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Tuesday, April 23 2019

The Oral Microbiome

Like all mammals we are introduced to our first dose of microbes via two ways.  1. Coming through the birth canal and 2. Suckling for milk and having skin to mouth contact with our mother.  Not only are we exposed to bacteria through ingesting colostrum and breast milk, but also from skin contact.  Amazingly, the mothers gut bacteria travel through the entero-mammary pathway. Starting from the gut beneficial bacteria enter the mesenteric lymph node and then travel through the mammary gland epithelium to reach the baby.  This period of our lives and the inoculation of bacteria we get from out mother is a key moment in the establishment of our oral and gastrointestinal microbiome. 


There has been a lot of news about the importance of a healthy balance of the good and bad bacteria in our gastrointestinal system.  I wrote a newsletter about the strains of bacteria about 18 months ago.


However, new information is revealing that there are bacterial strains specific to the mouth that are important in preventing illness’ such as bleeding gums and periodontal disease beyond what you might get in a typical probiotic. 


Bleeding gums and periodontal disease in women and men

For women, the conditions of gingivitis and periodontitis are more common in menstruation, pregnancy and menopause.  Hormonal changes create changes in the saliva of women that could lead to increased swelling and bleeding of the gums.  The bacteria porphyromonas gingivalis is an anaerobic bacterium involved in the pathogenesis of periodontitis, an inflammatory disease that destroys the tissues supporting the tooth, eventually leading to tooth loss.  The presence of this bacteria has been shown to cause leaky gut issues, and a higher incidence of insulin resistance and diabetes.  The hormonal connection for gingivitis can be helped with regular brushing and flossing, periodontitis is a more complex problem.  There is a hormonal connection for men as well for periodontitis.  Prostate-specific antigen (PSA) is an enzyme that is secreted at higher amounts when the prostate is inflamed, infected, or affected by cancer. Research has shown that men with indicators of periodontal disease, have higher levels of PSA.  The same association has been made with heart disease, impotence and cancer.  Men with periodontal disease are 49% more likely to develop kidney cancer than women, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers. 


Plaque is a biofilm

The buildup of plaque on our teeth is a bacterial colony of multicellular organisms living on our teeth.  The amount of dental decay and gum disease that we see today is largely related to our society’s gravitation towards a more refined sugary diet.  This high sugar diet leads to problematic opportunistic bacteria residing in our mouths.  Good bacteria release calcium from the biofilm to counterbalance the acid release the biofilm produces and harmful bacteria demineralize tooth structure by removing calcium.  This leads to both tooth decay and gum disease.  Additionally, this leads to disruptions in the gut microbiome, and increases PGE2 (inflammation marker) levels in the gingival crevices due to the activation of the cox inflammation pathway.  This leads to activation of T-cell and B-cell responses, along with all types of autoimmune responses such as rheumatoid arthritis and other health issues.  In children, swollen tonsils and adenoids could be associated with a disrupted oral microbiome.  This inflammation could cause breathing problems and affect jaw and cranial development. 



The problem with conventional mouthwashes like Listerine or Act over the long term for gingivitis or periodontitis, is like antibiotics because they kill off beneficial bacteria that are protective of our teeth and gums leaving the mouth more susceptible to recurring problems.  Also, they have ingredients that are allergenic or could be toxic if used over the long term.   The ones that have alcohol in them, have an alcohol content that is very high, and this can cause drying of the mucous membranes of the mouth, reduce saliva and cause bad breath.  Bezalkonium Chloride can do the same thing.  Chlorhexidine is a chemical that is found in many that can cause an increase in blood pressure and can stain teeth.  Methyl Salicylate: one tablespoon of this is equivalent to 23 300 mg aspirin pills. Too much can cause low blood pressure, difficult breathing, convulsions, and vomiting.  Methylparaben has been found in breast cancer tissues.  It is also found in skin creams, cosmetics and deodorants. Propylene Glycol should not be used by pregnant women and it is associated with neurological cardiovascular and respiratory symptoms. Poloxamer 407 has been linked to elevated cholesterol levels.  Excess fluoride has been found in 50 out of 57 studies to be linked to lower IQ levels and 97% of Europe has stopped fluoridating their water. 


There are natural alternatives to the commercialized products we see on T.V. and in the typical pharmacy.  Natural mouthwashes that use essential oils without harmful chemicals can be found at almost any health store.


Oil Pulling: This is something that has developed out of ayurvedic medicine.  Most often it uses coconut oil, but olive oil, or sesame seed oil could be used too.  Research shows it can reduce streptococcus mutans bacteria- a significant contributor to tooth decay and it can improve bad breath and plaque-induced gingivitis.  You can add an essential oil to the procedure too.  It is best to do on an empty stomach first thing in the morning.  Swish one tablespoon in your mouth for 10-20 minutes, then spit out the oil into the garbage.  Do this 3-5 times per week. Oral by Invivo is a powdered probiotic mouthwash.  It contains S. Salivarious (K12).  This bacteria releases BLIS (bacteriocidin like inhibitory substance) and S. Salivarius M18 which promotes gum health and inflammatory response.  B. Bifidum W23, B. Breve W25, E. Faecium W54, B. Lactis W51, L. Plantarum W21, L. Rhamnosus W71, L. Salivarius W24, L. Salivarius W57.


PerioBiotic toothpaste from Designs for Health.  A toothpaste with Lactobacillus paracasei.


Finally, I want to thank Dr. Steven Lin author of The Dental Diet, a progressive dentist with a background in functional medicine for some of this information.

Posted by: Dr. Goldstein AT 12:01 pm   |  Permalink   |  0 Comments  |  Email

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