A New Understanding of Our Oral Health: A Conversation with Dr. Kourosh Maddahi.

A New Understanding of Our Oral Health: A Conversation with Dr. Kourosh Maddahi.

Award-winning Beverly Hills dentist Dr. Kourosh Maddahi has been one of Beverly Hills premier cosmetic specialists for over three decades. During that time, he has developed his practice to create a truly one-of-a-kind experience for people looking to transform their smiles.

After 28 years of practicing dentistry, and treating over 6,000 patients, Dr. Maddahi realised that even with great oral hygiene practices, his patients were suffering from persistent problems. This led him to challenge traditional oral care products that claim to kill 99% of all bacteria, relying on harsh chemicals and alcohol. He set out to create a product without harsh chemical ingredients for his patients. What originally started as a small batch of mouthwash for his practice, eventually grew into an extensive product line, now known as Lumineaux.

In this interview, I speak to Dr. Kourosh Maddahi about the new understanding of our oral health, how critical oral health is to our overall physical and mental health, and what we can do to improve our oral health.

Q: Where did you get your passion for dentistry?

[Kourosh Maddahi]: I think the story is a simple one. When I was around 13 years old, I decided I wanted to be a dentist and it was based on two main factors, the first one being because I love to work with my hands and second, I love to problem solve. So it was either becoming a surgeon, and my uncle was a general surgeon and he didn’t have much of a life. He was constantly being called at all hours of the day, and I didn’t want that. And so dentistry was sort of the natural next thing and that passion to work with my hands and problem solve has carried me through for now 36 years.

Q: Why have our teeth become such an important part of our aesthetic?

[Kourosh Maddahi]: To really understand the importance of teeth in terms of the aesthetics, that took me a while. I think what brought it all together for me was a research study that was done which showed that the first impression is the smile and is the teeth. What they found was that people thought the person with the whiter, straighter teeth looked healthier, younger, more well educated. Just the teeth. Same person. Whiter, straighter teeth. Everything else was the same. Same makeup, same dress and I think that actually brings it to a really good point of understanding that the rest of your face is sort of the frame.

I used to do a lot of makeover shows and what people told me repeatedly was that their smile was most impressive even though the person was doing a facelift, hair and makeup, removed their glasses and I was surprised by that.

Q: What is the role of our oral health, as part of our physical health?

[Kourosh Maddahi]:  Overall it is huge because the gateway to your body is actually your mouth. I don’t think you can find any other organ in the body that has correlation with so many other organs than the mouth. Research has been widespread, and over the past 30 years, gum disease has been linked to heart disease, to colorectal cancer, to diabetes, to all sorts of issues within the body. A lot of risk factors linked to death, stroke, the diabetic sections and everything else, the risk factor, one of them, is gum disease.

I think the reason why it’s so underappreciated is because people don’t look at toothpaste and mouthwash, anything that they do an everyday basis. They basically use what their parents used. They don’t really pay any attention, but yet they pay attention in terms of should I eat this type of food, that type of food, gluten free this and my gut health and all of these different things, but they’re not really looking at the link.

[Vikas: What about our oral microbiome?]

[Kourosh Maddahi]:  Yes, what I always try to do to get people to really understand something, I always try to give a brief background to what is a microbiome, first of all. So a microbiome is a series of microorganisms mainly made up of bacteria, but there is viruses and fungi also in there. And what they do is what is so important. And the reason why I really locked in to why is a microbiome so important was this – how did we survive for thousands of years without modern medicine? What was it that we inherently had that was protecting us? And as I went deeper and deeper in that area and in that research and in that study, what I came up with was microbiome. Now, why would the microbiome fit this broad question of how did we survive? Because microbiome is in our eyes, is in our ears, is in our nose, is on our skin, is in our gut, it is in our mouth and it is in the birth canal. So now if you look at it from that angle, your skin covers your body. So it has microbiome, your microbiome covers your eyes. Yeah, the microbiome covers inside your ears, inside your nose, inside your mouth. So you see all areas that are exposed are then covered by microbiome. So, okay, now you’ve got the microbiome that’s covering every exposed area of your body. Now the next question is what does it do? And the simple mechanism of a microbiome is a simple one. It protects you against infection and disease, so it protects you. How does it protect you? Because in this microbiome, there’s such a great number of healthy, good bacteria, what it does is suppresses the bad bacteria to a level that is not destructive, but it can help the immune system produce the antibodies against those bad bacteria and viruses so that if the volume of it goes up, there’s antibodies there for the immune system to actually destroy it. So that’s how it’s protected. Then the other way that it is protecting you is even more simple than that, taking up real estate. In order for bad bacteria and viruses to come in and grow, they have to attach to something. Visualize you have Manhattan. It’s very difficult to find an empty land to actually build something. Next visualise destroying Manhattan, then anybody and everybody could come into Manhattan, gang members, everything. They can, and they can build stuff. But when it is all full, it’s very difficult for them to come and build anything. The microbiome is taking up space, so it is not letting the viruses and the bad bacteria come, adhere to the tissue and then grow. To conclude these are the two mechanisms. It’s very simple.

