Oral Microbiome and Breakthroughs in Preventative Oral Health

I’ve been fascinated for a long time with the body’s microbiome, which are the bacteria and fungal species that live naturally and in harmony with each other and our whole body. After learning that the body's cells are actually a minority compared to our microbiome, I began to learn more about what their role was in our body’s functioning. Turns out it wasn’t just a “gut instinct” that they play a larger role in our health than we initially believed. In fact, the gut microbiome is responsible for supporting our physical, mental and emotional health.

As the mouth forms a direct connection with the gut, we also recently found a similar relationship with the microbiome in the mouth. The mouth houses over 700 various types of bacteria and fungi that support our gum structure and teeth. When in good health, these bacteria and fungi live in a harmonious balance with each other as part of the microbiome. Occasionally, we can see a poor balance, or overgrowth of particular bacteria in a certain organ of the body, such as the gut, mouth or skin. What we’re now learning is that some bacteria that overgrow their natural proportions in the microbiome compared to other happy bugs on our body can result in serious whole body health problems. In some instances, they can even translocate, or migrate to other organ systems they don’t normally live in and cause illness.

With current research in genetics, scientists have been able to identify and quantify thousands of bacteria and fungi that make up our microbiome. The figure above shows various oral microorganisms that are either abundantly found (blue) or in decreased population (red) in a variety of systemic conditions. The key to understanding the microbiome is to understand that these microorganisms are all normally found in the body, but can result in pathology if the proportions are too high or too low within the oral cavity. Organisms in purple have elevated or decreased populations based on the phase of disease or environmental condition.

In particular, some bacteria if found at higher levels in the oral cavity, can result in increased risk of dental caries and gingivitis, and even have whole body implications on diabetes, coronary artery disease, Alzheimer’s disease and GI pathologies. Specific examples where we see overgrowth of the microbiome in the oral cavity causing issues is in dental caries formation and periodontitis. The bacteria Streptococcus mutans is a bacteria commonly found as part of the microbiome in the oral cavity, however if in larger populations can lead to damaging effects on teeth resulting in caries. In patients struggling with gingivitis and periodontitis, we find the main culprit being a bacteria called Porphyromonas gingivalis as having grown out of its normal population size within the oral microbiome. However we have just learned that this bacteria does not work on its own, and is even more likely to cause disease in the mouth when other bacteria named Fusobacterium nucleatum and Prevotella intermedia are also in high numbers.

We are still learning the intricacies of the microbiome’s role in disease, but what we do know is that the mouth is an important source of the bacteria that have grown out of their healthy proportions.

As a holistic dentist, it’s my goal to use this cutting edge research in microbiology and apply it to diagnostic testing and treatment planning goals. With an ever increasing amount of knowledge coming out of microbiology and genomics, preventative dental health has reached a new breakthrough. At Bloom Holistic Dentistry, we offer oral microbiome testing for the most studied bacteria we see being out of balance that are associated with chronic dental and whole body disease. We can now answer questions like why a person could be more prone to dental caries or gingivitis, and the information helps to guide a specific form of treatment based on preventative oral health and dietary changes to promote and reestablish a sense of balance.

For more information, please see the following links:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375741/
https://askthedentist.com/oral-microbiome/
https://goop.com/wellness/health/oral-microbiome/
https://draxe.com/health/oral-microbiome/

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