Hacking Your Oral Microbiome with Danny Grannick of Bristle
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Podcast Notes
Danny Grannick is one of the brains behind Bristle, the new health company that is using genetic sequencing to determine risk for dental disease. Using Bristle's affordable and convenient kits, customers can get accessible and clear results that they can easily apply to their everyday lives and know exactly which concrete actions they can take to improve their oral health.
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Autogenerated Transcript
[00:00:00] Aakash: Hi there I'm Aakash Shah, founder of Wyndly, a healthcare company where we fix allergies for life. And this is Founders and Builders, a podcast with the experts who are working hard to bring something new and meaningful into this world.
This episode of founders and builders is brought to you by Wyndly. At Wyndly, we fix allergies for life with personalized treatment plans that train your body to ignore its allergy triggers. We've built the best healthcare experience ever with convenient tele-health doctors you can text at any time, and even free shipping. If you want to live without allergies, then visit wyndly.com.
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Hi everybody. I'm here with Danny Grannick of Bristle. Bristle is incredible. I know Danny and Bristle through my time in Y combinator. But I'm going to let Danny introduce himself and his company.
[00:01:04] Danny: I'm Danny Grannick the CEO and co-founder at Bristle. We leverage the oral microbiome to help people measure, understand and improve their oral health.
[00:01:14] Aakash: So dig into that for me. What is the oral microbiome?
[00:01:18] Danny: So, the microbiome. Kind of the makeup of bacteria, fungi and viruses that reside somewhere on the human body. And we have a bunch of different microbiomes. There's a gut microbiome, there's a skin microbiome, an ear microbiome, and we also have an oral microbiome. So the oral microbiome is the makeup of bacteria, fungi, and viruses that live inside of your mouth. Have some of these microbes. Helpful and provide benefits to your body, help you break down foods and fight off infection while others can be pathogenic and cause damage to your teeth or your gums, and eventually lead to oral or systemic diseases.
And it's really the makeup of your oral microbiome, the balance of good and bad bacteria that can provide insight into your oral health status and risk for disease.
[00:02:10] Aakash: So it sounds like a microbiome is almost like a small environment that exists in our, on our body and you can measure it and it can be a guide or a tool for us to understand what could happen next. Am I understanding that correctly?
[00:02:27] Danny: Yeah, exactly. It's the identity of the different microbes that are within your, in this case, the oral microbiome. So you want to know who's there and you want to know if they're beneficial or harmful and how much of each there are. So there's the idea of being able to identify all of the microbes in your horrible microbiome.
And understand the relative abundance. So how much of each there are in your oral microbiome and we can do this with genetic sequencing technology. So the same thing that, that a company like 23andme or ancestry would use to look at your genetics, we can instead turn towards the other critters that are living on your body.
[00:03:06] Aakash: I don't know how I feel about that. But this is really interesting for me because, you know, my mother is a dental hygienist, and so we, my family, my sister and I, we grew up learning the importance of brushing your teeth every day, flossing all the time, all that jazz. And even though my sister and I have the same habits, I've been lucky enough to grow up without cavities knock on wood.
But my younger sister has had three or four cavities and she eats healthier than me. She probably has better the hygiene than me. Would the oral microbiome be something that could help detect why this difference could occur between us?
[00:03:46] Danny: Yeah. And I think even more specifically, the oral microbiome is why the differences occurring. So the relationship between these pathogenic bacteria and oral diseases, very close they're causally related. There are specific pathogenic bacteria, especially in the case of your sister, that produce acid as a byproduct. And if you have a high abundance of these bacteria and you're producing a lot of acid, eventually the acid will decay the enamel on your teeth and eventually the tooth itself and that results in what today we diagnosed as a cavity. And so understanding that the oral microbiome provides you with insight into your oral health status and understanding the abundance of bacteria related to a given condition provides you insight into your risk for that condition.
[00:04:32] Aakash: Can you walk me through the experience of taking a bristle oral microbiome test?
[00:04:37] Danny: Yeah, it's really easy. So you would go to our website, bristlehealth.com and purchase a test. Uh, we'll deliver a saliva collection kit directly to your house. Your first step will be to log into your dashboard. And we ask you a few questions related to your oral health and various kind of clinical and behavioral risk factors related to oral health status. Afterwards, you would spit in the tube that we sent to your house. Just provide a really small saliva sample and you mail it back to us in a prepaid envelope. When we receive it, we process the sample in our lab. And then about two weeks later, we'll send you an email and you can access your results online. And your results will show you high levels for us related to the bacteria that we detected related to beneficial aspects of oral health. So what's helping you maintain good oral health, gum inflammation, tooth decay, and halitosis or bad breath. And then we'll give you a lot of opportunities to kind of dig into your scores and understand what specific bacteria we detected and how much they're contributing to your risk for any given condition.
