Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1145 Dr. Ryan Nolan DMD Founder of Elementa Oral Care and The Biofilm Factor Podcast : Dentistry Uncensored with Howard Farran

1145 Dr. Ryan Nolan DMD Founder of Elementa Oral Care and The Biofilm Factor Podcast : Dentistry Uncensored with Howard Farran

2/24/2019 10:52:00 AM   |   Comments: 0   |   Views: 561

Ryan Nolan, DMD is a researcher who is among the nation’s leading scientists on studying cutting edge preventative oral care. He attended the University of Illinois in Chicago, where he majored in Chemistry before attending Dental school at Midwestern University. 

VIDEO - DUwHF #1145 - Ryan Nolan

AUDIO - DUwHF #1145 - Ryan Nolan

While in Dental School, he realized how out of touch product development was with research and core chemistry concepts. Ryan partnered with a colleague from Dental School Matt Callister, and they began their journey of exploring how to make better hygiene products possible. After years of research, Elementa was born, a company which focuses on using plant based nanosilver to target biofilms and raise the pH of plaque drastically within a short period of time.  

Howard: It's just a huge honor for me today to be podcast interview and Dr. Ryan Nolan, he's with the Biofilm Factor Podcast. He is a researcher who is among the nation's leading scientists on studying cutting edge preventive oral care. He attends he attended the University of Illinois in Chicago where he majored in chemistry before attending dental school right here in Phoenix at Midwestern university in Glendale Arizona. While in dental school he realized how out of touch product development was with research and core chemistry concepts. Ryan partnered with a colleague from dental school Matt Callister and they began their journey of exploring how to make better hygiene products possible. After years of research Elementa was born, a company which focuses on using plant base nano silver to target biofilms and raise the pH of plaque drastically within a short period of time. Ryan is a dental materials expert and patented inventor dedicating to dedicating to researching dental plaque aka biofilm what you learn about the oral biofilm if your health depend on it. So how did you get tell us about your journey how do you go from dental school to a b to c products development course.

Ryan: Hey thanks thanks again for having me on yeah it was kind of an interesting way of going about it so my colleague and I Matt, oh Matt Callister brilliant brilliant guy but he came to me in dental school and I have a background in chemistry and specifically nanotechnology and so I had been looking at certain things and he kind of came to me and said Ryan I mean is there something that we can do about this problem because we keep seeing a lot of these products that aren't really addressing some of these core issues. So naturally we got together and fast forward a couple years later we applied for we did a clinical study and then applied for a patent, so we ended up testing one of our hypotheses which was can you use a nano silver compound or specifically nanotechnology to change the pH of plaque upwards pretty quickly and we ended up finding that that was actually true. So we ended up making a deal with a manufacturer and because they were so interested in it and here we are. So we've been in product development for a couple of years now and we're just keep keeping the punches going forward so it's been a really interesting journey but before that I practiced full-time dentistry for like three and a half years so like it was kind of a overnight transition for me.

Howard: So nanotechnology is a branch of technology that deals with dimensions and tolerances of less than a hundred nanometers especially the manipulator individual atoms and molecules. So how does how did you said you're an expert nanotechnology how does that happen and how is that all work?

Ryan: So Howard I actually started working on nano compounds back in University so back when I was in undergrad and we were looking at everything from carbon nanotubes, silver nanoparticles things like that so I had a background in it. So I kind of it's kind of like one of those things if you understand a lot of the core concepts they actually kind of stopped teaching a course I don't think they teach her any more in the curriculum in organic chemistry which is this the study of you know inorganic compounds may not with carbon but I actually I think was one of the last class that took and I gave me a lot of knowledge on these particular subjects. So fast forward a couple years I was able to really apply some of this base knowledge that I had to make new compounds and make better compounds. So I ended up did I did spend a lot of time in the lab kind of perfecting what we wanted you know with my colleague but it's still one of those things where very very difficult to do but it was something I had a background in.

Howard: and what made you think that it would apply to biofilm?

Ryan: Yes so you know biofilms have been studied pretty extensively and there has been a lot of studies that have already shown how effective nano silver compounds and specifically other nanotechnology compounds are on biofilms, everything from reducing plaque attachment to interfering with the EPS layer which is the layer that kind of makes the outside of the biofilm. So we knew there was going to be some properties but what hadn't been tested and discovered was whether or not you could use these or modify these to manipulate plaque into doing what you wanted and part of that was making plaque less pathogenic right. So when we look at plaque one of the things that we're always thinking about his dentists, if someone doesn't clean that plaque off they're gonna get decayed they're gonna get some sort of you know demineralization or something like that right and so we know that the longer it goes on removed that it's going to shift towards pathogenesis and so we don't want that obviously right so we're always trying to do our best with oral hygiene instructions but one thing that you can do which you know we were really thinking move word was if we can incorporate these compounds with some of these other compounds like xylitol and calcium we'll have a really really good shot at disrupting a lot of the carrier genic organisms and and that's that's basically what we were looking at.

Howard: and then silver seems to be like making a comeback I mean when I when when I got our school 30 years ago I mean there was no there was no pediatric dentists didn't have anything to argue about and endodontists didn't have anything or argue about but now how does the pediatric dentists are the silver diamine fluoride it's a huge controversy on Dentaltown. I mean you know there's nine specialties and probably the most active specialty on Dentaltown has got to be pediatric dentists there's just a ton of really sharp ones and they either love it or they don't love it and it's a very emotional. Right here in Phoenix we have one of the superstars of silver Diamond fluoride and was on the cover of the New York Times what you know you're an expert in silver in dentistry and what do you think of this silver diamond fluoride?

