Our oral microbiome is a fascinating and complex topic. To date, science doesn’t have all of the answers. That means that there is actually a lot of guesswork going on. There still isn’t a way to properly study all of the microorganisms that exist in our oral microbiome. Even with new technology using whole-genome sequencing, only 54% of the 700 species or so colonising our mouths have been identified. Apparently, some cannot be cultured in petri dishes. They are unnamed and unidentified, for example eukaryotes (specific kinds of cell containing a nucleus, viruses and drug-resistant species). Nonetheless, what is known is that the microbes in our mouth are the gateway to our gut (and its larger microbiome) - they have a profound influence on our overall, or systemic, health.

Research in 2014 showed that the oral ecosystem is mainly composed (85%) of single celled bacteria, fungi, viruses, archaea (cells without a nucleus), and protozoans (cells with a nucleus and the ability to move, but can’t make their own food). The researchers found that factors such as smoking, antibiotic abuse, mouthwash, toothpaste (particularly antibacterial toothpaste) and even antibacterial throat lozenges, can cause an imbalance in the oral microflora and eventually result in dental caries, gingivitis, periodontitis, candidiasis, endodontic infections, orthodontic infections and oral cancer. Are you still with me?

A 2017 study found that periodontal disease is an important cause of Alzheimer's Disease (AD) due to epithelial cell barrier disruption and chronic infections. Then, a 2020 investigation revealed that many pathologies and diseases are closely related to an imbalance of oral bacteria: osteitis, tonsillitis, cardiovascular disease, ictus, pre-term childbirth, diabetes, pneumonia, obesity, colon carcinoma and psychiatric issues. Uh oh … from this information, we can work out just how important it is for our oral microbiome to have the correct balance.

Those same scientists were able to publish images illustrating the complexity of our oral microbiota after using 16S rRNA gene next-generation sequencing (NGS) and real-time quantitative Polymerase chain reaction, or PCR, microarray. It’s a technique to make many copies of a specific DNA region in vitro (in a test tube rather than an organism). Fluorescent dye-based labelling, enabled measurement of species. The sampled oral micro-habitat included tongue dorsum, hard palate, buccal mucosa (the lining of the cheeks and the back of the lips, inside the mouth where they touch the teeth), keratinized gingiva (the gum structures), supragingival and subgingival plaque (bacteria on or below the gum structures), and saliva with or without rinsing. Don’t worry, I had to Google a lot of those terms to help both of us out! And here are the amazing images: 

I’m not going to pretend that I know what it all means. However, it is the first time in history that such imaging has occurred. This year – the year of Covid-19. Yep, I have mentioned that the scientists haven’t identified all of the viruses in our mouth. If we put two and two together we can understand how our immune system is crucial to defense and that those little guys in our mouth are part of the big picture.

What if we then consider that fluoride destroys bacteria? It’s been included in many modern toothpaste formulations, and water supplies, to reduce oral cavities caused by dental caries and periodontal disease, common oral diseases caused by the dominance of acid-forming and acid-tolerating species (e.g. Streptococcus mutans) or the inflammation produced by these decay-causing bacteria. Perhaps the extra fluoride is contributing to the upset of the natural balance in our mouths. We actually produce our own fluoride in our saliva. Haven’t you seen images of ancient skulls containing teeth in good condition, just like the one below? I’ve seen a little five-year-old girl with no teeth – they had all rotted!

Human dental health started to go downhill after we stopped being hunter gatherers. Once people started cultivating crops, the foraging declined, and the human diet became less varied and relied on what was grown. Fast forward to today, with our vast (fast, processed, refined, mass-produced) food and beverage industries. (Don’t get me started on today’s pollution and pesticides and how they could be killing our microbiota!)

The main culprit in promoting acid formation in our mouths is sugar. Sugar is converted into acids that erode the dental enamel and cause cavities. Simple sugars, like those in fruit, are unprocessed. When we eat dried fruit, the sugar is more concentrated, so we would usually eat a smaller portion, compared to if it were fresh. The same concentration idea applies to fruit juice. Yet, the modern diet increasingly sees people consuming too much sugar in manufactured food and drinks.

According to the Australian Bureau of Statistics (ABS) on December 5th, 2019, the average Australian consumed 60 grams of free sugars per day – around 14 teaspoons of white sugar. That's well over and above the World Health Organisation's (WHO) recommended healthy level of six teaspoons for women and nine teaspoons of sugar for men each day.

Free sugars are sugars added to foods and drinks by manufacturers, cooks or consumers, and also sugars found naturally in honey, syrups and fruit juice. Sugars found for example in fruits and vegetables (fresh, frozen or dried) and in milk and products such a plain yogurt and cheese are not classed as free sugars.

It is increasingly argued today that a whole food plant based diet is the optimal one for good health. This way of eating cuts out processed food that contains added sugars, preservatives, animal products and salt. Of course it is better for our oral health and our overall health. Remember, the relationship between our mouth and our gut microbiomes are a two-way street.

In any case, brushing our teeth removes the (bio)film that builds up on our teeth. This film is where the harmful bacteria multiply, especially when fed sugar (they get their nutrients from our saliva when we eat and drink). If we brush with a fluoride toothpaste, we are definitely killing bacteria. But, there are good and bad bacteria - the good guys are our oral defense mechanism and by default, part of our body’s defense system.

I’m not a health professional. I am a person who is highly interested in maintaining my health. I’m a has-been drinker of alcohol and soft drinks and a has-been eater of ice cream, cheese and chocolate etc etc! I developed an alternative to modern toothpastes in response to my dentist telling me that I’d eroded my dental enamel through years of using abrasive toothpaste. What I uncovered in my quest to know more was the importance of a healthy oral microbiome.

I hope this sharing has given you some food for thought (pun intended)!

GENERAL DISCLAIMER

The contents of this sharing are for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment . . . Read More →