Oral Microbiome 101

One of the most revolutionary discoveries we’ve made to date has got to be the gut microbiome. We’ve only just begun to get a clear understanding of how great its impact on our overall health can be, but the implications are exciting. 

If you’re not already familiar with the term “microbiome”, it speaks to the bacterial colonies you have living in your digestive tract. When you take probiotics to help balance your gut flora, it’s really your microbiome that you’re bringing into balance. The microbiome plays a huge role in everything from the quality of your digestion to the state of your mind. Incredibly, there are billions more bacteria on and in you right now than cells in your body. It’s crazy to think about. What you put into your body, is everything. How you feed your bacteria, how healthy they are, affects you on every level imaginable. You literally are what you eat.

The Oral Microbiome

It turns out you have an oral microbiome too. Incredibly, there are over 850 different types of organisms in your mouth at this very moment. And the colony at the front is not the same as in the back. Just as the health of your gut bacteria affects everything, so too does your oral microbiome. And when these bacteria are in stasis, all is well. But they can wreak havoc on your health when they aren’t. You might be surprised to learn that brain tumors and heart problems often have oral bacteria at their source. It is estimated that 97% of diseases start in the mouth. 

In Ayurveda and Traditional Chinese Medicine, it is common practice to look in the mouth to gain a clearer picture of what’s happening in the body. Until about 150 years ago, doctors and dentists studied together. This offered more of a holistic approach like the ancient physicians had. But unfortunately all “mouth stuff” got relegated to dentistry, and they became little more than technicians… the mechanics of the mouth. But your mouth holds a ton of useful information, and dentistry is waking up to the truth that the mouth is both a marker for the current state of your health as well as a gateway to what’s coming down the pike. 

A Window And A Mirror

For example eating disorders are always evident in the teeth first, way before long term damage has happened to the internal organs. Osteoporosis too is evident very early on. Almost every single systemic disease known to man, shows up in the mouth in some way.

You now know the oral microbiome is a combo of different bacteria that live symbiotically together, and you might already have known that you swallow 1 trillion bacteria per day… about the size of a soda can. So if there’s a dysbiosis, or an imbalance in your mouth bacteria, it’s going to throw off the balance in your gut too. It’s all connected, and if it’s bad up there it will be bad everywhere. Leaky gut, anyone?

Bottom line: What you take into your body will either throw off the equilibrium or harmonize with it.

Healthy Mouth, Healthy You

Indeed your mouth is both a window and a mirror. An unhealthy mouth is a cause of disease, and also reflective of it. There’s a ton of valuable research going on about this right now, and thank goodness for that! Huge connections can be seen between periodontal disease and other diseases. Understanding all that the oral microbiome is trying to tell us, is key to getting ahead of some scary health problems. 

The number one bacteria found in colorectal tumors is fusobacterium nucleatum, which just happens to also be the most common bacteria in the mouth.

P-gingivalis is a bacteria found in saliva and is known to contribute to Alzheimers in predisposed patients. When out of balance, this normally harmless bacteria becomes a pathogen. Another, gingipain, breaks down neurons in the brain and is speculated to contribute to the development of Alzheimers as well.

The Blowback From Bacteria

Brain abscesses are almost always caused by mouth bacteria. Thyroid problems run rampant in our population. Well! The mouth drains right into your throat, where the thyroid is, so that makes a lot of sense.

Inflammation that’s the most impactful is the chronic, low grade kind. Oral microbes in a state of dysbiosis enter the bloodstream and cause chronic disease, heart valve infection, brain abscesses and more.

Many of the digestive problems we’re seeing that manifest in diseases like irritable bowel syndrome and leaky gut, can be traced back to unhealthy oral microbes. 

Autoimmune disease is another area that is being illuminated thanks to research around the oral microbiome. Lupus, crohn’s disease, ulcerative colitis, Sjogren’s syndrome… they seem rare when considered individually, but placed under the umbrella of “autoimmune disease” and totaled up, they represent around 50 million people. That’s about 16% of the population, more than cancer and heart disease combined. 

If what we find in the mouth can help us address underlying conditions that contribute to these diseases, the implications are fantastic.

How does it work?