Ryan: So I love silver diamine fluoride I think especially for kids so I actually use it in my office sometimes have kids that either don't you know aren't comfortable and they're going you know standard drill and fill or maybe we're waiting on an exfoliation and you know we want to just get them through and silver diamond fluoride is a great compound for that. Now obviously you know it stains right but one of the things is is that sometimes when you're looking at especially some of these poorer areas right, they can't afford treatment right away so if you can delay how much that decay progresses in a short period of time I mean I think that's a miracle really I mean I think that's modern science just doing us a favor. I will say this and and one of the things that I worked on and that silver diamond fluoride that kind of gave me some clues for is you know there's some new studies about to come out which just that nano silver actually can like so our nano silver is non-staining which might surprise some people but nano silver can actually be used in lieu of silver diamine fluoride not stained and there is a study coming out here pretty soon saying that it's actually more effective at remineralizing teeth than SDF. So it'll be really cool to see how that pans out but yeah I'm a big fan of SDF I think Jeannette McLean I think you had her on she knows a lot about silver diamond fluoride but it's a very very cool compound and if you don't know about it I think you should definitely do your research and check it out.

Howard: So are you thinking about having a silver product with your company that doesn't stain are you thinking about a competing product for a silver diamine fluoride that doesn't stain?

Ryan: Yeah so what we're doing right now is we're actually looking at getting a remineralization study done comparatively and we're gonna do it against a couple of different compounds and one of the things is yeah these these compounds that we make are actually surrounded by a custom coding and that custom coding doesn't allow it to stain. So even though you might get some silver uptake into the tooth you're not gonna see any staining even if you were to use a flouride for example so I use a fluoride toothpaste right so you would expect that hey look you know I'm using fluoride right after my rinse you know maybe there would be staining absolutely not. So it's been customized to get around that issue so it's it's really cool stuff.

Howard: Silver's had a long history in medicine and dentistry in the development of radiology improving wound healing, silver was the most important antimicrobial agent available for before the introduction antibiotics. When when did you first get turned on to silver and were you a big fan of it's history?

Ryan: Yeah I mean look I know a lot about silver simply because I'm a chemist and silver is one of these really cool compounds that just happens to you know be useful in a variety of settings but what really got me turned on to it Howard is I ended up looking at a lot of these studies and so Matt and I actually looked at a lot of things because we wanted to see what what in the world was gonna have the highest potential right especially for fighting care genic organisms and time and time and time again you can find these studies you know against SP tans and these different biofilms and it was just super effective. One of the original one of the original studies that we looked at was actually University of Maryland so they have actually like a nanotechnology team over there and they worked on applying silver and composites which is really really cool, their's also some studies that have been done on mixing silver into dental sealants and what they found is I think it was a forty to sixty percent resistance to demineralization they've also applied it in orthodontic brackets. So it has it has a long history of being a very broad span antimicrobial the real difference and the way I look at it is there's a couple generations of silver specifically nano silver. So we kind of started out with this kind of archaic use a silver wire pumps and electricity through it the problem is is with that method is it doesn't really work too well and you get a lot of particles that are one size or the other and they kind of fall apart the second you put them in any kind of salt or sugar or anything so they're not very useful outside of maybe just basic scratches on your arm they don't really have extended antimicrobial action and then generation two came along so generation two is what a lot of people use and that's actually chemically modified nano silver and so it actually has coating but it's still known as protected from oral salts, saliva, blood. So it still kind of falls apart and the chemicals they used to make it are pretty pretty harsh so that was that was great because we saw improvements in the size and consistency but we didn't really see we had some issues with the toxicity and then came along plant-based compounds do you make a no silver which is actually quite new. So post-2012 and that's generation three and it's actually quite rare to find most people don't work on it because it's so tough but yeah so we fixed a lot of those issues while maintaining a lot of the extended my antimicrobial action that generation two had. So that's that's kind of where we're at but it's it's been a long way but the nice thing about playing compounds is they are completely biocompatible so they're just non-toxic on top of it but they also seem to be very stable in lots of different situations and so that makes them very viable to use as a preventative measure with different compounds. So it's just been really awesome to you to discover some of these things in such a pivotal time in dental history.

Howard: Yeah you know and one no I'm 56 how old are you?

Ryan: I am 30 soon to be 31 in June here.

Howard: So you're my oldest son Eric is 28 so you're old enough to be my son. I feel like your generation might not be as aware of as my generation how silver fillings I mean composite doesn't have an active ingredient I mean when I was your age the number one filling was a silver filling and fillings you know they're half liquid elemental mercury which is you know you don't find that in a multivitamin and then the other half is not elemental silver but a mixture of silver zinc and copper and my gosh they lasted 35 years, they were made well they were metal and they were antibacterial and they and and when you took out people say oh well they broke teeth well big deal is 38 years later and they need a crown. I place these composites for 31 years and six years a lot of them have recurred decay where you're taking a number four round bird just taking out oatmeal and and and I just I just feel like dentistry went the wrong way because when I was little it was all my restorations our gold you know I had all gold inlays onlays and crowns are amalgams and that just lasted forever and now aesthetic health compromise came along said well I want to have tooth colored restorations like I've been I've been talking to you now for 20 minutes I haven't seen any your molars.

Ryan: I have gold.

Howard: Yeah but you had to do that, so why are we doing an aesthetic health compromise for these molar especially on men. I mean I get it if you're a gorgeous woman but if your a 56 year old bald man why the hell do you want a emax crown on your second molar. I mean it just looks like you know that I don't know who needs therapy more the patient or the dentist providing it but talk about you do you think do you agree that amalgams last twice as long as composites and you agree that composites need some type of active ingredient?

Ryan: Yes so totally agree, now I will say this the biometrics guys will tell you if you isolate right and everything that you'll get a longer lasting composite but...

Howard: The dental insurance will people will tell you that when they hundred million insurance claims in America they only last six years so I know that every dentist say well you don't understand in my hands in my practice and I'm like Mozart and Amadeus and my farts smell like poo pourri and I mean no no they just they just don't last.

