in at high tide and put your net over the mouth of a small creek or stream and then when the tide lowered you'd have a virtual shmorgaus board. Now nothing suggests seafood is important for Humans for than our daily obligate need iodine yet we have no means of storing so the main posit or e of iodine a planet is ocean. So you need that for neural development you need it for yeah by roid proper thyroid function so...
Howard: and that's why a lot of advanced countries that mandate that salt be iodized because it's that important.
John: Absolutely absolutely that seems to be a public health thing that worked out very well that you know we're getting iodine because humans live everywhere but I mean you can't find a major city on the planet that isn't on a major waterway like for example the fat content in oysters and mussels and clams are the same ones of the same omega-3 fatty acids they make up your brain in the same ratio other than that I would say green leafy vegetables and fruit in season. Humans did not begin eating grains until 12,000 years ago and again the seafood based diet and you know fruit is the only part of the plant that's actually designed by the plant to be eaten by us and you got a look at the people that we evolved from what they ate and these people didn't have cavities okay didn't have diabetes they didn't have heart disease and they certainly were not obese. I mean I started doing this the first thing I did is I took 40 pounds off myself and I dropped my BMI from 26 to 21 and my physician when I told him how he did it I did it he didn't believe me and I said why didn't you tell me when I had a BMI of 26 that I was overweight and the answer is because we go into your physician he's working with people with BMI of 30 and 32 and he said hey this guy's doing pretty good. Like I said grains are not part of the diet and it doesn't matter if it's a whole grains or refined grains that and I would invite anybody to invest 16 dollars in a glucometer and then eat a slice of white bread and watch over the next hour of what your awfully close to us and then do it the next day with a slice of wheat bread and you're gonna see the same exact response.
Howard: and what is that device called a glucometer?
John: Glucometer, yes you can get it in any drugstore diabetes use it for measuring your blood sugar your finger sticks.
Howard: Okay so it's a little pinprick on your finger and then what do you recommend, you do that an hour after you eat?
John: You do it seven or eight times every 15 minutes after you eat a slice of white bread. You know get up you know in a fasted state you get up in the morning and you eat a slice of white bread or you do a finger stick you get your fasting glucose and then eat the white bread and then you do it every 15 minutes for two hours and you'll see a nice glucose rise and then the next day do it with wheat bread you'll see the same thing okay these are not species appropriate foods for humans you know until we dentists start living that message you know we're going to have you know more more of the same.
Howard: So is it still your glucose should be between 80 and 120 what it would have been a micrograms per deciliter what's the unit on that?
John: I think milligrams per deciliter and I believe so and that is something that your body actually wants to keep that if you are in a starvation State your body, you can go roughly if you're healthy as long as you stay hydrated you know six to eight weeks before you starve to death if you look at somebody in that states if you look at their blood glucose it is going to stay in that range that it's highly conserved in the body your body will do other bad things like you won't be able to form mucus you know you'll get a dry hack you know and others systems will shut down but up until the very end your body maintains a blood glucose of 85 to 105 and every time that we eat things that aren't species-appropriate we raise insulin okay which is a pro-inflammatory hormone okay it drives glycation and the formation of advanced glycation end-products and you know okay that is what drives inflammation and this is a very hard concept for people to understand that we are not calorically controlled we are not controlled by the amount of calories we eat, we are hormonal and controlled that when insulin is out of whack and the reason it goes out of whack is it it's rising okay because it wants to drive that excess glucose out of the blood and what happens we get fat. What also happens is if you want to talk about teeth and the systemic theory of tooth decay which I'm a big fan of what it does is it shuts down the pressure gradient in the in the teeth and makes you more susceptible to tooth decay. Are you familiar with that?
John: Okay go back to your dental school ask for your tuition money back they didn't teach it to me either okay there is a form the parotid gland is like a is like the pancreas it's a dual function it has a endocrine function as well as an exocrine function it releases a hormone called parotid hormone and what that does is it drives a pressure gradient from the inside of the tooth to the outside of the tooth so that there's actual fluid flow that if you dry off okay and watch it over time you will see the surface get moist because the pressure gradient is dumb works that way now what blocks that pressure gradient sugar when you eat sugar it shuts it down and so plaque is more likely to form it doesn't have that pressure gradient driving it off the tooth and this is all a detail it's called the systemic theory of tooth decay. There's a great paper on it and I've got the reference here I'll give you.
Howard: What's the paper called?