And based on all of that information, we'll pair you with product recommendations, dietary recommendations, hygiene changes that you can take to address any one of your indications and improve your oral health.
[00:05:57] Aakash: Oh, so what I really love is this focus on things that I can do today to become healthier tomorrow. One thing that always frustrates me is sometimes I'll go get a test or a diagnostic and a doctor's office, and that comes back to me and it's complete jibberish sounds like you've really focused on making the results easily understood by someone like me who has no knowledge or education in dental care.
[00:06:19] Danny: It's been a really big miss for the genomics industry as a whole. So many people are kind of catering to the well-educated socio-economically wealthy kind of biohacker class of people. And what ends up happening is a lot of the products are these complex reports that you either have to have a PhD in, you know, whenever you're analyzing or you have to have an access to specialists that can help you interpret the results and act on them.
The reality is oral disease is relatively ubiquitous. It effects all kinds of people from all different kinds of backgrounds. And if we really want to help people solve their problems we need to create a product that is easily understood by the people experiencing them. So we focus on creating really easy to understand scores, and then we provide a lot of paths for the users that want to really dig into the data and see the research behind what we're doing.
[00:07:15] Aakash: And my experience at Wyndly where we fix allergies. This is a common frustration when people get something from their medical. But they feel like the medical provider is gatekeeping.
The actions that they can take. Nowadays in our patients, we see a huge interest in taking control of their own health. The bristle oral microbiome test is really enabling folks to access their dental care by themselves. They don't have to go to a dentist to learn, but they can start taking the first steps of their.
Today from the comfort of their home,
you know, the reality is getting access to dental care is really difficult today. We certainly don't want to tell anybody not to see their dentist regularly. It's absolutely a part of good oral health and good dental care. But 50% of us adults don't see a dentist every year.
Gum disease and cavities are the most prevalent conditions on the planet. There's a clear gap between. People, either being willing or being able to access care and the prevalence of these diseases. So we wanted to make a product that would help people own and act on their oral health on their own terms without needing to get access to the standard of care today, because it's really hard to get access to
50% is a huge number that aren't getting their dental care. I didn't know. That's actually incredible because like I said, my mom's a dental hygienist and she says that you can detect a lot of things that are going wrong just with a regular dentist. But I guess just the system is set up whether through insurance or through inconvenience or anything that. It's just not easy enough.
[00:09:01] Danny: It's really hard. Or a court that I had read that had cited that 50% statistic and also noted that the three biggest reasons are cost inconvenience and anxiety. So, you know, there's kind of this pervasive set of problems within the standard of dental care today. Prevents lots of different kinds of people from getting access.
So you can imagine that somebody who is socioeconomically disadvantaged may not be able to afford a dental visit. So cost becomes the barrier. You can imagine that somebody with a really busy schedule, like, you know, the founder of a company doesn't have time to set up an hour or a two hour dental visit with a follow-up in two weeks.
So it convenience becomes the barrier and, and, you know, you've got people like me then. Uh, really kind of traumatic dental experiences as a kid, whether or not those are really subjective interpretations or not, you know, that make it a really uncomfortable experience and something that I don't want to do unless it's an emergency.
And that's the real problem is all of these barriers result in people avoiding care until.
[00:10:13] Aakash: That that is actually exactly one to one. What I have experienced Danny. So, you know, these past few years, because of the pandemic, it's just been very easy to say, Hey, I don't want to go into the day. And the only reason I went is because my current fiance was like, if you don't get a dental checkup, your teeth are going to look ugly in our wedding photos. Honestly, the biggest reason for me is I feel like I go to the dentist and I get punished because my teeth hurt the next day. I think you've really identified those three key factors of cost, convenience, and anxiety as things to tear down, to make dental care. More prevalent. Not that it's not already very prevalent.
We've talked a ton about why, what the product is and how it helps, but how'd you discover this problems?
[00:11:02] Danny: So my background was, or is in genomics and I was on the commercial side of genetics and sequencing. I worked for a company called Illumina, which is kind of the market leader in sequencing technologies.
And, you know, really saw like a lot of exciting innovations being applied to. Every aspect of healthcare, right? We've seen liquid biopsy for detecting cancer at the earliest stages, noninvasive prenatal testing. There's obviously been a lot of work in the gut microbiome, and I think complimentary to all of that innovation, we've seen this rise in.
Telehealth medical care. We've seen wearable devices that can measure heart rate and sleep quality and exercise and metabolic health. I think for as pervasive as a lot of these technologies are. Always a very clear gap where they're not being applied. So, I mean, for a long time, I had been thinking about kind of new areas that these advanced technologies could be introduced to.
And it just so happened that me and my now co-founder were at a, we were just sitting in at a pitch competition and we heard, I think, five companies pitch about the gut microbiome. And my co-founder is the cliche patient who is kind of like your sister, great about oral hygiene. And inevitably has cavities.