Ryan: So the average lifespan from what I understood was five to seven years so six years bang-on and you know it's funny because sometimes I'll place these miraculous composites and you know three years later I'm like how did this get beat up so badly and then you look at the amalgam that was placed 25 years ago and it still looks like it was place yesterday. So that's interesting that you bring that up and their is a reason for it but one of the things that's really interesting about amalgam is if you actually cut a tooth lengthwise or widthwise doesn't matter you can actually see that amalgam isn't actually their's an interface that there's a gap between amalgam so the question that becomes why the hell did these things last so long if there's a micro gap where as composite dents it doesn't tend to have as big of a micro gap but they seem to fail a lot a lot easier and it really comes down to surface chemistry. So this is really important actually so even though there's an actual gap the metal alloy actually has the ability to kind of project charge into that area and what does that really mean, that means the bacteria that try and slip through those gaps and of dying in the process of doing so. It also repels a lot of bacterial Meccan is his acid release and things like that. So even though amalgams don't have a perfect seal they're so antimicrobial and they have so many you know different metals specifically silver it just prevents a lot of the caries progression and I'm sure that like me you've opened up a lot of these alloys and sometimes even even though it's darkly stained it's quite hard right and so that's from different metals depositing into actual lattice and enhancing the actual lattices resistance to you know acid attacks. So same thing with gold you know gold doesn't really stain as much as depending on the alloy as silver but I mean you see gold lasting forever but the thing that's unique about gold is it actually again has these surface properties that actually enhance the existing enamel the thing that I try and really get across the dentist because they don't seem to get this concept very well composite has no charge, so one of the things that's the downside of composite is because it has no charge it's much easier for biofilm to attach to and it's also much harder to resist acid attacks when you're relying on the game strictly on the enamel to prevent some of those surface attachments like pellicle and things like that. So yeah biofilm biofilm just loves composite and I think that's part of the reason that even though it's got a better seal it doesn't have any antimicrobial action or very little and so what we've seen actually is a lot of people are trying to incorporate nanoparticles into composite to enhance its antimicrobial action and we've seen great success. I mean I think Maryland did a couple of studies on that and actually found that it actually remineralized as the teeth right after the acid and salt so it's really cool stuff Howard it's growing very quickly but I do agree composite needs to be modified to make it last as long as amalgams 100%.

Howard: Yeah and gold I mean I remember the I mean gold it's it's so shiny it's got that that high energy surface and my instructors used to tell me that it's kind of like imagine you have two apartments living you you move in next to the high-energy gold surface and it's all static electricity and your own charging and then you go next door to the composite apartment there's no static charge do you think that surface electricity has a lot to do with deterring the biofilm?

Ryan: Absolutely

Howard: and remember the studies that came out when cap tech was big cap tech really big it was so high energy. I mean there were a lot of studies as showing that it resisted recurrent decay but it kind of got killed when a gold hit a thousand dollars you know and that's why BruZier took over it was it was because the price of gold was so high.

Ryan: Yeah so gold actually has a unique property that a lot of people don't know about it's the only atom on the table that actually has a dual bilayer. So basically what it does is it forms charge around itself and it forms two unique layers now silver doesn't form as much of a charge layer as gold does but this bilayer actually projects charge into solution and that charge is actually what discourages bacterial attachment and acid in an acid dissolution of tooth structure. So one of the things that's cool about that is when you look at nanoparticles if we can embed them in some of these materials what we're actually doing is we're adding this charge to the actual you know property of the deposit and just to give you an idea like S. mutans I think is I think it's negatively charged if so the membrane actually when it goes into an area like an electric field it actually disrupts the ability of that microbes I guess to work but it also impedes it from attaching to that surface and I don't know about you but if you look at composite and amalgam or even gold when you look at plaque it hardly ever builds up on the surfaces and if it does it like almost comes off right away whereas with composite it can really attach to those those surfaces quite well. So the other thing is is you know composites can be on the micro scale pretty rough and so that gives that gives a you know biofilm a really good chance at adhering and with his with when is gold I mean I have gold crowns in my right and those things hardly ever get like I never see them with black on right. So it's interesting that you know some of these dentists who were working along long ago really did know a fair amount about these materials but even though the aesthetics have been proved I do feel like we've taken a risk mitigation on some of the carries that we see nowadays I feel like things do fail much faster definitely.

Howard: So see another problem of the journey of gold is when I got at school in 87 gold was like $600 an ounce and then by the time I got to 2000 it was down to $400 an ounce and we were just doing gold and cab Tech and everybody was having longer-lasting restorations and then by 2010 it was like over the past $2,000 an ounce and that Jim Glidewell the genius he is said this is just it's just it's just too expensive for the working man

Ryan: Right

Howard: and he's the Southwest Airlines dentistry and so they switched completely to non gold, so gold gold is dying as fast pfm.

Ryan: Yeah I actually when I was in dental school you know I had a lot of great mentors I had Dr. Reynolds and I had a couple other guys that were just great but I ended up going with gold on my molars so I had some pretty bad wear on my first molars I ended up going with gold just because of the long history of use I kept seeing these you know as a dental student I kept seeing these patients come in with gold restorations hey when was that place 1942 and it's like okay well clearly their's something to this because you know I see these emacs come in ten years five years later and they're failing right not not to say that Emacs is a bad material but I think that you know for me as an investment I paid the extra to get the gold because I will I knew that it was gonna last a long time and I didn't want to have to do it twice if that makes sense.

Howard: Well it is, let's call it for what it is, Emacs is an aesthetic health compromise. I mean you want beauty so yeah I've Ivoclar gave you this beautiful Emax but it's inert it's inert. You know you're in Orem Utah so you're up the street from Provo Utah with a court the god of Dentistry lives Gordon Christiansen and behind every successful man there's a successful woman in Rella is the the genius and Gordon is the prosthodontist and he did all of her restorations were gold onlays that he did in like dental school and they're still there 50 years later and when I see people with gold cemented with zinc phosphate cement or you know I mean all these old these old materials and I mean I'm in Phoenix Arizona a lot of retirees. I've seen these things routinely go half a century and then so when you got your fellowship on the AACD and you're like woohoo I'm a cosmetic dentist and then you go and take your Alzheimer's patient and you don't put glass ionomer or you don't put amalgam because you say it's not translucent enough on us some 80 year old woman who doesn't can't even name her children it's like dude you're not a doctor you're a quack. I mean I've never seen the lady with Alzheimer's enter a beauty contest and I don't even believe in the beauty contest because have you ever noticed the Miss Universe the winners always from Earth how what are the odds one planet in the solar system always winning the contest but so yeah the other forty thousand pound elephant in the room is four-and-a-half percent of Americans will end their life in a nursing home and it's mostly women and they're averaging a root surface cavity every month or in there. So as soon as grandpa has been in there for a year and she's probably in there because she's got dementia, Alzheimer's, she's certainly had rheumatism arthritis she can't brush can't floss and and and I was spent I spent several days following around LPNs and certified nurse assistants and LPNs and nursing homes and they got to take care of like 20 people by themselves.

