Here are a few of the most relevant research and/or documents regarding Breathific



Since the mouth is the beginning of the gut, and digestion begins in the mouth, dental problems can be considered a dysbiosis much like certain gut problems (IBD irritable bowel disease, SIBO Small Intestine Bacterial Overgrowth, etc.) I like to call gum disease “Irritable Bowel of the Mouth”. Traditional therapies to try to kill 99% of germs and/or prescribe antibiotics are falling out of favor due to tendencies to kill too many good along with the bad and potential for developing resistant strains of pathogens. I’m not against traditional therapies if really needed, but I think we would be better off to try to solve things naturally – or, after killing off 99% of germs, at least try to repopulate with known good microbes instead of leaving things to chance.   

Featherstone JD, Fontana M, Wolff M. Novel Anticaries and Remineralization Agents: Future Research Needs. J Dent Res. 2018;97(2):125127. doi:10.1177/0022034517746371


The dental caries disease process is a balance of biofilm dysbiosis, fueled by increased access to frequent sugars/carbohydrates, and the prevention or reversal of noncavitated lesions by enhanced remineralization. Caries risk assessment tools are available and will be improved further in the future. Novel approaches to biofilm modulation, remineralization therapies, and caries management are in progress and well advanced, and many more promising strategies will be available as research continues. The extension of knowledge and appropriate skills to other health care providers, together with enhanced electronic health records and registries to improve interprofessional care, will be essential to reduce the large disparities in dental caries around the world. Some of the barriers to success include difficulties associated with behavioral change, the ease of access to cheap sugars and carbohydrates, the cost of clinical trials for testing interventions, the need for a major change in the way caries management is approached by the dental profession (away from restoration of the consequences of the disease to management of the disease throughout the lifespan), and the financial support for this paradigm shift.




A nice report showing the benefits of dental probiotics

Cannon ML, Vorachek A, Le C, White K. Retrospective Review of Oral Probiotic Therapy. J Clin Pediatr Dent. 2019;43(6):367‐371. doi:10.17796/1053-4625-43.6.1

Purpose: There have been many in vitro studies reporting on the efficacy of probiotic bacteria in inhibiting pathogens, and there have been published studies reporting on the inhibitor effects of probiotic bacteria on the salivary levels of bacterial pathogens. However, there have not been but a few studies on the clinical benefits of oral probiotic therapy. 

Conclusion: The tested probiotic supplements had a statistically significant effect on the caries experience of the enrolled subjects.



This report evaluates several dental probiotic lozenges and found only one to satisfy certain criteria. The problem is that all of the dental probiotic testing to date has been done with tablets, lozenges, powders, drinks, chewing gums, and even strings tied around teeth and tiny, slow-dissolving chips placed in the gums. These methods are not the correct methods to be used for delivering dental probiotics. All these methods are inadequate to allow the freeze-dried organisms enough time to rehydrate, adapt, repair, find food, grow, and replicate (it takes about 2.5 hours!). So, no wonder the reports on dental probiotics are still somewhat guarded. I am the first one to develop a dental probiotic strip and also with prebiotics. Furthermore, since my product is a strip, it is not bulky like a lozenge, so it can be used safely, discreetly, and unobtrusively while sleeping. Use during sleep is also the best time to deliver dental probiotics because people are not salivating a lot, nor swallowing too much. Essentially, the mouth is like an incubator at night. So, why not promote the growth of good microbes while sleeping, so they can displace and fight the bad bugs. After all, most people tend to grow billions of bugs overnight anyway, which results in morning dragon-breath. And nighttime is the main time for oral bugs to replenish, so let’s replenish good ones.

Banas JA, Popp ET. Recovery of Viable Bacteria from Probiotic Products that Target Oral Health. Probiotics Antimicrob Proteins. 2013;5(3):227231. doi:10.1007/s12602-013-9142-2


~~ This investigation did not address whether any of the tested brands could accomplish the health claims made by the manufacturers. Consequently, we cannot say definitively that the relative yields of viable bacteria are a determinative variable in the efficacy of the product. Still, we anticipate that the probability of a beneficial effect is at least somewhat proportional to the availability of viable bacteria, being the basis for recommended daily dosages of a billion to 10 billion organisms. Based on this criterion, only Udo’s Choice meets the dosage recommendation. It is possible that effective dosages will be less for oral applications than intestinal applications since the bacteria do not have to survive the low pH, bile acids and other anti-microbial components in the alimentary canal. However, the rapidity with which dehydrated forms of the bacteria revive within the oral cavity is uncertain and may influence the effective dose as well. For the oral health studies included in the cited review articles [46], most utilize at least 108 organisms. Those studies employed various probiotic species and targeted oral health both on mucosal surfaces and teeth. Variations in effective dosages will almost certainly occur based on the intended application and the properties of individual probiotic strains, but the current state of knowledge dictates that efficacy be established using dosages and deliveries that are balanced between ensuring at least temporary retention at the target site and avoiding an immune suppressive effect.