John: It's called the systemic theory on tooth decay or the systemic theory of dental caries by Dr. Ken Southward it's in the Journal of Academy of General Dentistry the September October 2011 issue but okay.
Howard: So what does that say what does that tell us
John: It basically says that it ties tooth decay to the inflammatory response like first of all like I said we're not color controlled we're hormonal controlled okay. What that means is that and I was talking about insulin but in the case of to decay it's driven or shut down by the hormone parotid hormone pH secreted by the parotid glands and if it's a very it's a fascinating read it's not very very long it's only five or six pages and basically we're working currently with the acid theory of tooth decay which is proposed by Miller in the 1940s and there's this theory was proposed in the nineteen fifties and I can't remember the gentleman's name but it basically the acid theory that we were all taught is incomplete that it is the same drill fill bill but you know I keep coming back to a species appropriate diet if we eat it you're never going to you're not even gonna need a toothbrush let alone get decay.
Howard: So yeah I just found that on the JAGD was that words the resort of the systemic theory of dental caries by Ken Southward DDS MAGD. So interesting so continue...
John: So basically the carbohydrates the sugars okay shut it down and it forms a cascade response okay where it changes the redox state and it becomes favorable to plaque formation in decay formation and different people have different redox states and the higher it is the more likely I mean the more free radicals are running around and the more likely you are to get decay.
Howard: So yeah that's replacing the the acid theory of tooth decay?
John: It's not really replacing the acid theory it's building on the acid theory the acid theory isn't wrong it's just it's part of the equation. Now I'll tell you this in your career you've seen a number of patients with bulimia right, all right I think most dentists have one thing that always amazed me according to this theory is I've seen lots of lingual a exposed dentin but very little decay you know we were all taught that dentin is softer than enamel which it is and I was wondering why it has always had this glassy appearance and the reason the matrix of dentin is impervious to an acid attack. When the parotid hormone is shut down okay it blocks collagenase is what attacks and destroys the organic part of the dentin okay and that's when decay steps in that thing so you know you don't usually see that in bulimics you see this fine glassy dentin that that they have it just and I always wondered why it didn't decay and that's the answer and that's all in the paper it goes through that.
Howard: and what about gird?
John: Gird about as far as the teeth are concerned
John: Yeah they'll have the same the same exact issue that unless they have a high sugar diet shutting everything down, the collagenase isn't going to be working so the acid can do its work and the body's collagenase is can come in and they take out the dentin and they'll lined up a lot of decay but suddenly if that happens.
Howard: So in your practice as a dentist do you talk a lot about nutrition and diet?
John: Absolutely and what that what it does is when you get the patient okay to discover what they're doing wrong it transfers ownership of the problem from the dentist to the patients. For example if you do a bunch of crowns or some root canals and you come patient comes back six months two years three years later and they wind up with decay you know there's always that element of projection where they say I spent all this money and it did work and you say well what did you eat what did I tell you to eat. You know if you're eating things that aren't bad for you God Himself could have done the dental treatments then you're gonna wind up with decay or another way to look at it is like this do you remember every first-year dental student sometimes on the first day they see a Venn diagram with three interlocking circles one says teeth one says bacteria anyone says carbohydrates. Do you know not I'm not putting out in this spot but do you know what your daily obligate need for carbohydrates are?
John: There's no need zero, okay we have a process called gluconeogenesis it'll provide all the glucose that your brain will need okay as dentists okay we've been giving fluoride to strengthen teeth we've been teaching oral hygiene to get rid of the bacteria but we need it's a three-legged stool and the way the dentistry wins and believe me I like to win is to kick that stool that leg out from underneath the carbohydrate one. That you do not need them that your body will live better without them and the the implications are much greater than dentistry I'm talking about you know not only ending tooth decay okay this will put a huge dent you know in obesity this will put a huge dent and type-2 diabetes and this will put a huge dent and cardiovascular disease.
Howard: Do you think those diseases are reversible?