Q: How did you begin your entrepreneurship journey?

[Kourosh Maddahi]:  The oral care industry and oral products is mainly made out of three or four companies that control 90% of oral care products in the world. All multibillion-dollar, multinational companies. I don’t think these companies are stupid. They are run by very intelligent people, but I think the premise has been wrong and I want to explain this, so that we really understand why this has come about. What do we know at the moment? Most of the issues in the oral cavity are caused by bacteria. Cavities are caused by bacteria. Gum disease is caused by bacteria, and bad breath is caused by bacteria. So the simplest thing was, let’s go kill the bacteria. So then you wouldn’t have gum disease, you wouldn’t have cavities, you wouldn’t have bad breath. But what we found out is that even though all these products that even advertise ‘it kills 99.9% of the germs’, still you have cavities, still you have gum disease, still you have bad breath. So, it’s just not that simple. If it was that easy to kill all the bacteria, then the problem would have been solved and we wouldn’t be sitting here discussing this. However, what we have found in actuality is that has not resolved the problem. We have also found is that if you destroy bad bacteria, within the cell wall of the bad bacteria, there are toxins. So you have a dilemma. The dilemma is this. Bad bacteria secretes toxins that destroys the enamel, which is the cavity, secretes toxins that destroy the gum and the bone. That’s why you have gum disease and also produce Sulphur compounds so that’s why you have bad breath. So it is the by-products they produce. The toxins that they produce is the problem. If these don’t exist or are destroyed then you have another type of toxins that are also produced.

The dilemma is if you don’t kill them, you are going to have toxins being produced that is destroying everything. And if you kill them, you’re going to have toxins as well. Therefore I concentrated on and what brought this whole thing for me, was a particular study that was done by my co-founder, actually, Dr. Hessam Nowzari. It was a ten year landmark study with homeless kids in Manila. These people were infected with a type of bacteria called AA bacteria that infects one and a half billion people worldwide. It has a very particular characteristic. It affects the four upper and four lower front teeth, and the back molars.  The rest of the mouth is completely healthy. It destroys the bone and the gum around those teeth. So, it has a very particular characteristic. What he asked these homeless kids to do was to rub sea salt on their gum and they followed them for ten years and what he found is that the disease stopped. But the AA bacteria was still there. This is the first glimpse of it’s not the bacteria, it’s the toxins. So what we found with our formulation is how to actually neutralise the toxins without killing the bacteria. That’s the Holy Grail – not to kill bacteria, but neutralise the toxin. That is what my products do, and that’s how we came about it.

We have done 62 clinical studies and we are doing more constantly every year to take on and to really understand why microbiome is so important. How could you have a product that is actually non-toxic and the word non-toxic means that it doesn’t kill healthy cells. We are certified non-toxic which means that we do not kill any bacteria, so we are microbiome safe. At the same time, our hero product, which is our whitening product, it whitens teeth without peroxide. Peroxide is the key ingredient that’s been found to whiten the teeth, but it causes sensitivity and gum irritation. If overused, you can cause enamel damage. We found an alternative and healthier way to do something – with coconut oil, sage oil, lemon peel oil instead of peroxide to whiten teeth.

Q: How can our lives be transformed by switching to a new oral health paradigm?  

[Kourosh Maddahi]:  I think at heart I’m a scientist, so I test thoroughly. I want to make sure every statement that I make is something that’s been tested and proven.  So what we found is – Cardiovascular disease, for example, we are not finding the bacteria that are causing gum disease in heart disease. The question is, if those bacteria is not there, what is the correlation? The correlation was inflammation. Next question is, how do we transfer the inflammatory markers to the heart? So this is what we started to look at and the type of inflammatory markers, TNF alpha and also the immunoglobin B. So we started to look as to, with the products that we have, in sort of the wall between the gum and the tooth. There is a particular fluid called crevicular fluid. Within this crevicular fluid lies the inflammatory markers. So when you have gum inflammation, the gum inflammation markers are within this fluid. Now when you have gum inflammation, that means their gums bleed. Because the gums bleed, that means there is a way for these inflammatory markers to get into your body and hit the different organs. So we don’t look at things in a very superficial manner. We have to follow the entire pathway and understand the pathway for us to say okay, now we have something. So what then we did was ,we started to do studies with people that had inflammation in their gums. So, they have gingivitis or gum disease. We had them on our products for 30 days and then we started to look at the volume of their inflammatory markers within their crevicular fluid, and we saw significant reduction.