Ryan: Oh it's really hard yeah.

Howard: So if anybody's gonna help them it's good it's not gonna be brushing and flossing for minutes twice a day that is not gonna happen it's either gonna be a mouthwash or applying silver diamine fluoride. Well what are your thoughts on route service decay.

Ryan: Yeah so that's an interesting topic that you brought up and I'm one of the things I'd like to talk about and which is a kind of a recently recent phenomenon a lot of people know I'm not as big of a fan of chlorhexidine as I used to be part of the reason why chlorhexidine such a problem is it can actually increase especially elderly patients you might think that you're doing them a favor by giving them chlorhexidine but actually can increase risk for route carries in elderly patients and the reason is because of substantivity so it actually kind of makes this little 25 micrometer or layer on the tooth and it actually ends up in inhibiting remineralization and so there's actually I think it was like a review of chlorhexidine where the said do not use this as a remineralization strategy it won't work. In contrast to that silver has seen a huge upswing with silver diamond fluoride especially for root carries it just works so well but we really think that that what we have as far as a mouthwash could be really helpful for elderly patients people who get in comas people who are under care that aren't doing the brush with best with brushing and look we know that either you know maybe they have some sort of physical degeneration where they can't hold their brush properly or maybe it's like you're saying that they don't have a great caretaker or you know that they have 20 people to look after so brushing and flossing is you know at the end of their list I really think this mouthwash could be pivotal for people like that because it's very easy to use doesn't require a lot of technique and you know if they just rinse with it a couple of times a day they're gonna bring that plaque pH right back up you know silver is a natural antimicrobial so that that always helps and and looking at plaque attachments and things like that so it's not a perfect solution but I'd say for those individuals who are higher risk we really think this could really help them.

Howard: and silver seems to be a more stable price I mean yeah you know when I got a school in 87 it was I mean it was eight dollars an ounce it and it didn't even pass ten dollars an ounce till 2005 and what do you think silver prices are more stable than gold prices when you're when you're thinking about them being a manufacturer and this is your main ingredient?

Ryan: You know that's a good question you know I I'm a big fan of silver you know economically as well I mean I we saw a dip to like four dollars there like in the early 2000s. I think I think it's a one of those things where so I think for a long time the supply I think out pays gold and I think that's part of it you can extract silver from base metal mining. So when you actually look at China when they were doing a lot of their building they were mining all sorts of base metals and so you're not gonna find gold base metals mining but you will be able to extract silver and so that definitely adds the the quantity but the one thing that you're right on is you know silver can be manufactured and used in manufacturing processes and it's a lot cheaper than gold right and so luckily we've been able to make these compounds affordable you know on a scale that people will be able to buy and and it's hard to say whether gold would be like that I think gold has a better shot of being used in cancer therapy. I'm not sure oral care is ever gonna see you know I actually believe in her I've worked on a lot of gold compounds so we'll see but that the price inflection point for gold is much much higher so you really got to be committed to a higher price point if you're working with a compound like that but ya know it the the price of silver has been quite stable over the past. I mean I think it's what $14 an ounce now but the amount that you can make with an ounce of silver as far as nanoparticles is quite astounding. So one of the big attractions for this stuff is that it could be made cost-effective right so it's scale if you can make something cost-effective and it's a preventative and it does better than a lot of the other ones that's a huge attraction for for us specifically to because you know look at the end of the day you got to have something that's affordable for people to use plain and simple and if we can get that into to other areas and countries we're you know I specifically I know you know South America it's like they drink coke is water and so that they've there's actually been a lot of dentists who have it reached out to me and said Ryan get this in my hands you know I really want to try this out because we have a lot of people who would just come in all the time with rampant decay and it's just getting worse and worse. Yeah I know I silver is a great alternative because it can be made cost effective and that's nice right now that the cost is not sky-high compared to some of the other metals.

Howard: You know you go back to the silver amalgam gel you know there's two million dentists and 1 million dentists don't even have a chance in isolation and when I've been in a lot of those developing world countries the dentist recommend that you drink coke out of a can and because yeah cholera and you know they don't care what two-year-old gets a bunch of cavities they don't want to be a cholera and die of diarrhea in fact in those countries you know what the most common treatment is you want the most famous most common medication is you know a teaspoon of salt wrapped in black tar honey because when you get diarrhea you start having you start losing all your water and your glucose right. So by having that salt and then sugar the salt retains the water the sugar keeps your your glucose level in your brain so you don't go into coma and what was most interesting in South Africa where they have about a 25 percent hiv-positive rate the dental offices that I observed in during the cleaning they didn't talk anything about brushing and flossing was all HIV prevention.

Ryan: Really, that's interesting

Howard: and I still do you know gold silver and copper were the first three elements known to man I mean that group 11 periodic table is pretty intense but why do you why do you say when you're mining that you can run into silver but not gold if they're both in group 11 on the periodic table?

Ryan: So gold tends to occur in different kinds of so I think it's more isolated to the ore that you're mining so if you're if gold doesn't naturally occur as is in higher rates at certain base mine on base metal mining operations that's a lot in one sentence. So when you're looking at base metals it's a different it's a whole different setup or so when they scour for gold you're actually looking at different basically a whole different set of mines now when you do gold mining you will be able to extract silver they do a core commonly together but when you base metal mining it's a lot less likely and so depending on where the demand is in the economy like it depends on whether we're building steel structures or we're building or we're looking for lead for batteries or whatever copper is a more commonly mind and found with silver has a base metal but depending on where you're at in the world and what you're looking for that's actually going to drive the demand or cost of silver and frankly gold right because there seems to be some relationship between silver price and gold price as well. So I'm not an expert on the mining process but I can say that yeah there does seem to be areas where the ore is more gold rich and then other areas where it's all base metals and so that's kind of what has determined a lot of it the drive up for silver. Now I do think China's actually stopped mining a lot of base metal so it wouldn't be shocking to see some increase in price but based on the forecast I haven't really seen too crazy of a change so luckily hopefully we'll be able to keep it in a nice range and affordable for everybody.

