It might blow your mind to realize that at any given moment, you’ve got about 20 billion bacteria living in your mouth. You’ve also got viruses, fungi, and parasites.
This isn’t a bad thing. It’s a life thing. This community of tiny critters makes up what we call the oral microbiome. And it’s a driver of both your oral and your systemic health.
A Healthy vs. Unhealthy Oral Microbiome
Although hundreds of species of bacteria can be found in the human mouth, only a fraction predominates at any given time. Some are harmful; some are not. What’s inescapable is that they work in relation to each other.
There is a symbiotic relationship between the microorganisms in our oral cavity based on mutual benefits. The commensal populations do not cause harm and maintain a check on the pathogenic species by not allowing them to adhere to the mucosa. The bacteria become pathogenic only after they breach the barrier of the commensals, causing infection and disease.
To put it another way, the biofilm called “plaque” that builds up in your mouth can be healthy or unhealthy. It all depends on the microbial balance. If the “good guys” such as cocci dominate, then all is well. One of the things they do is keep the “bad guys” in their place.
If those baddies dominate, though – microbes such as spirochetes, trichomonads, and gliding rods – disease is happening.
And this is why our phase contrast microscope is such an important tool in caring for our patients: It lets us see the composition of a patient’s oral microbiome. While it can’t tell us the specific species involved, we can tell what kinds of microbes are present by their shape and movement.
In a healthy biofilm – glimpsed in a small sample of saliva placed under the microscope – you actually don’t see much happening at all:
When disease is present, though, you see lots of wild movement:
The goal of oral hygiene, then, isn’t to eliminate all bacteria but to foster a healthy balance. Both oral and whole body health depend upon it.
How You Shape the Health of Your Own Oral Microbiome
“Various studies,” write the authors of a 2018 paper in AIMS Microbiology,
Demonstrate [a] relationship between unbalanced microflora and [the] development of diseases like tooth caries, periodontal diseases, type 2 diabetes, circulatory system related diseases. etc…. Human diets and habitat can trigger virus activation and influence phage members of [the] oral microbiome. As it is said, [the] “mouth is the gateway to…total body wellness, thus, [the] oral microbiome influences [the] overall health of an individual.”
In a recent letter to the BDJ, one dentist likened oral bacteria to humans, particularly in relation to systemic health issues such as cancer.
They dwell in people’s intestines and oral cavities. Bacteria have their own chemical factory, which transforms nutritional components absorbed through the permeable membranes of cells, into energy that allows them to grow, reproduce and sustain themselves and produce molecules that travel in the bloodstream acting as chemical messengers between them and tumour sites or teeth and gum surfaces.3 Microbes transcript and translate absorbed nutritional components in a regular fashion. The dysregulation of either transcription or translation leads to abnormal tumour growth ‘malignancy’. And therefore, microbes are ecological communities of symbiotic and commensal microorganisms, that literally share human genomic footprints, coevolved with humans and are continuously shaped by modern aspects of lifestyle such as diet and smoking that improve health or cause illness.
That last part is most important, for it points to the active role we play in determining the health of our oral microbiome – or its propensity to cause disease.
Simply brushing and flossing are important, but they’re not enough on their own. They help break up the biofilm, making it harder for harmful microbes to proliferate, build up, and harden into tartar that must be professionally removed.
Nutrition is just as crucial in keeping the oral microbiome in balance. When you eat the kind of food you were designed to eat – a wide variety of whole foods, minimally processed, with lots of fresh produce, lean meats, healthy fats, and so on – you create conditions that support the kind of diverse microbial communities that help us thrive. At the same time, you’re maintaining a neutral (healthy) salivary pH and giving your body the nutrients it needs for ongoing natural remineralization of teeth and maintaining healthy soft tissues.
Hyper-processed diets full of highly refined carbs have the opposite effect. They limit diversity while feeding pathogens their preferred foods: sugars.
Other habits that change the oral environment – smoking is a big one; so is drug or medication use – likewise change the composition of the oral microbiome. Pathogens that would otherwise have a hard time taking over find it easier to do so in the altered environment.
This is why we focus on so much more than just cleaning your teeth when you come in for your regular hygiene visits. Biological dental hygiene is so much more than that. It’s helping you identify and remove barriers to maintaining a healthy microbial balance so your mouth becomes a contributor to your overall health and well-being, not a detriment to it.
