Caring for the Microbiome in Your Mouth

We can all agree taking care of our teeth and gums is important. After all, we only get one set of permanent choppers and we need to keep them healthy. The question is, what’s the best way to care for them? The prevailing theory for most of the last century was that gum disease and cavities were caused by bacteria, and we needed to banish the bacteria to prevent oral disease.

However, in the last few years, dentistry and medicine, in general, are undergoing a paradigm shift. We’re increasingly understanding that we have a diverse and organized microbiome in our mouths, which consists of 700 or more different species of bacteria. The majority of microorganisms in our mouths are harmless, and many are actually helpful. Research suggests they do crucial jobs, such as regulating the body’s blood pressure, helping the immune system function better, and aiding the body in synthesizing and excreting vitamins. However, to complicate matters, microorganisms aren’t actually good or bad; they can be beneficial or harmful depending on the conditions. The body’s microbiome is much like a forest ecosystem, where organisms work symbiotically to maintain a state of balance.

What does the new paradigm mean for oral care? The science is still in its infancy. But, as it develops, you may want to adjust your approach to oral health to promote a healthy state of balance in the mouth rather than banishing bacteria. Keep reading to learn how.

Boosting Biodiversity in our Bodies

The truth is we’re losing the battle we’ve been waging against oral bacteria. According to the Center for Disease Control, about half of Americans have some level of gum disease, a chronic inflammatory condition in the mouth and jaw that can lead to tooth loss. People with gum disease have a higher risk of heart attack, stroke, osteoporosis, and pregnancy complications.

Evidence-Based Modern Oral Hygiene - Caring for the Microbiome in Your Mouth

Here’s an alarming hypothesis: common oral hygiene practices (such as brushing with harsh detergents and rinsing with broad-spectrum antibacterial agents) may actually be contributing to chronic infections. How? Think about what happens when you bulldoze a garden and leave behind bare soil. Invasive weeds eagerly come in to fill the space. The same thing may happen in your mouth when you regularly wipe out the microbiome, except, in this case, opportunistic pathogens eagerly colonize.

Oil Pulling - Caring for the Microbiome in Your Mouth

Oral hygiene has been recognized as an important part of health in every culture. But dental procedures and self-care practices should promote our microbial allies. A healthy mouth where good bugs are thriving is not a friendly environment for pathogens. How do you create such an environment? You can start with these four practices.

1. Stop Wiping Out the Oral Microbiome

Broad-spectrum antibacterial rinses wipe out the good bugs with the bad. They can be beneficial in some circumstances, but they also can do more harm than good.

Antibacterial Mouthwash - Caring for the Microbiome in Your Mouth

Research is limited on how antibacterial toothpaste, toothpaste containing harsh detergents, over-the-counter antiseptic mouthwash, and commonly used natural antimicrobials such as essential oils and hydrogen peroxide impact the oral microbiome. But you may want to be cautious about routinely using them, especially any product that promises to kill 99 percent of the germs in your mouth. After all, you want your microbial allies to stay put! Treat antimicrobial therapies like antibiotics. They may be a necessary treatment for a short time, but use them in a targeted way when advised by a medical professional.

Also, consider getting a water filter. If you’ve ever kept a sourdough starter, you know chlorinated tap water is not a friend to microorganisms. It’s added to municipal water supplies to kill them. Chlorinated water is an important public health achievement that’s eliminated cholera and other deadly diseases. However, it may upset the balance of your oral microbiome.

Your municipality either uses chlorine or chloramine as a disinfectant. Check their website or call and ask. If they use chlorine, a relatively inexpensive activated carbon filter will remove it. If they use chloramine, you’ll need a more expensive catalytic carbon filter. While we wait for more research on the topic, you’ll get the benefits of a chlorinated water supply while reducing the amount of disinfectant you introduce to your oral microbiome.

2. Create a Healthy Host

We’ve long treated the health of the teeth and gums as separate to the health of the body, but your general health and lifestyle impacts your oral health. High stress, a poor diet, smoking, lack of sleep, and sedentary habits are all linked with poor oral health. Emerging research suggests the combination of a healthy diet and exercise positively impacts the oral microbiome.

3. Feed and Seed the Good Bugs

Scientists are increasingly understanding that everything we eat impacts the microorganisms that share our bodies. However, the way bodies and microorganisms react to food seems to be highly individual, so there’s not a one-size-fits-all diet. That said, you’ll likely do well to stick to a varied, mostly unprocessed diet that’s abundant in vegetables and low in sugar and processed carbohydrates.

You may be able to reseed your microbiome by regularly eating a diversity of (unpasteurized) fermented foods, such as kefir, yogurt, kimchi, sauerkraut, etc., which are known to be abundant in beneficial microbes. If you’re not used to eating them, add them to your diet gradually to help your body get used to them.

4. Do Your Research and Ask for Evidence

When a new paradigm arises in medicine, it’s tough to know how to proceed with self-care. We’re already seeing probiotic toothpastes and mouthwashes emerge in the oral care market. However, it remains to be seen whether they’ll improve oral health. A surprising number of common practices and over-the-counter products aren’t actually backed up by evidence. Talk to your dentist, do your own research, and pay attention to your own experience to determine the best methods for caring for your teeth and gums.

How to Make a Chewing Stick Toothbrush - Caring for the Microbiome in Your Mouth

Managing the Ecosystem in Your Mouth

You not only manage your own health; you also manage the health of a vast ecosystem of microscopic critters. Scientists are still at the frontier of understanding how the microbiome impacts oral health, and dental practices and self-care recommendations will evolve to reflect our new understandings. But the good news is, ecosystems are resilient. Create a healthy host environment by eating well, managing stress, and taking good care of yourself, and the beneficial flora in your mouth are likely to flourish as well.

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