Howard: Yeah and that's another thing about China China's house cards I lived through this before I mean you don't you don't know what exactly causes these these big empires to collapse nobody saw the Soviet Union the Berlin falling but man when you're over in China they have 50 million homes they built that no one lives in.

Ryan: Yeah it's like a ghost town, yeah I've seen a documentary on it.

Howard: I mean people can't even comprehend what that means 50 million homes built with no one living in them it is it is purley a house of cards. So on your website is elementasilver element yeah

Ryan: Yeah Elementa

Howard: What's elementa mean as opposed to element silver I'm trying to I'm trying to draw so they're listening in the car.

Ryan: It just ended up being the name we all end up agreeing on so Elementa just sounded better than element and I think there was already if someone who had element but so elementa is just this so we kind of sat in the boardroom on day and we were just looking at names and we really liked the word elementa because our product lines really about using different kind of metals in incorporating them into nanotechnology. So we're using various elements like I said I've worked with everything from gold platinum palladium everything that you can think of now silver was the first one out just because you think that has the most promise but our company has worked on a variety of different metal compounds and we think we think that there's going to be applications in oral care. So Elementa that just fits our name really well because we're using various elements on the periodic table.

Howard: So your website you sell your products is nano silver mouth rinse is that is that your only product right now or is that your main product?

Ryan: Yeah so that's our mainstream product that's the first one we came out with but we are actually making a tooth gel we're gonna have mints and then we're gonna come up with some gum you're pretty soon. So keep your eyes peeled out we're gonna definitely be expanding our flavor profiles as well I'll have to to get you some samples Howard but we're having it we're launching a kid's line in April so a bunch of kids flavors and then pretty soon here we're we're doing our rebrand so we're actually getting our new bottles and labels out but we're also adding peppermint to our to our regimen for our adult flavors so yeah keep an eye out for that but yeah we we're currently just the mouthwash but we should have some other products coming out here soon.

Howard: Now are you are you making a living doing that, I mean that's a vicious market b2c I mean you and I are you know I mean b to c you're out there competing with Procter and Gamble, Gillette, crest, colgate. How is that going I mean are you making a living do this really?

Ryan: Yeah it's going really well and I'll tell you what thanks Procter and Gamble and Colgate and all those other companies for not innovating as much because it has given us a upper hand in the market and I'll tell you what if you actually go out and look at a lot of these rinses or toothpaste or anything they're all acidic and they just have a bunch of junk in them. I mean I think Colgate and crest that just released charcoal toothpastes I mean I don't know how you feel about that but I kinda feel like that's a step in the wrong direction. So we've just been able to really get a very good we got a very good reaction in the market to dentists saying finally something that makes sense as a scientific basis is alkaline and it's innovative. So yeah it's definitely an uphill battle when you look at some of these big guys but yeah luckily we've gotten a really good response, sales are doing very very good. Yeah so I only practiced one day a week so this is what I do and luckily I have a lot of people who really believe in it. So with we've been able to kind of secure funds and so it's it's been a really cool experience and so we're hoping to keep blowing it up and and luckily like I said the competition doesn't seem to have caught on to a lot of these problems with some of the you know I mean some of these companies even still use alcohol in their products or citric acid. I mean really you're gonna put citric acid dissolves teeth and an alcohol on your product I mean it's people are just tired of that and they're tired of being told that you know a lot of dentists are tired of being told hey this is an innovation, you know it's not an innovation if you just repackage something that you've already made 30 years ago and so that's what we're really seeing is a lot of people just especially you know younger dentists, pediatric dentists even endodontist and oral surgeons that are super happy with the the way that we're trending so yeah it's been it's been quite good so sales or sales are doing very very well I have a really good marketing team here at Elementa.

Howard: Well it's funny you you say the big boy is Procter & gamble, Crest and Colgate are not innovating I mean well hell you're in Provo Utah which is the home of Dentrix and look at all the dent look at all the dental software innovations that sprouted out around dent ryx all I still think every one of those companies Dentrix should have done and you know and how many how many Dentrix employees left Dentrix and started a start-up in your you area because of innovation?

Ryan: No idea but I'll tell you it's probably a fair amount.

Howard: Oh huge amount.

Ryan: I've actually run into them out yeah I'm into a couple of companies that have just come we actually just went to a recent conference and there's another company I think my friends are already using them in his office but I mean I'll tell you what the software actually makes a huge difference in your in your productivity you can track a lot of metrics sure your I know your a practice management guy so you appreciate what goes into that software probably more than I do but ya know I really like Dentrix, I have used Dentrix for some time. I used to Eaglesoft I thought Eaglesoft was a little less intuitive than Dentrix so it just seems like there's more clutter and that seems like it harder to get to different menus and things like that but that's just my personal experience, I'm sure there's people who really like to Eaglesoft.

Howard: I think that young kids have the number one thing they have to remember is that you would think if you made it to the s&p 500 that you're just a hall-of-famer and you're there for life and they don't realize that the average lifespan of the fortune 500 company is 20 years because that's

Ryan: It's  getting lower and lower too.

Howard: Yeah in 1950 it was 60 years and by the year 2000 it was 20 years and they owe it the same thing every time they get mowed over from behind they're going down the road or looking out their windshield is not looking at the rearview mirror. So innovation so just because you're all that in the baggage of sight like look at Gillette I mean they were kind of like a nuclear arms race with themselves adding more blades to the shavers one to the three then four and five then all sudden one company came back and said you know all the professionals only use one blade why are razors are so expensive but so you started a podcast that's why I'm a big fan of your podcast I called you to come on the show and you didn't call me. The Biofilm Factor with Ryan Nolan, you got it upload you got 17 shows so far right

Ryan: We're gonna put it in the Dentaltown I'm telling you, we're going to do it.