John: Yes I do okay over to a point and if you're you know you know the point where you need you know n state diabetes I'm talking about adult onset diabetes where the pancreas is just burnt out I don't think you can ever come back from something like that but I think that you know doing what I say will bring things make things you know certainly better that you know if you're the problem would wait the hormone there is lectin I was talking about parotid hormone before that's what controls up decay and teeth but as far as obesity lectin is a hormone produced in your fat cells they feed back to any kind of amounts in your brain to tell you your fault and sugars and starches bypass that that feedback loop. Now there's a number of sites and I'll link to it on my own you know on my thread when I set it up called the leptin reset that was put together by one of my classmates Dr. Jack Cruz who's now a neurosurgeon and you know I did it and that's that was the key to losing 40 pounds and tell you honestly Howard one night in January of 2011 I was laying in bed and I said if the problem with the obesity is carbohydrates and this is right in the middle of what I was losing the weight I said it occurred to me that as a dentist that carbohydrates are the sole cause of dental disease they don't like I have it okay we don't need more dental school rules okay we don't need more access to care in fact there's a lot of hand-wringing about the access to care. Access to care is two things people who are unwilling or unable for financial reasons or other to go to the dentist teaching a species appropriateness eating a natural diet of what people should be eating okay this all goes by the wayside you know I'm attacking the demand side of the problem not the supply side of the problem. I mean you know just because somebody's poor you know you have your birthright as a human is to have healthy teeth and to have a healthy body okay and the answer isn't you know dragging them into a dental office or putting clinics and subsidizing people to go there, it's to teach people what's species appropriate for humans to eat okay and then putting an end to our need. I judge the metrics differently I think we're succeeding when we close dental schools because we're not needed not opening more.
Howard: The cards are stacked against Americans because 10 companies control almost every large food and beverage brand in the world I mean it's Nestle, PepsiCo, coca-cola, Unilever, Danone General Mills Kellogg's Mars associated British food and Mondelez and when you go into Walmart or are you going to Kroger you go into the grocery store I mean those countries I mean they just want to sell packaged goods and and it's so tough for Americans that they walk into a Kroger and there's 60,000 SKU items made by these 10 companies, how do you help your how do you Americans get around those 10 companies?
John: OKay it's even worse than you said because if you look at the advertising they're always selling us about telling us about how busy we are in their product is going to help us because it's gonna buy more time in our day so yeah I understand exactly what you're saying I tell my patients to shop around the outside of the supermarket you know I don't I mean this isn't anything earth-shaking that you know don't buy anything in a box I think as a profession okay what we have to do is identify the problem and then identify the solution now dentistry has done a great job everybody knows that a Snickers bar is not good for your teeth, everyone knows it. What I'm telling you is that bread isn't good for your teeth okay that pasta causes cavities and people look at me I've had dentists look at me funny like that and I said do you have an enzyme in your saliva called amylase then they think about it and say yeah I said well what does it do I said it turns starches into sugars in your mouth I said nobody had a cavity to allow Mesopotamia twelve thousand years ago. Okay that's what they were eating they were eating grains and they were having you know all kinds of other problems this is where diabetes was first recorded. I've examined a number of Egyptian mummies okay diabetes is a word that has to do with water okay and I've never seen a mommy that didn't have tooth decay. Maybe there were rich people but again they weren't eating Snickers bars okay the only sweep there the Egyptians had was honey and it was very expensive they were a brat eating civilization and these people got decay the Mesopotamians were eating eating porridge. I mentioned my friend who's anthropologist it's Dr. Peter Unger of the university of arkansas and we worked on a project together and I asked him I said it seems to me pre-columbian America would be in a perfect place to look at decay rates whose first of all he studies teeth because teeth survived very well in the fossil record and he said I said do you see decay in pre-columbian civilizations in America and he says yes and no he says since pre-columbian America was a mixture of hunter-gatherer societies and agricultural societies like you might remember from the pilgrims came over they were taught to grow corn, squash and stuff okay that was an agricultural society but there were plenty of hunter-gatherer societies and Samson was very simple he's deep decay in agricultural societies you don't see any decayed and hunter-gatherer societies now we're not trying to you know reconstruct their diet peace for peace we're trying I want to look at the actual of macro nutrient content of the diets and try to emulate it and use it as a template and I think that that's how we win. I don't expect it to happen overnight you know but I think our message has to be clear on it. It's got to be different I mean if we if it was just drilling filling and training more dentists we would have won this years ago okay and the hardest thing I've ever tried to do is affect paradigm change and to ask my profession to do it I know that's going to take a while.
Howard: So it's really corruption than I mean I look at the obesity rates the diabetes rates and yet the United States government still subsidizes corn farmers and wheat farmers. I mean what do you think of the American and the food pyramid that's put out by our own government recommend several servings of grains and bread.
