11 days ago • Comments on a post

Hi! That's a great question that we've heard more than once. We're compiling the data, and so far we simply don't have enough data around water flossing vs string to draw any conclusions. In general, it definitely appears that any flossing is better than none with a caveat:

There are flossing "responders" and "non-responders" that we are looking into and hopefully we'll have another post to share soon. It appears that the oral microbiome may be able to predict whether flossing (or perhaps water flossing) actually improves your health because for some it does not have as much of an effect as others.

11 days ago • Comments on a post

This is an excellent anecdote for exactly why we are building Bristle. We're finding more and more that oral health is not a one-size fits all. I'm glad you've been able to find something that works for you.

If you look closely at the data from the blog, there are flossing "responders" and "non-responders". I'll have some follow-up data published about this soon, but we've been able to define oral microbiome archetypes that we're using to predict which oral health regimens may actually work for you. There are some people who never floss and still never get gum disease or caries, and unfortunately some who do everything they can with no improvement.

11 days ago • Comments on a post

cofounder at Bristle here. Unfortunately there is a lack of data around the efficacy of behavioral, lifestyle, and product interventions on oral health despite decades of dentists telling their patients to "brush and floss more". We decided we would share some of our findings with the community in an effort to shed some light on the importance of the oral microbiome in oral health.

11 days ago • Created a post

The effect of flossing on the oral microbiome, gum disease, and bad breath

35 points • 19 comments

1 month ago • Comments on a post

I’m glad you brought up the history of halitosis and marketing. In fact, the oft recommended twice-per-year visit to the dentist began as a pepsodent ad! It turns out that in low risk individuals, the frequency of dental cleaning and checkups did not improve oral health outcomes.

https://evidence.nihr.ac.uk/alert/dental-check-ups-every-six...

Now onto halitosis. Intra-oral halitosis is caused by volatile sulfur compounds and volatile organic compounds that are generated by microbes in the mouth: aka the oral microbiome. A number of studies have shown that halitosis is associated with specific bacterial species that have been shown to create these compounds both in vivo and in vitro. A good review on the subject is here:

https://pubmed.ncbi.nlm.nih.gov/32748883/

A number of clinical trials aimed at the efficacy of mouthwashes, probiotics, probiotics, lozenges have even been published. The general consensus is that mouthwashes offer temporary relief (through broadly decreasing microbial burden), and some probiotics are effective long term, but there is still much to uncover in this space as community dynamics of the microbiome are complex.

https://pubmed.ncbi.nlm.nih.gov/30834725/ https://pubmed.ncbi.nlm.nih.gov/27508274/ https://pubmed.ncbi.nlm.nih.gov/31799694/

1 month ago • Comments on a post

Regular oral hygiene is a decent predictor of oral health. However this does not explain why the incidence of caries and irreversible gum disease are so high. Almost half of all Americans have some form of gum disease, which we can predict using the oral microbiome, which are the same people that regularly see a dentist and have “normal” hygiene habits.

Let’s stop normalizing reactive medicine and start thinking about personalized preventive approaches to health. There is no one size fits all approach to your systemic health, and the same applies to oral health.

1 month ago • Comments on a post

Depending on your oral microbiome, there are more specific mouthwashes that primarily target anaerobic species that are implicated in diseases like gum disease and halitosis. Fluoride is highly effective at reducing caries incidence, but some newer ingredients also exist (such as nanohydroxyapatite) with high clinical efficacy if you worry about fluoride overexposure.

Additionally, depending on your oral microbiome, and your risk for oral disease, we recommend other products that can reduce your risk of disease and prevent the outgrowth of species implicated in oral disease.

Unfortunately we don’t ship to Australia yet! Someday soon I hope!

1 month ago • Comments on a post

This is because of negative impacts that broad antimicrobials have on your oral microbiome. These mouthwashes essentially burn away your microbiome and allow for new species to repopulate the niche. Many times this means that anaerobic species that cause halitosis can come fill in the space.

1 month ago • Comments on a post

Not directly related, but Listerine and other broad antimicrobial mouthwashes have been shown to have a negative impact on the oral microbiome similar to how antibiotics cause dysbiosis in the gut.

At Bristle Health, we advocate for products that foster an environment that supports your oral microbiome rather than destroy it, as it’s crucial to both your oral and systemic health. You can find more about our research here:

www.bristlehealth.com

1 month ago • Comments on a post

Might be related, but mouthwash use is correlated with a drop in systemic nitric oxide levels due to the negative impact on the oral microbiome. You can find a review here:

https://pubmed.ncbi.nlm.nih.gov/35081826/

At Bristle (oral microbiome testing) we advocate against broad antimicrobial mouthrinses as they can negatively impact your oral health similar to how antibiotics cause dysbiosis in the gut.

3 months ago • Comments on a post

The associations between gut microbes and disease may be valid, but simply not actionable. The gut has incredible size, and is thousands of niches rather than a bag of marbles.

The oral microbiome, however, is an entirely different story. Decades of research show causal links between oral bacteria and disease. And it’s readily accessible so it can be easily tested and modulated.