One “autoimmune mechanism” involves molecular mimicry antibodies. If you have an allergy to wheat, for example, your body is making antibodies to fight the perceived threat. Amelogenin is a substance that makes up the enamel of your teeth, but it’s also weakened by the wheat antibodies. So you’ll have a high likelihood of suffering tooth loss because of a chronic immune response in your body.

I learned of a woman who was having bleeding gums and horizontal bone loss in her mouth. There was no outward evidence of periodontal disease, but through testing they determined that she had a gluten sensitivity. Her gluten antibodies were elevated, and she was developing autoimmune disease. So, it was not traditional periodontal disease but instead an allergy, and antibodies, causing her bone decay. This information was a game changer for her, as it would be for anyone. With the problem identified, they were able to immediately halt her bone loss and put her back on the road to health.

Healthy Pregnancies Start In The Mouth

Periodontal status has also been linked to a host of pregnancy problems, including low birth weight and premature birth. 

Pregnant women often suffer a condition known as “pregnancy gingivitis”. Hormone changes cause inflammation in the gums, and that leads to bleeding when brushing teeth. As we now know, oral pathogens can get into your bloodstream, and a pregnant uterus is a fabulous spot for them to go. Why? No backtalk from your body. The area is immune suppressed so the baby can grow, and bacteria love that. So off they go to wreak havoc on your pregnancy.

Researchers looked into this link between problems in pregnancy and oral hygiene, and noted that improved oral hygiene mid-term, had no effect on the problems experienced in pregnancy. The key seems to be getting your mouth in tip top shape before you get pregnant.   

You might be completely unsurprised at this point to learn that unchecked periodontitis can lead to infertility too. 

The Big C

What researchers are seeing very clearly is that we have biomarkers in our saliva that will indicate disease before it manifests. They will tell us what issues we are predisposed to, and even what diet is best for us, based on the environment in our mouth right now. This is incredible news where cancer is concerned, of course.

Esophageal cancer is the 6th leading cause of death in the world. 

Interestingly, oral cancers in younger people are often caused by the human papillomavirus, HPV. In older folks, it’s smoking and drinking that causes the dysbiosis that leads to cancer. 

It’s important to realize that cancer, anywhere in the body, is the end stage of dysbiosis. An imbalance has been present for so long, that it has manifested in something else entirely. Cancer.

Annually, about 50,000 Americans are diagnosed with oral or oropharyngeal cancer.

This type of cancer is notoriously difficult to diagnose. Most are discovered in stage 3. That is often too late. That’s when the pain sets in, so there’s something to investigate, but the dysregulation has been present for so long that little can be done at that point. 

Cancer is one obvious area where a deeper understanding of the mouth, on the part of doctors, would go a long way toward better care. For example doctors tend to go right for extraction of the tumor, chemo and radiation, but if they don’t address the underlying cause, say HPV, the likelihood is high that it will just come back.

By regarding the whole organism, the entirety of the person, quality care becomes a reality for big and little things alike.

Badly Needed Reintegration of Medicine and Dentistry

This is really just the tip of the iceberg in terms of all the ways our oral microbiome can inform our own personal care. Each of our microbiomes is as unique as we are, and with one in our mouth and more in our body, it’s easy to see why these disciplines need to work hand in hand, not separately.

The separation started around the 1840s, when self trained dentists went to University of Maryland in Baltimore. They wanted dentistry included in medical training but were told no. They were told that dentistry was little more than a “mechanical challenge”. Pulling teeth, root canals and whatnot. Training for dentists began focusing on procedures, but it’s clear now how wrong that was. There’s so much more going on in your mouth than brushing and flossing and pulling teeth! Medical insurance doesn’t even cover the mouth. That’s madness.

I learned that on average it takes 17 years for new information to start making its way into teaching curriculums and finally into a doctor’s practice. Knowledge of and research into the oral microbiome is just now starting to take off, which means this stuff isn’t going to be common knowledge for a really long time. I want it to be common knowledge for you, now. I think it’s such valuable information, and truly usable. It is applicable to every single one of us, in our own unique way. This understanding of the importance of your microbiome is one more tool that you have now to care for yourself better. Use it wisely, and watch your mouth!

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