John: Yes it does and it's very simple that just take that pyramid turn it upside down that's I mean it's a cliche I'm from the government and I'm here to help okay. Very simple I'll give you the the the answer to all those questions is found in Gary Taubes book Good calories bad calories and I'll give you the I'll give you the 30 second version is basically the Germans had this figured out in the 1920s then in the 1930s Germany went to war all their scientists went to war and were killed then what happened is we won the war so we looked at the German science as bad and the American science is good and then in the 1950s there was a researcher and up in Minnesota they Ancel Keys that postulated that a low-fat diet would be good and Dr. Keys became president of the American Heart Association fast-forward another 15 years in 1977 and McGovern Commission recommended a a low-fat diet to Americans and then if you look at what the actual rate of obesity has since 1977 it's gone like a rocket so but you know it's a big book but it's a good read and it explains he also talks a lot about...
Howard: What's the name of the book again?
John: Good Calories Bad Calories by Gary Taubes
Howard: Good calories bad calories. So what are the good calories one of the bad calories?
John: Good calories are natural seafood grass-fed meats green leafy vegetables fruit in season.
Howard: You know it's funny when you say fruit in season because I'm 56 when I was little we all knew when the strawberries would come in season we do with the things were season and then as I got older and airplane travel one I got cheaper and greenhouses and all this stuff now little kids don't understand the seasons because they can go buy strawberries at the grocery store year-round.
John: Correct and one thing I'm not sure if I mentioned it or even emphasized it before that fruit and season changes with the latitude that you're at. So if you're in the tropics you can certainly eat more fruit okay or if you are an Eskimo in northern Alaska that's probably not something that should be part of your diet. Where I live in New York like for example I don't eat bananas because they don't grow in Pokipsie you know but you know I eat I'll start in the winter I'll eat berries through the summer I'll eat plums and peaches and now I mean we're one of the major apple growing trees that region so you know I'm eating like apples and pears and then as we get close to the colder season you know I'll cut down I might not cut it out but you know certainly cut down on the amount and I mean you gotta eat something and then starting in early spring late winter I'll start again with blueberries and strawberries and just go through the whole cycle.
Howard: So you know I think we mail the orthotown magazine to 12,000 orthodontists how come you never you see orthodontist really talking or marketing or having lectures about how diet affects malocclusion. First of all do you howdy how does diet affect malocclusion why are human teeth so messed up?
John: Great question, it affects growth and development okay through the process of glycation in the formation of advanced glycation end-products it's not just teeth and it's why in the Western world for example women have much narrower pelvises and you see many more c-sections it's everybody's thinking genetically when they should be thinking epigenetically. Epigenetics is basically how the environment influences gene expression that if you're eating a lot of things that aren't species-appropriate okay that's going to cause your face to be narrower your pelvic girdle to be narrower it may stunt your growth I mean this is how natural selection works and the best example I can give to you of epigenetics is Korea you ever been to South Korea?
Howard: Yes that's where Megagen is.
John: Okay the average I'm told the average South Korean is two and a half inches taller than the average North Korean okay and you're talking about people separated for 70 years by politics okay. In North Korea they don't have the nutrients or the food that they have in South Korea so the development is like gates opening and closing that all of a sudden we open the world to North Korea and we flood the country with food okay everybody is still going to be two and a half inches shorter because it can't make them taller those those gates are closed. It's the same with growth and development of the jobs that you know I think it might take a generation or two to sort out but it goes back to again environmental biology or it's not or it's not taught orthodontists are taught how to straighten teeth they are not taught how to prevent teeth from becoming crooked that I mean usually you know when you're born you know and you know if your mother is feeding you cereal by the time you're three four or five I mean the dye is set you're gonna have malocclusion.
Howard: Right so would you do just do tell people that he the Paleolithic diet?
John: I do and but I don't necessarily call it that I tend to call it species-appropriate which I keep using because I think to say Paleo diet you're kind of pigeonholing it that you can pick out you know thirty books on the Paleo diet and it's going to say it's going to say meat green leafy vegetables and fruit okay and I'm telling you that there's been a late development that you know humans can eat a little bit of dairy that there's a there's a gene that most people have that will make it so you can digest lactose but again it's one of those things your mileage can vary but you know species-appropriate I'm looking more at the latitude of where you are and I think there's an emphasis on seafood because that's what the people that we evolved from okay originally ate that encephalo is their brains made us these big thinking apes.
Howard: So you're also not a fan of silver fillings?