The use of probiotics in periodontal disease prevention.


Ketaki Kanade*., Nilima Landge., Amita Mali., Amit Chaudhari

and Priyanka Agarwal

Department of Periodontology, Bharati vidyapeeth Dental College and Hospital, Pune

ABSTRACT The interest in probiotics and the modulation of the microbiota for restoring and maintaining health have gained a lot of attention over the past decade. Researchers have been keenly investigating the beneficial effects of probiotics on human health and focusing upon the different mechanisms, such as their ability to compete with pathogenic microorganism for adhesion, to antagonize the pathogens, or to modulate the host’s immune response. This has led to a widespread use of probiotics in the management of systemic infections and disease. In the field of periodontics, probiotics have come up as an attractive alternative to antibiotics. They target particular periodontal pathogens, thus increasing the long-term success of periodontal therapy. This review evidence the use of various probiotic strains in periodontal diseases.


Recent advances in technology have led to a constant drive to develop novel strategies for the treatment of periodontal diseases. The probiotics concept essentially entails the introduction of specific viable microbial species in order to confer health benefits upon a host by functioning via different mechanisms. The literature review shows that use of oral probiotics is associated with improvement in periodontal health. However, the effects of probiotics on periodontal health and its maintenance including means of administration, dosage and safety aspects are not clear. Numerous randomized clinical studies will be required to clearly establish the potential of probiotics in the prevention and treatment of periodontal diseases. There is no doubt that with further significant progress, probiotics may have an important role to play in the near future within the periodontal arena.



The use of probiotics in caries prevention. They discuss compliance problems. But what could be easier than merely placing a time-release strip in your mouth and going to sleep!

Cagetti MG, Mastroberardino S, Milia E, Cocco F, Lingström P, Campus G. The use of probiotic strains in caries prevention: a systematic review. Nutrients. 2013;5(7):25302550. Published 2013 Jul 5. doi:10.3390/nu5072530


The use of probiotic strains for caries prevention showed promising results even if only few studies have demonstrated clear clinical outcomes. Therefore, the scientific evidence is still poor. A continuous regular almost daily intake is probably required; this may be a compliance aspect to be considered. However, for all products effective in caries prevention (i.e., fluoride and chlorhexidine) a frequent intake is required, so a possible way of administration could be to insert probiotic in other daily preventive products like toothpaste.



This article discusses the potential benefits of synbiotics, which are prebiotics plus probiotics. Its interesting because I had already developed a dental prebiotic/probiotic lozenge in 2016. But, in 2017, when I got requests for a strip, and I saw the benefits, advantages, and safety of a strip, so I took my lozenge off the market and focused on a strip. Now I know why there was never a successful probiotic strip before – because it was extremely hard to make. Two weeks ago, I called the main author and told her I was coming out with a dental synbiotic time release strip, and she was excited. She had not heard of such a thing yet. She wants samples when I’m ready to produce.


Zaura E, Twetman S. Critical Appraisal of Oral Pre- and Probiotics for Caries Prevention and Care. Caries Res. 2019;53(5):514‐526. doi:10.1159/000499037


In recent years, the concept of preventing caries-related microbial dysbiosis by enhancing the growth and survival of health-associated oral microbiota has emerged. In this article, the current evidence for the role of oral pre- and probiotics in caries prevention and caries management is discussed. Prebiotics are defined as "substrates that are selectively utilized by host microorganisms conferring a health benefit." With regard to caries, this would include alkali-generating substances such as urea and arginine, which are metabolized by some oral bacteria, resulting in ammonia production and increase in pH. While there is no evidence that urea added to chewing gums or mouth rinses significantly contributes to caries inhibition, multiple studies have shown that arginine in consumer products can exert an inhibitory effect on the caries process. Probiotics are "live microorganisms which when administrated in adequate amounts confer a health benefit on the host." Clinical trials have suggested that school-based programs with milk supplemented with probiotics and probiotic lozenges can reduce caries development in preschool children and in schoolchildren with high caries risk. Due to issues with research ethics (prebiotics) and risk of bias (prebiotics, probiotics), the confidence in the effect estimate is however limited. Further long-term clinical studies are needed with orally derived probiotic candidates, including the health-economic perspectives. In particular, the development and evaluation of oral synbiotic products, containing both prebiotics and a probiotic, would be of interest in the future management of dental caries.





From the 2000 first ever US Surgeon General’s Oral Health Report. This report is a goldmine of information, and we have known much of this stuff for >20 years, yet most of the public still doesn’t know tooth decay is an infection!!! Dental problems are the 2nd most common human affliction and the #1 chronic illness in children. Dental problems in general are a silent epidemic.

