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Periodontal Disease & the Oral Microbiome

The gut microbiome is getting a ton of attention these days, but what get less attention is the oral microbiome. Whether you are fighting periodontal disease or not, taking care of your oral microbiome is a must. You are swallowing an estimated one trillion bacteria each day and seeding your gut with the bacteria from your mouth (1). In fact, the Human Microbiome Project showed that there is a 45% overlap in the microbes found in the mouth and in the colon (2).


An imbalance in the oral microbiome, like an imbalance in the gut, will lead to inflammation, illness, and disease. Studies have shown connections with cardiovascular disease (3) rheumatoid arthritis (4), inflammatory bowel disease (5), recurrent Helicobacter pylori infections (6) and blood pressure (7).


A 2019 study in the Journal of Oral Microbiology discovered that bacterial populations from the mouth make their way to the gut microbiota (8). This can alter immune responses and potentially lead to systemic diseases. In particular, this study names the P. gingivalis bacteria as one that is found in both the gut and the mouth in individuals with gum disease (aka periodontitis). According to the CDC, half of Americans have periodontal disease! HALF!! This disease occurs when bacteria accumulates on the teeth and creates inflammation on the gums. At the extreme ends, it can lead to loss of teeth but before that, these bacteria can have on impact on your health and be the instigator of inflammation. If you haven’t taken your oral hygiene seriously yet, now is the time. Prevention or reversal in the early stages is much easier than dealing with larger infections or gum disease.


6 Tips for taking care of your oral microbiome

Many of these recommendations are what my boyfriend used to help combat a major tooth infection found in an old root canal. FYI, root canals are common place for infections to hide and are often missed by routine dental check-ins.


1. Schedule regular dentist cleanings

While we can do a ton to support our mouth microbiota, getting a deep cleaning is someone we need to outsource to a professional. Dentists do manual scraping and they remove plaque and biofilms that we can’t reach on our own. I recommend a biological dentist when possible. Here’s a resource to find one close to you. Dental visits every 3-6 months is recommended (the more frequent side if you are battling periodontal disease at any level).


2. Use a good toothpaste & mouth wash

If you're fighting periodontal disease or a healing for a tooth infection, these next products are worth the investment. Dentalcidin by Bio-Botanical Research has been studied and shown to rid biofilms that hid bacteria and reduce the bad bugs within the mouth. You only need a pea sized amount per brushing sesh.

Follow this with Dentalcidin LS Liposomal Mouth Rinse. Dose is 2 pumps and swish for 1-2 minutes. Do not swallow after rinsing. You want to spit out the bacteria this just pulled up. You can find both of those Dentalcidin products here. Other clean toothpastes options (with less antibacterial impact) is Tom's of Maine.


You could also try oil pulling with coconut oil as a mouth wash. Again, don’t swallow this after rinsing and spit this in the trash (not the sink) to avoid clogging your pipes. Dentists recommend 1-3 minutes per morning or after meals.

Visuals of bacteria changes with Biocidin toothpaste

3. Eat a healthy diet & avoid an acidic mouth

Bacteria love an acidic environment so minimize growth by brushing or rinsing after things like coffee, lemon water, apple cider vinegar, etc. One of the foods known to trigger dysbiosis within the mouth and lead plaque build up, inflammation and cavities is…. sugar. This parallels general healthy diet recommendations I'd make but minimize sugar intake and build a foundation of real food with anti-inflammatory and antioxidant rich foods to support the mouth microbiota in a positive way.


4. Implement morning tongue scraping

This one is so simple and takes seconds in the morning. Tongue scrapers are also inexpensive. Tongue scraping is an old Ayurvedic practice and is aimed at removing the buildup of gunk (bacteria and plaque) that has coated the tongue overnight. Some studies estimate that 80 to 95% of bad breath comes from the buildup of food, bacteria, fungi, and dead cells at the back of the tongue. Tongue scraping is simply one step in removing this and preventing that stuff from getting to your gut and your gums.


5. Mouth taping (if you're a mouth breather)

This is something I’ve been doing for 2+ years. If you’re a natural mouth breather at night or wake with dry mouth, this is for you. Keeping the internal surfaces of the mouth moist is essential to oral health. Mouth taping has been talked about by many dentists for mouth structure, oxygenation, nitric oxide production and sleep quality reasons but it also helps your oral microbiome stay in check. Without a steady flow of saliva to maintain moisture, populations of bacteria can build up in the mouth.


These are the strips I use. [code "NUTRITIONBYROBYN" will save you 10%]

Tip: don’t put it on right after moisturizer or it won’t stick well. I reuse a strip for 4-5 days and just stick the edge on my nightstand.

6. Swap gum/mints for xylitol versions

Xylitol is a sugar alcohol and used as a sugar replacement but it’s also great for dental health and preventing tooth decay. You can find mint, gum and powder versions of xlyitol. The powder is something you can brush with. The mints are great if you have dry mouth or just want a minty flavor and gum is a great alternative to sugar based gums.


That's the jist. Take what you want from this list of recommendations. If you're struggling with health symptoms especially unexplained or frustrating digestive symptoms, please take a serious look at your oral care and consider the impact it may be having on your gut. In fact, experts are looking at the oral microbiota and the impact on things like SIBO, IBS and IBD.


An organized list of the products I mentioned.



References:

  1. Struzycka I. The oral microbiome in dental caries. Polish journal of microbiology / Polskie Towarzystwo Mikrobiologow = The Polish Society of Microbiologists. 2014;63(2):127-135.

  2. Segata N, Haake SK, Mannon P, et al. Composition of the adult digestive tract bacterial microbiome based on seven mouth surfaces, tonsils, throat and stool samples. Genome Biol. 2012;13(6):R42.

  3. Reichert S, Schlitt A, Beschow V, et al. Use of floss/interdental brushes is associated with lower risk for new cardiovascular events among patients with coronary heart disease. Journal of periodontal research. Apr 2015;50(2):180-188.

  4. Ogrendik M. Rheumatoid arthritis is an autoimmune disease caused by periodontal pathogens. Int J Gen Med. 2013;6:383-386.

  5. Vavricka SR, Manser CN, Hediger S, et al. Periodontitis and gingivitis in inflammatory bowel disease: a case-control study. Inflammatory bowel diseases. Dec 2013;19(13):2768-2777.

  6. Jia CL, Jiang GS, Li CH, Li CR. Effect of dental plaque control on infection of Helicobacter pylori in gastric mucosa. Texas dental journal. Oct 2012;129(10):1069-1073.

  7. Hyde ER, Andrade F, Vaksman Z, et al. Metagenomic analysis of nitrate-reducing bacteria in the oral cavity: implications for nitric oxide homeostasis. PLoS ONE. 2014;9(3):e88645.

  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6427756/

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