John: No I'm not I'm not a fan and of any feelings I'm trying to prevent all fillings
Howard: but if someone has a cavity do you is it about acceptable to you or not?
John: I'm trying to avoid amalgams I've had to have a place in a Malcolm in 15 years again the body has certain elements that it wants to work with I'm not I'm not saying silver fillings are gonna kill you don't misunderstand I'm saying that your body has certain elements it wants to work with okay iodine okay iron magnesium calcium phosphate you know if we can come up with you know better solutions that you know I think you know I've been using a you know white fillings I've been using you know gold when I can get people to afford it and you know and you know porcelain crown you know try to stay away from silver.
Howard: So I don't want to switch gears I know this is your passion but I gosh I can't help but to ask about forensics how did you get interested in forensics and what was that like working on 911?
John: Thanks for asking that was just luck I knew people I live about an hour north of New York City and when 9/11 happened I looked into seeing what I can do and I knew some people on the forensic team and they put out a call for volunteers I didn't have any formal training in it and what I did was I went down to NYU about two or three times a month and they would bring the bodies in and we had we had two teams we had a ante-mortem team and in post-mortem team the post-mortem team did just what to think we would categorize you know and chart the teeth you would try and you don't make matches they sent from dentists. It was fascinating work it bent from about the fall of 2001 through June of 2002 it was a experience I'm glad I had and I hope I never have to do it again.
Howard: Man that was that was that was the biggest shock I loved her I mean I wasn't old enough when I John F Kennedy got shot. I mean I was born in 62 he was shot when I was one my mother said that was my level was comparable to that day I mean it was the two the two days like that and that was crazy. So talk about out your interest I mean you were talking about you examined Egyptian mummies, where did that journey begin?
John: Well that began with you know what are the anthropologists that I worked with Dr. Jerry Rose he's a colleague of Dr. Peter Unger's had written a number of papers on it and we had a meeting down at Duke University and he brought a number of the papers that that was his area of interest and I said that but you know I had seen a couple you know in museums in the back rooms in New York and he said that no they're all riddled with decay. In fact I remember what Dental my dental books in college or in dental school they had they showed a picture of the world's first root canal it was in an Egyptian mummy you know when they just stopped they opened the tooth up and they just pounded some gold down into the to the root canal.
Howard: Wow so what about liquids, drink liquids people like that mean do you drink coffee tea alcohol beer wine? What your what's your liquids like?
John: I drink a lot of a lot of water I mentioned Pellegrino it's a you know sparkling water I like. I do drink coffee in the morning but I drink coffee black you know no creamer on no sugar. I like to have a glass of wine at the end of the night you know with my dinner.
Howard: Is that because you're Italian?
John: You got it
Howard: So it must have been very tough being raised italian you probably grew up on pasta spaghetti all the pastas was that pretty hard to switch your your diet from that?
John: You know i get that question all the time and the answer is it's simple if you have an emotional need to eat something that I said is bad for you your emotions always going to win over you know over health my goal is is health.
Howard: I notice on your Twitter I love following you on Twitter your Twitter's @dentalque What does that mean? Where is dentalque come from?
John: Oh that's just the first email back when AOL was the thing in the mid 90s okay I had to come up with a with a handle like a CD CB Hannibal so at the dentalque I mean my cousin's a dentist he's molarDG so.
Howard: Oh yeah I think it's funny how some of these young kids think social media was just some Bennett. I mean I can remember social me from when I was a I mean when I was little in Kansas when I go to my friends houses and farmers after everything was done all the chores were done and it was dark and dinner was done Oh dad or Grandpa would walk out of that barn and have those big ham radios and they'd be talking to farmers from Kansas Nebraska all the way up to Canada and you know everybody would say oh I'm talking about farming techniques they were talking about baseball and the boxing fights and when were they were driving the tractors they had the CB radio and they were talking so humans have been extremely social with technology you know, I mean the Telegraph the telephone the ham radio to CB these you know the internet the the Telegraph turned into the telephone which turned into the Internet but it's still just so social monkeys loving to talk to each other. You said that was I saw on your Twitter where you also tweeted that a find the nine point seven million year old tooth discovery in Germany but you said that was an oddity you don't you don't think that rewrites the Out of Africa theory?
John: Well the Out of Africa theory I think it's probably going to dovetail into the Out of Africa theory in that it's you know we left Africa in phases is it nine point three million
Howard: nine point seven million year old tooth
John: I want to I want to see that I want to see that verified.