Every time he sees the dentist, he had a dental appointment the next day that he was complaining about. And, you know, I think just being in the context of this gut microbiome pitch and him talking about his dental appointment, like we had this aha moment knowing that. The same technology being used for the gut microbiome could be applied to the oral microbiome and oral.
[00:12:43] Aakash: There's kind of like a one, two skip a few that you just. 'cause going from, we were alert. We were pitching about the gut microbiome too. We have a test that can actually tell you about the oral microbiome. There's a huge journey right there. Tell me more about what happened there, but what was the most challenging aspect of that?
[00:13:01] Danny: After we came up with the idea, like we spent a lot of time just investigating what was on the market and really didn't find anything available. And then we started just kind of testing. The idea that really didn't exist as a product yet, we were doing a lot of, you know, surveys through LinkedIn and through our network and we would cold call and cold email dentists and interviewed them and just get an idea of what is your dental experience for the patients and for the dentist.
So it was like, what are the tools that you're using today and why aren't you using the oral microbiome as one of those tools we spent around a year. Kind of going through those motions and then COVID hit. And the lockdown happened and I had kind of been in San Diego for a few months and obviously had a lot of time to myself.
And by that time, you know, bristle, as a, as a concept had been on the back burner for awhile, I was actually applying to graduate school and towards the end had revisited the idea and. Really kind of gotten to the point where I felt confident that we had something promising, started reaching out to more people in my network, just talking through the concept of bristle and, and what we could do.
And a couple of months later, I felt like we had enough validation. We put the team together, which is a whole other story in and of itself and apply to. Y Combinator. Think we submitted our application the last day that applications were due and we got an email the following week setting up an interview and a few days later at the call and receive the good news that evening that we were accepted.
[00:14:42] Aakash: Did you have to build the test and make sure the science worked before.
[00:14:47] Danny: So we had kind of mapped it out on paper and we, we knew the technology well enough that we knew technically it was feasible. There wasn't a big question of like whether or not it would work. The big question was how low can we get the.
You know, what are, what are kind of the criteria that we'll need to make it work. But the fund didn't really start until after we got into Y Combinator. And then we sat down and really developed the test itself and moved beyond just accessing some public data to see what we could, we can analyze and generate.
[00:15:19] Aakash: So you've developed the test you've gotten into why. What'd you do next?
[00:15:24] Danny: We had been lucky enough to connect with the university of the Pacific dental school, and they were really interested in partnering with us to help develop the initial biomarkers, the signatures that we were going to use to detect these bacteria and in science of oral disease.
So we kicked off a clinical research partnership. We would sequence patients going into the dental clinic and we got access to the dental records and diagnosis from that day. So it formed this really beautiful clinical baseline that we could use to develop our scores and our algorithms off of that is proven to be really valuable and a really accurate measure of oral.
No further down the line, we released a very clunky MVP during the Y Combinator. And we started analyzing consumer samples. And until September, we had been kind of refining the product and then relaunched in September. That's incredible that you develop this technology in concert with a dental school like that.
[00:16:27] Aakash: You're literally on the cutting edge of dental research.
[00:16:31] Danny: I think it's just another sign of how behind the dental industry has been, because if we had gone to a university and I think pitched the same concept of what the gut microbiome we probably would have been laughed at, but pitching this concept and this product and this idea around leveraging the oral microbiome for oral.
It hasn't been done before. And I think that, you know, it took a lot of hard work, but I think for us, it was also just an incredible opportunity and a classic case of being in the right place at the right time to be able to, to generate this momentum.
[00:17:04] Aakash: And if I wanted to get a test today, I can just go to your site. What exactly would be the. If I want one to show up at my home day after tomorrow.
[00:17:12] Danny: So go to our site, there's a get your kit button and we have three versions available. So there's the single test which we sell for $119. And all of these would be shipped directly to your doorstep. There's a single test.
And then we have two subscription options because the oral microbiome is a dynamic environment. Obviously your oral health changes over time. And so does your oral microbiome. So there's a lot of value in being able to monitor your oral health and kind of track how the changes you're implementing are affecting.
Your oral microbiome profile. We have one subscription where we deliver a kit to you every six months, and that is $109 per kit. And then we've got another option where we deliver every three months and that's $99 a kit
[00:17:58] Aakash: I'll visit bristle health.com. I'll hit get your kit and I'll just make the. This is brilliant. Thanks for coming on, Danny.
[00:18:07] Danny: Of course, anytime.
[00:18:08] Aakash: Thanks for listening to founders and builders. Make sure to subscribe and then share this episode with a friend. You can find more episodes@aakash.io. That's A A K A S h.io, or just find Aakash on Twitter.