Howard: I owe this whole podcasting thing to Bill, Trump and Hillary Clinton it was about 1,200 days ago dentist started emailing me saying dude I got our commune to work and I can't listen this toxic Benghazi and they were listening to podcasts on you know cooking, raising kids, elk hunting and so I think they just I mean I look at the metrics on that app that podcast section of the app has been opened over a million times and it's only been not even three years but I think what they do they got an hour commute to work they open it up and if you're driving to work and you're all stressed out because you got a molar root canal there if they're driving in the office they don't have any patience or looking for a marketing thing. I mean I think in hope growth and abundance. I want to promote any information to anybody that'll make my homie dentists do better but so tell us your journey how did you go from into the the podcast and which is The Biofilm Factor with Rylan Nolan. So it says would you learn about the oral biofilm if your health depended on it well it just might on the biofilm factor Dr. Ryan Nolan discusses the importance of diet biofilm management and the oral systemic link. I think most people listen to my show actually for my dieting advice I've been so successful at it. So talk about and talk about your podcast and also back back to that biofilm you when you talk about diet that's another new thing. When I got out of school nobody talked about snoring sleep apnea diet but now no it looks like when you look in the mirror 90% of what you're looking at isn't even from your mom and dad it looks like that the microorganisms living from your mouth to your rectum might even be ninety percent of all the DNA inside you is that true?

Ryan: Yeah so I think it's 92% or something like that it's crazy we are bacterial planets and I am quoting that from Kim Koosh actually of all people but he's a really great guy. Yeah that's so that's his term I can't steal it from him but yeah so one of the things that's really really cool it kind of got me into this biofilm thing and specifically diet and oral systemic things is if you actually look at a lot of the journals and the data that's being published on this it's kind of miraculous. I mean there's actually just one the other day Howard for the related autism not sorry not autism, Alzheimer's - just poor hygiene right and so I think it was P gingivalis that they've said hey look we're finding this in in brain deposits and we're seeing that people who have an increased incidence of these in their brain are actually more susceptible to developing Alzheimer's which is absolutely crazy but yet diet has a big impact on you know how your oral health risk goes because if you're constantly consuming you know sugar or carbohydrates or things that are easy to digest for bacteria you're giving them a competitive advantage and I don't know about you and I really like coca-cola unfortunately for me but sipping on it's probably the worst thing you can do because you're constantly introducing substrate into your plaque and that plaque takes it up and then grows and multiplies and releases more acid but yeah there's just a lot of new theories and hypotheses on how biofilms work and one of the things that we're really looking at is pH. So one of the things that's interesting about this is when you actually start looking at biofilm pathogenesis we used to think there's one bad bacteria and there's a good bacteria and they're constantly in battle and that's necessarily untrue but what has evolved into is we've realized that those pathogenic switches are a little more complicated than that. So when you actually set up an environment that's acidic for example there's certain commensal organisms commensal meaning you know health benefits that actually have to adapt or die so one of the things that they end up doing to adapt is they really stress responses and when they do that they actually end up releasing acid as a factor in that so they actually will release acid to compete with things like S mutants and and lactobacillus to keep themselves alive. So now a commensal organisms that we thought was purely commensal is actually pathogenic in certain circumstances specifically when there's things to tolerate like acid or low oxygen or things like that. So we know that basically the biofilm is a constantly changing kind of apparatus and the longer it remains undisturbed or interrupted it can become more and more pathogenic and that's actually called the ecological plaque hypothesis. So it's really interesting to study because it's just it's just been a huge problem for us right I mean cause billions of dollars every year to do these fillings so that drill and film model and and on top of that prevention doesn't seem to really have caught up and so we need things that are going to be better at interrupting these biofilm shifts and lots of other you know components of acid for release and things like that. So biofilms are constantly changing our ideas about them are constantly changing but I think now I'm more in the modern camp of it really depends on the commensal or pathogenic nature of bacteria individually can change in a heartbeat. So you can't just label something as commensal anymore you have to say okay well under these conditions it's commensal but not under these conditions and so that's where the big shift has happened I feel like in the past a couple of years with with biofilms.

Howard: So you know I I want you to answer this question because my homies I get this from their patients all the time, kids sometimes water is boring and they want something fizzy and tasty what do you think is worse for you diet regular coca-cola with sugar or diet soda that's high in acid, if mom wanted to give her kids a treat which one's worse Diet Coke or regular coke?

Ryan: I would still say regular coke because sucrose is shown to be the most easily digestible you know substrate that are is and even compared to high fructose even though high fructose is more common than sucrose and our drinks now the DMFS I think it's like compares there's like a two or three der study that showed how many surface has got decay and I think the average for sucrose only was seven point two and I think high fructose is three point six xylitol is zero but the point is is depending on what you actually are taking up sucrose is the worst by far and high fructose isn't far behind. So I don't like a lot of the compounds and diet sodas you know they're they have a lot of natural alternatives now a stevia or monk fruit which is less cariogenic obviously like...

Howard: What is cariogenic?

Ryan: So stevia and monk fruit and some of these other natural on you know plant-based sweeteners.

Howard: What's your what's your favorite sweetener?

Ryan: I actually believe it or not really like xylitol don't mind stevia but stevia is still isn't as good as some of the polyols like xylitol and or erythritol not a huge fan of sorbitol, I think that one of the misnomers that so sorbitol is actually one of the most commonly used polyols in dental products well one of the things that people don't realize is S mutans and a lot of these other cariogenic bacteria can easily recognize or sorbitol turn it into lactic acid. So I think there's gonna I think we're gonna see a shift away from sorbitol in the near future you know I know Listerine and a bunch of other companies use it but yeah I actually just a hygienist submit a blog post for us objective about talking about this so sorbitol and versus xylitol benefits and the downsides but yeah if I'm going to give my kid a drink look it's great you can use diet i know some of those compounds like aspartame aren't very good for you if you can't then what you need to do is after that your kid has you know that sucrose challenge get them on xylitol product or rinse. I mean that stuff just neutralizes it.

Howard: Like what xylitol rinse, what would you recommend?

