We’ve all heard of the gut microbiome… but how about the oral microbiome?

There are considerable studies highlighting the importance of the oral microbiome not just for oral health but for other systems in the body as well.  Following from the gut it harbours the second most abundant microbiota with an average of about 50-100 billion bacteria. 

Studies have shown associations with a disrupted oral microbiome and certain diseases such as IBS, Alzheimer’s, autoimmunity as well as certain cancers such as pancreatic cancer, oesophageal cancer and gastric cancer.  There are interesting associations seen with periodontal disease and cardiovascular disease such atherosclerosis.

A recent paper by Fan, et.al., (2020) concluded “This study provides supportive evidence that oral microbiota may play a role in the aetiology of pancreatic cancer.”

As Leishman, Lien Do & Ford (2010) point out:  “The anatomical proximity of the oral biofilm to the periodontal vasculature facilitates the systemic spread of oral bacteria to distant sites from the oral cavity such as the heart… In both gingivitis and periodontitis the periodontal vasculature dilates, increasing in surface area, further facilitating bacteremia” 

It is hypothesised that transient bacteremia during periodontal infection may lead to bacterial invasion of the blood vessels and subsequently causing damage.

According to Li et.al., (2000), “less than 1 min after an oral procedure, organisms from the infected site may have reached the heart, lungs, and peripheral blood capillary system”. 

 Certain oral bacteria have been found in aortic aneurysm specimens, heart valve specimens and are often detected along the arterial tree where atherosclerotic lesions commonly are found. 

Whether oral bacteria are causative or an innocent bystander has not yet been elucidated to my knowledge. 

Oral Microbiome and Alzheimer’s Disease

Let’s take a closer look now at the associations with periodontal disease, the oral microbiome and Alzheimer’s disease (AD)…

We know that Alzheimer’s disease patients exhibit neuroinflammation that is consistent with infection, microglia activation, and altered cytokine profiles. Infection with Porphyromonas gingivitis is a keystone pathogen in the development of chronic periodontitis and in mouse models “have been identified as significant risk factors for developing Aβ plaques, dementia, and AD [Alzheimer’s Disease]” (Dominy et.al., 2019). 

There is now also evidence that Porphyromonas gingivitis lipopolysaccharide has been detected in human Alzheimer’s disease brains (Poole et.al., 2013).  Further to this is it is also reported that low levels of Porphyromonas gingivitis in 25% of healthy individuals with no oral disease (Griffen et.al., 1998).  According to Dominy et.al., (2019) “We hypothesized that P.gingivalis infection acts in AD pathogenesis through the secretion of gingipains to promote neuronal damage.”

Oral Microbiome and Autoimmune Disease…

Researches out of Sweden conducted a 30 year study where they tracked 1676 subjects over a 30 year timeframe to see if poor oral health was associated with autoimmune diseases.

“The result showed that subjects with a higher plaque index, marker of poor oral hygiene, were more likely to develop autoimmune diseases in 30 years.” (Julkunen et.al., 2017).

So as we can see from the research it is quite essential we take good care of our oral health! I personally use and have been recommending for my patients both the Dentalcidin Toothpaste and Dentalcidin LS Oral Care Solution. I was first put onto them when I was using their broad-spectrum Biocidin formula with patients with gut microbiome imbalances.  Given the good success I was finding with patients that had Candida, Streptococcus & Klebsiella over growths and also small intestinal bacterial overgrowth (SIBO) I was naturally quite excited to start using their oral hygiene products.  The Dentalcidin Toothpaste and Dentalcidin LS Oral Care Solution contain not only broad-spectrum antimicrobial herbs but also CoQ10 & Quercetin to help support the oral tissues. A few other options to add into your oral health routine are the Gem Probiotic Toothpaste, Henry Blooms Probiotic Whitening Toothpaste & OroMax dissolvable tablets

We also have a Probiotic Toothpaste for adults & for kids

References

Dominy, S., Lynch, C., Ermini, F., Benedyk, M., Marczyk, A., Konradi, A., Nguyen, M., Haditsch, U., Raha, D., Griffin, C., Holsinger, L., Arastu-Kapur, S., Kaba, S., Lee, A., Ryder, M., Potempa, B., Mydel, P., Hellvard, A., Adamowicz, K., Hasturk, H., Walker, G., Reynolds, E., Faull, R., Curtis, M., Dragunow, M. and Potempa, J., 2019. Porphyromonas gingivalisin Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Science Advances, 5(1), p.eaau3333.

Fan, X., Alekseyenko, A., Wu, J., Peters, B., Jacobs, E., Gapstur, S., Purdue, M., Abnet, C., Stolzenberg-Solomon, R., Miller, G., Ravel, J., Hayes, R. and Ahn, J., 2020. Human Oral Microbiome And Prospective Risk For Pancreatic Cancer: A Population-Based Nested Case-Control Study.

Griffen, A., Becker, M., Lyons, S., Moeschberger, M. and Leys, E., 1998. Prevalence of Porphyromonas gingivalisand Periodontal Health Status. Journal of Clinical Microbiology, 36(11), pp.3239-3242.

Julkunen, A., Heikkinen, A., Söder, B., Söder, P., Toppila-Salmi, S. and Meurman, J., 2017. Autoimmune Diseases and Oral Health: 30-Year Follow-Up of a Swedish Cohort. Dentistry Journal, 6(1), p.1.

Krishnan, K., Chen, T. and Paster, B., 2016. A practical guide to the oral microbiome and its relation to health and disease. Oral Diseases, 23(3), pp.276-286.

Leishman, S., Lien Do, H. and Ford, P., 2010. Cardiovascular disease and the role of oral bacteria. Journal of Oral Microbiology, 2(1), p.5781.

Li, X., Kolltveit, K., Tronstad, L. and Olsen, I., 2000. Systemic Diseases Caused by Oral Infection. Clinical Microbiology Reviews, 13(4), pp.547-558.

Poole, S., Singhrao, S., Kesavalu, L., Curtis, M. and Crean, S., 2013. Determining the Presence of Periodontopathic Virulence Factors in Short-Term Postmortem Alzheimer's Disease Brain Tissue. Journal of Alzheimer's Disease, 36(4), pp.665-677.

Shoemark, D. and Allen, S., 2014. The Microbiome and Disease: Reviewing the Links between the Oral Microbiome, Aging, and Alzheimer's Disease. Journal of Alzheimer's Disease, 43(3), pp.725-738.

Verma, D., Garg, P. and Dubey, A., 2018. Insights into the human oral microbiome. Archives of Microbiology, 200(4), pp.525-540.