Let’s stop using “microbiome” to describe the gut only. The gut microbiome may be full of overhyped studies, but the oral microbiome or the skin microbiome are entirely different stories.

3 months ago • Comments on a post

Bristle (YC W21) | Software Engineer | San Francisco Bay Area, San Diego, US | REMOTE | Full Time | https://www.bristlehealth.com/

Bristle is a consumer wellness biotechnology company that leverages genomics and the oral microbiome to detect oral disease before the onset of irreversible symptoms that require expensive procedures like root canals and gum grafts. Our mission is to shift the standard of oral health care to personalized preventative solutions rather than reactive treatments. From a simple at-home saliva test, we provide users a convenient way to check their oral health status, discover the microbes in your mouth, and receive personalized recommendations and products to improve their oral health.

We’re hiring for a front-end or full-stack software engineer to help us iterate on our product!

Our stack is built primarily on TypeScript, React, Go, Postgres, Docker, AWS, and Python. If you're a jack of all trades and are looking for diverse projects that will have a significant impact, then we'd love for you to apply! Reach out to david at bristlehealth.com, I look forward to connecting!

9 months ago • Comments on a post

Bristle (YC W21) | Multiple Positions | San Francisco Bay Area, San Diego, US | Remote possible | Full Time | https://www.bristlehealth.com/

Bristle is a consumer wellness biotechnology company that leverages genomics and the oral microbiome to detect oral disease before the onset of irreversible symptoms that require expensive procedures like root canals and gum grafts. Our mission is to shift the standard of oral health care to personalized preventative solutions rather than reactive treatments. From a simple at-home saliva test, we provide users a convenient way to check their oral health status and receive personalized recommendations and products to improve their oral health.

We’re hiring for the following positions:

- DevOps Engineer: https://bristle.notion.site/DevOps-Engineer-Bristle-9988c2fe...

- Backend Developer: https://bristle.notion.site/Fullstack-Back-end-Engineer-Bris...

- Bioinformatics Scientist: https://bristle.notion.site/Bioinformatics-Scientist-Bristle...

Our stack is built primarily on Go, Postgres, Docker, AWS, TypeScript, React, and Python. If you're a jack of all trades and are looking for diverse projects that will have a significant impact, then we'd love for you to apply! Reach out to david @bristlehealth.com, I look forward to connecting!

12 months ago • Comments on a post

Caveat: I did not read the paper but can weigh in on this:

1. The eye has immune privilege, similar to that of the brain, meaning it can tolerate antigens that would normally trigger an immune response elsewhere, like your arm.

2. Fragments of proteins expressed internally are normally presented on the surface of cells through a process called antigen-presentation. This allows immune cells to "see" when cells are infected and expressing proteins in the cytosol they normally would not.

Together this means that exogenous expression of proteins in the eye do not trigger inflammation because the eye is immune privileged, but if those proteins were expressed in the arm, there would be an immune response even if proteins are only cytosolic.

1 year ago • Comments on a post

Halitosis is absolutely a wellness indication that we eventually plan to report on as we gain more insight to the pathways involved. A number of studies have suggested that sulfate reducing bacteria may be a culprit for bad breath, and we eventually may be able to target those specific microbes and limit halitosis in the near future.

1 year ago • Comments on a post

We do not sell personal microbiome, genetic, or survey-related data and don't have plans to do so. We will make every effort to keep your personal data yours. We de-identify all your data so that it can only be analyzed as an aggregate, so while your microbiome data and health survey data contribute to new scientific discoveries, they also remain completely personal. It will be nearly impossible for interested parties (such as insurance companies) to get a hold of your personal information on the Bristle platform and use it as leverage for their pricing. Hopefully this helps relieve some of your concerns, as we have similar concerns around health-related privacy, too!

1 year ago • Comments on a post

There have been some intriguing studies associating the oral microbiome with systemic diseases such as cardiovascular indications, diabetes, oral cancers, and neurological diseases such as Parkinson's and Alzheimer's. Some studies even suggest causal links between pathogens that reside in the mouth and arterial plaque and even neurodegeneration.

With the Bristle platform, we will have the resolution to dive deeper into these associations, and potentially improve patient outcomes through targeting the oral microbiome.

1 year ago • Comments on a post

One major feature of gram-negative bacteria is their production of LPS, which is inherently inflammatory and can contribute to disease. That said, many gram-positive bacteria can also be pathogenic. The relationship between bacterial pathogenicity is more nuanced than just their cell wall composition. We believe that Bristle can serve as a platform to reveal some of the host-pathogen interactions in the oral cavity.

1 year ago • Comments on a post

A majority of the products marketed today non-specifically ablate the microbiome. While they are effective at reducing the microbial titer as a whole, they are ineffective at specifically targeting pathogenic microbes associated with disease.

1 year ago • Comments on a post

Definitely! There's still a lot of unknowns in the microbiome space, and it's something we hope to look into as we gather more data. Some studies have suggested that adolescent oral microbiome profiles can serve as indicators of future health outcomes. Review here: https://pubmed.ncbi.nlm.nih.gov/32350240/