Ryan: Sure so I mean we have our product which we use 25% xylitol and so we use the clinically recommended amount I know their spry, spry has a great product I know Epic has

Howard: I'm on your website I see a cinnamon clove nanosilver mouth rinse for $19.99, wintermint honey sweet I don't see on products I'm not seeing xylitol.

Ryan: Scroll up to the main website and it'll have the five ingredients that we have so we have xylitol we have calcium...

Howard: Wait let me go to products okay I'm on

Ryan: and then just scroll down like halfway and you'll see it'll have a list of all the ingredients with pictures.

Howard: Okay Maxim say five simple ingredients nanosilver, calcium, xylitol, natural flavor, water. Okay so they're your those are your only five ingredients?

Ryan: Yep exactly keep it simple and believe it or not it's actually harder to keep it simple there's the thing basically what people don't understand is when you're making products it's actually hard it's actually harder to keep things out. One of the major issues with a lot of products is is shelf-life right and the reason why I think a lot of things are still acidic today is because it's much easier to kill bacteria in an acidic environment and so the reason why you see a lot of these products that are super super acidic is because they have to maintain the shelf-life over two years. So we got around those issues it took a lot of Engineering I believe we actually just recently got our two-year shelf-life testing done and it was great so we were able to keep everything where we needed to and worked out just fine for us but you won't find many alkaline rinses on the market for that reason but yeah so we use 25% xylitol and that's the clinically recommended amount and we always try and shoot between five to seven point five grams of exposure a day. So you only have to rinse two times a day with our product in order to hit that because we've got this xylitol at such a high level.

Howard: So you're on your website you quote the Wellness dentistry without Doug Thompson the wellness dentistry network is he a big fan of your staff?

Ryan: I'm not sure, I know I didn't make the website but I know that um there's been various dentists and people who have reached out 100% and we've had a lot of discussions. I couldn't tell you all their names but yeah we've gotten a lot of play in the market as far as people just wanting to know what it's about but also just trying to understand why people haven't done something similar in the past and so it's really come down to a lot about trying to innovate new things and really kind of questioning some of these paradigms about why we use acid in the first place. I'm sure one of the things that you've noticed in clinical practice is acid erosion is actually a really big problem so even if you don't get struck by decay I mean you get these ab fractions and erosion lesions just wears away your teeth so we really try and avoid using the acid because it's just so not good for your enamel.

Howard: Well you know what's funny even on Wikipedia it still says the jury still I don't want even causing that refraction I still meet dentist my age I think it's brushing back and forth veterinary dentists say well dude you see these an antelope and deer and cattle and then and then you have the occlusion people let's say it's the flexing of the tooth and it pops off at the neck. So what would you tell what cuca pedia causes fraction?

Ryan: So I mean from my clinical experience I definitely think bruxism and clenching and grinding has a huge thing to do with it I don't think you can ignore that because I mean even I've had some add fractions that I'm a mouth grinder and fortunately for me but yeah so it's it's one of those things that you definitely...

Howard: Are you married?

Ryan: Yes I am

Howard: So see what you do let's just say let's divorce for five years and see you at five and see if that stops then we'll have some good scientific evidence if marriage cause your bruxing but no I see it on 5yo kids you go to your friend's house and their grandkids taking a nap on the couch and he's five and he sounds like it's a bunch of marbles rolling around yeah and we weren't even looking out for that in the 80s I mean now now it's almost 2020 and you're sitting there it's hard to watch the game when some five-year-old sounding like he's chewing on marbles.

Ryan: So yeah you know it bruxism and kids is crazy right like I've actually seen a lot more believing in children and I think part of it is because the reclusive scheme is constantly changing. So if you look at kids when they're getting you know into that age of like six to eight where they start getting you know their molars and incisors in because the occlusal planes changing their bites distributed across less teeth this is those permanent teeth are erupting and I think that has a lot to do with how the bite you know changes and you can actually develop these really nasty bruxism habits and I don't know about you but I've seen a lot of kids that come in and they just have like really chipped or broken down or ground down teeth which which I feel like I don't know if you guys saw this earlier on because I mean I've only been practicing for five years but I think it's feel like it's getting worse but yeah I definitely think you know infractions and those lesions have a lot to do with grinding and bruxing but I do think there is something to be said about acid erosion. We have a lot of acidic things in our diet I don't think we used to and so we're starting to see a lot more of that kind of you know enamel erosion and it's definitely not good right.

Howard: So your your mouth wash that they're the pH of 8.2

Ryan: Yeah it's approximately 8.2 give or take

Howard: and what are like Listerine and then scope the two biggest ones they're like six points?

Ryan: You ready to have your mind blown Howard?

Howard: Yeah

Ryan: Take a guess well what do you think Listerine is?

Howard: 6.3

Ryan: No it's probably closer to like three point eight to four point five depending on the formulation.

Howard: Wow

Ryan: I just to give you an idea if you look at pH as a logarithmic scale every time you go down a pH point it's ten times more acidic. So just to give you an idea some of these are not only as close to acidic as soda because soda ranges in the range of like three point eight to four but it can be as high as five but the acidity of something that's at a pH of four is a thousand times more acidic than the pH of seven. So it's it's really really bad I mean these kids may as well be swishing around with soda and so that's the huge problem I actually recently just tested Tom's of Maine are you familiar tom's of Maine?

Howard: Right

Ryan: three point three eight is their pH and some people have even said it's it's two point eight and some of their experiments. So a lot of these rinses crest Colgate a lot of them are falling below the critical threshold of five point five and we know that below a threshold of five point five for most individuals is going to cause decay. So we know that there's going to be asked at erosion going on even with these rinses and so we've really kind of put under question be a situated model do we need it and why are we using it and that the answer was no and the second answer was we don't really need it you just have to be more innovative and find things that are gonna stabilize the shelf life without having you something so acidic.

Howard: That is amazing, so you think this is gonna, your mouth do you think... Shark tank questions, we went over an hour so if you were talking to shark tank you got the smartest guy on that show is obviously the bald guy Mr. Wonderful from Canada, Mark Cuban. They're gonna sit there and say I mean you do you think, Mr. Wonderful would say dude you can't compete with Proctor and Gamble and Gillette and Listerine or that you should license their technology to them that's what Mr. Wonderful will be telling you you just need a lawyer patents a protective motor on your business the best ones a patent and license it or are you gonna sit there and try to get shelf space and something like Walmart or Costco or Walgreens.