TNF Alpha and Immunoglobin B is key to asthma. Key to a lot of different autoimmune disease also, there’s inflammatory markers that go all over the body. Now the question becomes why is the mouth so important? Here it is. Things are absorbed through the tissues of your body, that’s the reason why, when somebody is having a heart attack, they tell them to put two nitroglycerine pill underneath their tongue, because the rate of absorption within those tissues is faster than if you swallow it. The reason is because it is absorbed via the blood system.

We did a study that we were using a very famous mouthwash brand that has colour. All mouthwashes, as you know, have colour. Green, purple, blue and all of that and most of them have alcohol. We had them rinse with the mouthwash for 60 seconds as directed and we found within 60 seconds that dye was already in the blood and the alcohol was already in the blood. Because the alcohol, it’s a very specific type of alcohol, it’s called a denatured alcohol, which is worse than actual alcohol because it’s poisonous.

Whatever’s happening in the mouth can get absorbed through the tissues. It can be swallowed and go into your stomach. Or another route is, if you have any inflammation through the inflammatory because of the bleeding of the gums can get into your blood system. Once it’s in your blood system, guess what happens? It goes to every organ. So that’s why there is such correlation. So, the inflammatory marker is one.

Let’s talk about microbiome. We started to see a correlation between destruction of microbiome in the mouth and change of microbiome in the gut. Ideas started to develop. The microbiome that’s closest to the gut in terms of diversity is the one in the mouth. The gut microbiome is the most diverse. The second most diverse is the one in the mouth. What we found, if you continually destroy the microbiome in the mouth, you are going to have problems in the gut as well.

[Vikas: Therefore Smoking and excessive alcohol and certain other foods can be so dangerous because they will be absorbed directly into your bloodstream?]

[Kourosh Maddahi]:  That’s exactly right. That’s why they check for alcohol level with breath, but also with the blood test. What’s your alcohol level? This is a blood test. So it’s getting absorbed into your body.

Q:  What are the few things that you wish all of us would be doing right now to improve our oral and physical health?

[Kourosh Maddahi]:  The simplest one, I’m going to start with the low hanging fruit. Do not use anything that destroys the microbiome in your mouth. Change the toothpaste. Change the mouthwash. Mouthwash is key. Use mouthwash twice a day, it’s a key.  Because your teeth are only 24% of your mouth. There are tissues. Mouthwash would be a key part of it. I don’t know of any other product that is certified non-toxic and also microbiome safe and everything, such as Lumineux.

The second part of it, I would say, is the dietary aspect which would be the sugar intake. Exercise is a key component of a healthy and living and then when we get into food, you have to understand when you are using pesticides. Pesticides are an issue because they are antimicrobial and antibacterial. Anything that is organic would be better. Alcohol destroys the microbiome. So you have to really make sure how much alcohol you consuming. In terms of meat, again no hormones and no antibiotic is the key. In terms of chicken, beef, all of that.  There are enough resources now that you can have this type of food, but these would be in terms of the paradigm or in terms of a pyramid of different things that you can change, these would be the simplest.

Q: What does legacy mean to you?  

[Kourosh Maddahi]:  I think the best question that can be asked would be, what do I want my legacy to be? What is the purpose of this company? What is the purpose of being a dentist for 36 years and wanting to start up a company? I want to tell you, to want to start up a company as consumer packaged goods, and your competitors are multi-billionaires. You’ve got to be crazy !  You’ve got to be out of your mind. It’s so difficult, it’s so costly, but it’s the passion. It’s the same thing that a singer, no matter how many times they get rejected, they continue to sing. So for me, the legacy is I want to change the oral care industry. We have to get away from toxic ingredients, chemicals. We have to stop killing bacteria. We have to stop using peroxide as a whitening agent. That’s the goal. The driving force behind everything I do is to disrupt the oral care or product category and change it to non-toxic and microbiome safe products and this has already happened with skin care products. Skin care products used to kill all the microbiome of the skin, they no longer do because they went to clean ingredients.

Our whitening strip is actually on the Amazon UK market, and we are hoping that we will be all over Europe. We are in the last stages of EU certification. So definitely we’re going to be everywhere in Europe.

Thought Economics

About the Author

Vikas Shah MBE DL is an entrepreneur, investor & philanthropist. He is CEO of Swiscot Group alongside being a venture-investor in a number of businesses internationally. He is a Non-Executive Board Member of the UK Government’s Department for Business, Energy & Industrial Strategy and a Non-Executive Director of the Solicitors Regulation Authority. Vikas was awarded an MBE for Services to Business and the Economy in Her Majesty the Queen’s 2018 New Year’s Honours List and in 2021 became a Deputy Lieutenant of the Greater Manchester Lieutenancy. He is an Honorary Professor of Business at The Alliance Business School, University of Manchester and Visiting Professors at the MIT Sloan Lisbon MBA.