 Donna Shalala



Information about the upcoming 2020 US Surgeon General’s Oral Health Report.

 Oral Health report


 Surgeon General


 Below are my emails to the NIDCR regarding my contributions to the upcoming 2020 SU Surgeon General’s Oral Health Report. If you watch the Surgeon General’s video requesting contributions, it’s almost as if he’s pleading with anyone and everyone to submit ideas because the state of America’s oral health is almost a hot mess. In fact, I know Dr. Harold Slavkin, former director of the NICDR. He was my Craniofacial Biology professor in 1982-83 at USC Dental School. He was also the Dean of USC Dental School.  Dr. Slavkin and I had lunch about 7 years ago. He told me then that dental health in America is a mess. He said that the #1 dental treatment in America, at least about in 2013, was tooth extraction.


Your Submission to the Surgeon General's Report on Oral Health 2020


Pitt, Michelle (NIH/NIDCR) [C] <>

Wed, May 29, 2019, 10:47 AM

to MichelleBruceJudithjudith.albino@cuanschutz.eduSue

Good afternoon all,


Once again, we want to thank you for commenting on the Surgeon General’s Report on Oral Health 2020.  All persons and organizations who commented will be recognized in some portion of the report.  Many of you also wrote to us about innovations in access, prevention, and treatment, and we are going to highlight a few of these in the report.  To prepare for our writers and editors to select from among the many interesting submissions, the NICDR Science Evaluation Officer, Dr. Sue Hamann, is reviewing the submissions.  She will want to speak with some of you about your submissions, particularly about the program status and evaluations you have conducted.  Sue will be reaching out by email or phone during June to August, and she looks forward to working with you.


Our team is making good progress on the report, and we appreciate your interest and involvement.



Michelle Pitt, M.Sc. | Scientific Project Manager


Office of Science Policy and Analysis

31 Center Drive, Rm. 5B55

Bethesda, MD 20892-2190


O: 301-451-6502


Acknowledgment of individuals/ agencies who submitted comments for 2020 Surgeon General’s Report on Oral Health


Pitt, Michelle (NIH/NIDCR) [C] <>

Thu, Mar 5, 2020 at 8:14 AM

To: "Boroumand, Shadi (NIH/NIDCR) [C]" <>

Cc: "Dye, Bruce (NIH/NIDCR) [E]" <>, "" <>, "Albino, Judith (NIH/NIDCR) [C]" <>, "Hamann, Sue (NIH/NIDCR) [E]" <>

Good morning,

As you are aware, over the past year we have been developing the 2020 Surgeon General’s Report on Oral Health.  We greatly appreciated receiving your comments during the public comment process, and we would like to acknowledge each contributor by name, degree(s), organization (as applicable), and state. For example:


Acknowledgment of a person representing an organization: first name, last name, degree; organization (or institution or agency or company); state.

Acknowledgment of a person representing himself or herself: first name, last name, degree; state. 


Representing an organization means to us that you were writing on behalf of that organization, that is, expressing the opinions or positions of the organization and not necessarily your personal opinions, and some of you would have needed approval to represent the organization. If you were expressing your own opinions or did not have the authority to write on behalf of the organization, we want to acknowledge you as an individual, representing yourself.

The acknowledgments will most likely be placed in an appendix of the report.


Please let us know how to acknowledge your contribution by sending an email to Dr. Boroumand at . If you do not wish to be acknowledged, that is fine – just let us know.

 Please respond by 5 pm on March 20, 2020.



Judith Albino, PhD and Bruce A. Dye, DDS, MPH

Co-Leads for the 2020 Surgeon General’s Report on Oral Health

 Michelle Pitt, M.Sc. | Scientific Project Manager

Office of Science Policy and Analysis

31 Center Drive, Rm. 5B55

Bethesda, MD 20892-2190


O: 301-451-6502





RE: my contributions toward the new 2020 Surgeon General's Report on Oral Health


Steven Edwards <>


Mar 5, 2020, 9:33 AM

to boroumands

Hello Dr. Boroumand,

My name is Steven EdwardsDDS of RENUzORAL, LLC, based in California.

Last year I contributed some ideas to the 2020 Surgeon General's report for new technology to fight dental problems.

I'm proud to say that in collaboration with an excellent researcher and manufacturer, Dr. Norbert McMullen ODF NUTRA in Quebec Canada, my ideas will finally come to light in March or April 2020.

The concept I proposed is a new way to deliver dental probiotics intraorally, via time-release and extended-release oral adherent edible strips that can last up to 8 hours and can be used while sleeping.

In this way, dental probiotics can finally stay in the mouth for extended periods and actually do their work in the mouth for hours, instead of being swallowed in 15 minutes.

Thank you for the opportunity to contribute my ideas to an excellent cause -- fighting the scourge of dental problems.

Best regards,

Steve Edwards, DDS


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