Ryan: Well we're in this for the long haul right like I didn't do this to just sell the company or do it just to make money. I think the thing is is you know yeah you could license the technology but I feel like a lot of these companies aren't going to be receptive to these changes until they see it making disruptions in the market right and so that's what we're trying to do. We're really trying to disrupt the market and say hey you guys need to be more innovative if anything comes out of this and that is positive for me it would be that a lot of these big companies turn around and say look we need something more alkaline if they come out with something and they say look we've done the research we made a new formula you're right we shouldn't be using such acidic you know you know rinses or preservatives or whatever that would be fantastic for me because then I can see that I made a difference right and I think a difference for the better but no I don't I think we have a really good shot at Procter and Gamble and a lot of these other companies because we can pivot faster because we're smaller so we can make changes faster we're definitely gonna be able to get into retail it is a competitive space but we have a lot of unique aspects of our product and our product lines that they don't have. So I do think it's gonna be somewhat of an uphill battle because they are the giant but I think just like anything right I mean if you stop innovating and you know and we saw this with GM I mean they became like a dinosaur right and so when you stop innovating and you don't do those things and you become too big it's harder to pivot it's harder to make changes and it's harder to stay competitive in a market that's constantly flexing right. So yeah we if anything I just want to bring some competition to the table let's have a let's have a marketplace of ideas discussion about what works and what doesn't and if people are really you know vibing with it and like what we've seen and with sales and everything like that then I think I think it's got a good shot. So I would disagree with Mr. Wonderful haha but yeah we're it'll take time obviously it's a business so it takes time to ramp up but I do think we have a good shot and at disrupting the industry and I think that's where we're heading.

Howard: So now your buddy now are you talking about this on Dentaltown?

Ryan: No I haven't I haven't been on Dentaltown in a little bit so I know I have I need to get on there Howard.

Howard: What about your buddy Matthew Mcallister?

Ryan: Yeah so he's on there I think he's I don't think he's a super super active at the moment because he's just been so busy but we need to we definitely need to we have we have user IDs on Dentaltown I'm sure I have one but yeah I know I was more active when I was a dental student a couple of years ago but I need to get back on there because it's such a great you know inventory of dentists and articles and all sorts of information but I do go to Dentaltown to look at different cases and things like that so it's it's a great resource.

Howard: Now is Matt your partner?

Ryan: Yeah so Matt Callister is my one of my founding partners but yeah he's a he's a great guy.

Howard: Well is their anything that you wish I would have been smart enough to talk about that I was too dumb to ask?

Ryan: No you've asked a lot of great questions man this clearly isn't your first podcasting gig so you know what you really know what you're doing. You know the thing is like I said I think you know just for dentist in particular I think you know just have an open mind, I mean I think I think a lot of things are gonna be changing here pretty shortly and I think it's time as dentists that we kind of push for these changes ourselves. We got just kind of frustrated with this idea of kind of letting these big guys push around us the little guys and tell us what what's good for us and what's not. I think people are sick of that and so they they want to see some change and they want to see things that actually work and and so I think we're gonna be pushing for that and I think it's it's a great and I'd like to thank everybody who definitely has helped us along the way but ya know yeah it's been a great interview so thank you so much for having me on and if you're if you're want to look it up our websites and my user handle is @ryannolandmd on Instagram and I think we're @elementaoralcare on Instagram as well. So thanks thanks so much for having me on Howard, really appreciate time man.

Howard: and if you go to Amazon because I know my homies I the one thing about dentists they all have iPhone as opposed to Android, it's just rich countries especially United States Canada, Australia, New Zealand, Western Europe, Saudi Arabia and they're also on Amazon Prime so you go to Amazon Prime or Amazon you type in an Elementa silver and it says dentist formulated nano silver xylitol mouthwash with calcium pH balanced enamel oral rinse alcohol fluoride free and by the way you go to Dentaltown and when you make a post you know you know what a youtube deal says share it has a link but the next button over is embed so you click that you go to Dentaltown there's a YouTube button when you post you dropped in the embed and there's your YouTube video and people that only have two or three hundred views on a YouTube video will post on Dentaltown it'll go into the thousands but yeah and in your signature some of these people in their signature have a link to their Instagram page or Twitter or whatever but man I respect you so much. I mean you came out of dental school and instead of sitting on an operatory assembly line Monday through Friday 8 to 5. I felt the same way you did when I got at school my first experience was like I graduated May of 87 then October of 87 the damn market crashed a quarter and things were slow and I'm sitting here doing all these pulpotomies and chrome steel crowns and realize that Phoenix was unfluoridated and I just felt demoralized that I was gonna drill, fill and Bill Monday through Friday 8 to 5 times 65, when water fluoridation would have been so much better so I blocked off every Friday for two years and started the Arizona Citizens better dental health we fluoridated Phoenix and it gave me more purpose, it gave my team more purpose it just made us so much more passionate. I just really think it's so cool that you got out of school and you've already cut drill fill and bill on to one day a week because you think it might be a macroeconomic way to reduce more decay than drilling them with your hands on a human one-on-one. So I and everybody with a brain cell what it told you shut the hell up and you get back to work Nolan, you either either fix your name and be the baseball player Nolan Ryan and go play for the Diamondbacks or our Ryan and what's so cool is that you followed your dreams and said no I don't think I mean they've been drilling and filling and billing since a Pierre Fauchard and GB black and you're gonna do something and you started this Elementa, The Biofilm Factor podcast. I just think you're you're cooler than the bee's knees Ryan thank you so much for coming on the show -

Ryan: Thanks man I appreciate your time yeah I appreciate all your comments too yeah it is you're absolutely right so hey thanks again I appreciate Howard.

Howard: All right buddy next time you and your buddy matter in Phoenix I call me a little of a beer and I eat some cheeseburgers and you can tell me what my oral plaque is after an oral bacon cheeseburger all right buddy take care. 

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