Howard: Oh you mean oh so this was published on your Twitter it's a USA Today it was October 21 2017 so you think that still might not be a verified or
Howard: You're not believing it
John: Well I want to see you know I want to see more evidence that's what I'm saying yeah
Howard: So that's why it's an anomaly to you because it's just one tooth right whereas an East African the horn Africa you have many specimens by the way Lucy is right here at Arizona State University.
John: Oh is she okay
Howard: That was amazing. So are you having luck with your patients I mean are they receptive of this have you seen cases where people change their diet because of your effort and talking to them in your practice?
John: Absolutely I have I believe it works every time it's tried and like I said I think one of the things about it is it transfers ownership of the problem to the patient that you know if you're gonna eat things that are bad for you you're gonna continue to have the problems that you're have their choice.
Howard: Yeah and I think it's frightening like them so the the main goal of a species is to eat drink and survive long enough to reproduce that offspring and that's her job to reproduce an offspring you're talking about the outer Africa I mean human Homo sapiens have been surviving for a long time and so you would think that when you get erectile dysfunction that should be a huge red flag. I mean once you can't reproduce in that offspring and it's amazing how many patients say yeah I told my doctor so he gave me you know a prescription and it's like a prescription I mean something so wrong that you can't reproduce that offspring and you're gonna take a pill. I mean the underlying causes of that the obesity the diabetes high blood pressure the emphysema the smoking though you know what I mean. I mean it's kind of a weird state of affairs were in that that when you go to your doctor and say I no longer can reproduce and have offspring and they just oh here's a pill.
John: Americans want a pill for everything and here here's what everybody needs to know the underlying thing that ties this all together is the inflammatory response that I said we're hormonally controlled not calorically controlled but if you have systemic inflammation you have raised cortisol levels low vitamin D levels okay you might reptile dysfunction you might gain weight and become obese you might have heart disease that's when you wouldn't you control the hormones you get rid of stomach inflammation and you wouldn't need a pill for that but then there wouldn't be somebody to sell you the pill. So there's no financial incentive the financial incentive is to sell you the pill that you know if you sell you know I'm trying to sell healthy lifestyles to people because there's no cure do you want to prevent the problem or do you want to treat the problem I think you know we're decide I stand on.
Howard: I'm so glad you mentioned vitamin D because I live in Arizona and the bottom line is everyone in here gets a mixed message you have all the dermatologists saying stay out of the sun use some sunscreen you know love it on do you know the Sun is your enemy and then you have nutritionists and naturopaths and other people saying oh no you you need Sun every day for vitamin D and the and and some people say that if you're dressed like I am in a short sleeve shirt that if you eat outside need to have enough skin exposed during a lunch hour you wouldn't get enough you know but if you are completely in your bathing suit you would need 10 minutes every day for your vitamin D and then they come back to you and say oh my god I told my dermatologist that he'd cry. So it's a mixed message where do you sit on that?
John: Well vitamin D is a lecture in and of itself that there's vitamin D has many different activated forms and so inactivated forms but vitamin D that you make through sunlight is sulphonated vitamin today that does things that better things for your body then then vitamin D supplements. I'm not a fan of supplements I'm a fan of raising it naturally and I can tell you when I started this journey in 2010 just like you or anyone else if I spend too much time in the Sun I would turn beet red and start to peel so even if people say oh Dr. Sorrentino you're right well and catch all this natural Sun you got to work up to it I live about 41 degrees north latitude and I never burn I can sit out in my backyard all day if I go down to the Caribbean or Florida and after two hours I better get out of the Sun quick or put a shirt on I'm gonna burn. So it's basically a local accommodation I'm a fan of the Sun and being in the Sun and the problem with dermatologists is exactly what I said at the start of this podcast that evolutionary biology is neither taught nor a prerequisite for medical school that if they had that knowledge okay I think they would change their opinion.
Howard: You also do IV sedation what type of sedation do you do for anxiety your website says nitrous oxide and sedation.
John: I work with an anesthesiologist who come in and sedate people using a general lack then trying to think Diprivan I believe.
Howard: Yeah so you don't do the IV yourself?
John: No I do not I work with an annistegioloist.
