Smiling is definitely one of the best beauty remedies. If you have a good sense of humor and a good approach to life, that's beautiful.
Rashida Jones
A healthy smile is an instant makeover and in good health, your mouth has a positive effect on your overall wellness. The mouth is the beginning of the gastrointestinal tract and anything that happens here is going to affect everything downstream – both good and bad.
Like the rest of your digestive tract, it is home to a wide variety of microbes, in fact, some 700 species of microbes inhabit your mouth including bacteria, fungi and viruses. The health of the bacteria in the mouth and the rest of the body begins at birth with the most diverse ecosystem being associated with the greatest health. Interestingly, the diversity of bacteria existing in babies that are born via cesarian is reduced and this can mean the good bacteria of non-vaginally birthed babies can need a little health. Oral bacteria have a big influence on the gut bacteria and there is a 45% overlap of bacteria in the mouth and the colon.
Saliva delivers nutrients to the mouth, immune protecting immunoglobulins like secretory IgA, is integral in determining the pH in your mouth and it also washes bacteria out of the mouth and into the high acid environment of the stomach. So having a dry mouth can cause problems for your oral cavity and further downstream in your digestive tract. Certain medications, autoimmune conditions and stress can all be sources of problems with saliva.
When you think about it, you are swallowing one trillion bacteria each day, seeding your gastrointestinal tract with the microbes from your mouth. So why wouldn't the health of your oral bacteria also affect the health of your gut?
What happens when the bacteria in your mouth are out of whack?
Dysbiosis is the word we use to describe an imbalance of positive and harmful bacteria in the body. When this occurs in the mouth this results in:
- Cavities – high sugar diets select for bacteria that like acidity which sets up for a perfect storm of dysbiosis leading to cavities as the acid-producing bacteria traps acid and demineralises the tooth enamel.
- Gingivitis – gum disease
- Periodontal disease – destruction of gum tissue, bone
At the intersection of your teeth and your gums, there is essentially a weak point in the barrier protecting the blood stream from the bacteria in the mouth, so the immune system must be strong to protect your periodontal tissues and prevent infiltration into the bloodstream. Bacteria cover every aspect of your oral cavities, from the mucosal surfaces of your gums, inside of your cheek and your tongue to the hard surfaces of your teeth. Plaque is a type of biofilm. Directly after a clean, certain bugs start to attach to your teeth, creating a film that can be harmful if good oral hygiene is not practiced.
Are there good biofilms as well as bad biofilms?
Yes, biofilms can also protect the good bacteria in the mouth. When dealing with really chronic and stubborn infections it may be necessary to remove or treat the biofilm. But we do want good bacteria in the mouth, so things like antibacterial mouthwash are possibly an example of too much dental hygiene.
The link between dysbiosis and periodontal disease
Your gums are particularly porous – even more so than the gut, so absorption of substances is very high through the gums into the blood. This can be an issue if there are high levels of problematic bacteria causing harmful by-products, which are then constantly being released into the system. Bacteria in the gums trigger the immune response to defend against this bacterial overgrowth but when the immune system is overwhelmed, you get an invasion of the tissues, inflammation of gums, bone and bloodstream and periodontal disease occurs. This is when teeth become loose and you are at risk of losing teeth due to damage to the gums and bone.
Oral inflammation and the link to other inflammatory diseases
The lymphoid tissue in the tonsils analyse the content of the mouth and is the first line of defence for our bodies. A constant flow of inflammatory bacteria can cause the immune system to be consistently on alert. In fact, this causes inflammatory defences to be mobilised in the body and there seems to be a relationship between inflammatory diseases of the bowel and periodontal disease in the oral cavity. Both have inflammatory origins and need treatment that is both local in the mouth and bowel and systemically to support the immune system.
H pylori infection
Interestingly, people who have a history of H pylori infection causing ulceration and pain in the stomach were less likely to be reinfected if they had regular dental cleans. This is thought to be because the H pylori bacteria can hide in the biofilm on tooth enamel. Conversely, people with chronic gastrointestinal dysbiosis and infections have had limited success in treatment without also making sure the mouth is healthy. This makes sense as how can you combat inflammation in the gut when the mouth has bacterial overload causing raging inflammatory by-products to enter the blood stream? Anything that happens in the mouth, due to the permeability of the mucosa, gets into the bloodstream.
Cardiovascular disease
People who have a history of cardiovascular disease have been found to have a reduced risk of future cardiovascular events if they consistently practice simple dental hygiene. Why this happens is still unknown but it is a really simple thing that people with heart disease can do to help prevent further complications. Conversely, using mouthwash to kill the bacteria in your mouth has been suggested in studies to increase blood pressure. This is due to the relationship between nitric oxide and the good bacteria in the mouth. Nitric oxide helps expand blood vessels and reduce blood pressure. Wiping out the good bacteria in your mouth, reduces the production of nitric oxide. In a way this is like using antibiotics and wiping out all the bacteria in your gut – it's not the healthiest environment for your oral cavity or your heart it seems.
Rheumatoid arthritis and other immune diseases
Similarly, systemic diseases like rheumatoid arthritis are more severe when patients also have periodontal disease. There is also a greater risk of cancers and autoimmune diseases in people who have poor dental hygiene or periodontal disease.
How can we reduce the risks of oral dysbiosis?
Some of these things are not going to be new to you, but hopefully, with the understanding of how important good oral hygiene is, you won't feel as inclined to miss your daily floss!
- Oral hygiene practices: brush, floss, regular dental cleanings
- Plant-based diet
- Low sugar
- Healthy salivary flow
- If you have chronic, recurrent gastrointestinal dysbiosis, make sure your dental check ups are up to date and pay your dentist a visit to make sure.
What about supplements?
- Chewable probiotics – the most common chewable ones in Australia are aimed at the children's market
- Probiotic toothpaste – Designs for Health has one on the market in Fennel and Spearmint flavours
- Chewable coenzyme Q10 – this is very nourishing to gums and oral mucosa
- Bacteria eat polyphenols: consider swishing with green drinks to nourish the good bacteria
- Green tea is also naturally high in polyphenols
Healing the environment of the oral cavity
If there are symptoms of inflammation, gum disease or cavities in your mouth, healing the oral mucosa can be helped through adopting some of these strategies:
- Deglycrryhized licorice is anti-inflammatory and nourishing to the mucosa.
- Make sure you have enough zinc in your diet and consider a zinc supplement, like zinc carnosine.
- Soothing, slippery foods like aloe and okra are great for soothing inflamed gums.
- Glutamine is the preferred fuel of the cells of the mouth and digestive system. Try swishing a diluted solution around your mouth for topical application to your gums. You could also consider adding the solution to a tooth bleaching tray or a mouth guard overnight.
- Systemic natural anti-inflammatories include aloe and turmeric, which can be added to foods or taken as supplements.
- Remove gluten – this is being found to increase the epithelial cell permeability of all people, not only in the cells of people who have Coeliac Disease.
- Treat chronic stress. High-stress levels can cause dry mouth and reduce the healthy cleansing effects of saliva, as also happens with some medications and in some autoimmune conditions, so might be worth checking out if it is a new symptom for you.
Oil pulling
While there is not much research supporting the practice of oil pulling, it is likely to cause changes the microbiome in the mouth and has been part of the Ayurvedic medicine for many years. In fact, Coconut oil has antimicrobial properties, while Sesame oil was the preferred oil used in Ayurveda.
Brushing and flossing
Flossing lowers the incidence of other diseases. All floss contains plastics but brushing after flossing and rinsing will help dissolve and expel the plastic residue and the benefits are considerable.