Howard: I cannot tell you how much I do not recommend doing IV sedation it's like so since I have a since I've had a media company since 94 I've had several malpractice companies send me reams of information because they want to give them myself but my gosh every time it's a million dollar settlement. It's either a mist cavity or an IV sedation bill and it in every hospital in America you're not allowed to do the IV surgery I'm into IV sedation and the surgery. I mean I work hard you talk about c-sections there's not an OBGYN in America that does the sedation and a c-section. I mean a cardiovascular surgery they were the only dentist does that why wait what why do you think they do that?
John: because dental insurance is not part of medical I'm sure but you probably know more about that than I do.
Howard: So what what do you what do you think of doctors doing the sedation and and and and we've had some horrible accidents I mean there was one in Hawaii last year I mean you know where a child died. What advice would you give to young kids listening to you in dental school or just out of school do you think and they're tempted maybe I should go learn sedation versus just having an anesthesiologist?
John: Well the first thing is that if you have everybody eating a species-appropriate diet you'll never have to take a little kid into the OR or sedate them so you know again it's prevention or treatment. You know as far as actually doing it we I worked I have a friend who's an anesthesiologist and he would come in and sedate the patients for me now he would get a separate fee for that and the reason I think in dentistry you don't see much of that at all is the fact that dental insurance is different than medical insurance. So you know it's kind of like we were the odd man out so but you know it's certainly that's not something I do in this office.
Howard: Does medical insurance cover sedation when they come into your office?
John: No they do not
Howard: Yeah I just cannot stress enough that if you want to do sedation become a board-certified anesthesiologist and just do it full time and by the way my oral surgeon right up the street for me on Greg Edmonds he agreed with that I he was the first oral surgeon I knew that agree with that but he even says not only is that the standard of care in every hospital in Arizona which he wants to to meet or exceed but he said it's also it's a practice management builder because he doesn't have to waste all the time going in there and starting IV. I mean when he goes in there they're all ready to go and he goes and does his stuff he thinks he sees far more patients by having a full time anesthesiologist in his office.
John: Well my wife thought had three c-sections and had it done with an epidural you know what medicine they used?
John: No lidocaine lidocaine okay and the anesthesiologist got $1,000 I mean yeah we we're giving it away you know I would do for a filling and they don't use that much more maybe two or three carpials they use lidocaine not even our adocain.
Howard: Are there any other questions that I was smart enough to ask you?
John: No I think you got through everything I think the most important thing to realize is the thing that ties everything together is the chronic inflammation that you know periodontists have been looking for years okay for the perio systemic link I have the answer, the answer is systemic inflammation it depends where the inflammation where the weak port in your body if this that I mean they're just waiting to find that periodontitis is a is a key trigger for heart disease and it's not the case at all. It's the systemic inflammation caused by consumption of carbohydrates and glycation information that glycation end-products also lack of sleep okay cortisol or reversal. I mean are things that you know drive drive the systemic inflammation and these these are all big problems in our society that I tell people eat a species-appropriate diet respect the circadian cycle and respect the circuit annual cycle and you will do well, do not get up to 3:00 in the morning okay and check your phone for messages that bright white light and blue light tells the reptilian part of your brain that it's day and it starts secreting cortisol at a time when it should be low okay this all plays into it and maybe instead of things species of appropriate diet I should say a species appropriate environment okay that's dark nights that's daylight during the day that's going to bed at a reasonable time and eating what we talked about.
Howard: What did you say circadian cycle and you said another cycle?
John: Circa annual so that circadian for the year the annual cycle
John: You shouldn't be don't eat strawberries in December
Howard: There's still a lot of periodontist even dentist debating whether or not decay and periodontal disease is contagious I mean obviously below the belt everybody knows STDs are contagious below the belt but what about kissing. Do you think decay and periodontal disease are contagious diseases?
John: You know that's a great question because I will admit there's a certain point where what's contagious is the bacteria that you know mothers if you have strep mutans, mother's gonna pass that to baby or friend a friend but if you don't eat the substrate if you have a low carb diet you're never gonna get the disease.
Howard: Very interesting
John: So it's what's in it's the environment driving it.
Howard: Alright well hey it really was an honor I know it's you stayed at the end of the day so you should have been home having your glass of wine and you decided to stay an hour and talk to me and my homies and I can tell you that I really really appreciate that. It's been an honor podcasting you and I look forward to the links on this thread under health is nutrition and that you'll postseason nutrition's and just thank you so much for coming on the show today.
John: Yeah thanks Howard it was a pleasure. Give me a day or two to put it together but I'll definitely do it this week.
Howard: Alright thank you so much