by Lisa Keilhofer

Watch your mouth! Understand the oral microbiome and treat it right.

The Oral Microbiome
The Oral Microbiome - take care of it! (Picture: © kei907 -

Our mouth is the orifice that has to deal with dramatic fluctuations in temperature, acidity, and composition of chemical substances every day. Depending on our cultural background, we are torturing our mouth with close to boiling-hot food (Chinese Cuisine, for example), an overload of sugar (western nations), are more or less neglecting our teeth in terms of hygiene (developing countries) or overdoing the whole hygiene thing with aggressive mouth washes. So, we thought it is high time, we looked at the issue a bit closer. What conditions are to be found in our mouth and how can we keep the system in balance?

What does the oral microbiome look like?

A team of scientists from various institutions of dental care and nutrition has summarized the key facts in this >>> essay. First, we differentiate nine sites within our mouth: buccal mucosa, hard palate, keratinized gingiva, palatine tonsils, saliva, sub- and supragingival plaque, throat and tongue dorsum. So, actually the oral microbiome is not one, but a summary of various sites that are all colonized very specifically.

An average oral microbiome holds as many as 20 to 50 genera from 6 to 9 phyla. The prevailing microbes are streptococci, but also Prevotellae, Veillonellae can be found – among many other bacteria, fungi, viruses, and other archaea.

How does the oral microbiome evolve?

During pregnancy, the fetus gets into contact with the mother’s oral microbiome through the placenta and develops a tolerance to it. The pretty much sterile newborn is instantly colonized by bacteria after birth, giving preference to those that the unborn child had a chance to develop tolerance to. Interestingly, even this very first event in a lifetime of giving birth either vaginally or by section plays a key role, as well as the decision of breastfeeding versus formula. These facts influence the rest of the person’s life as once colonized by the one or the other set of microbes, it is hard to “relocate” those.

What if the oral microbiome is out of balance?

Caries, calculus, and periodontitis are the most common results of an impaired oral microbiome. In actual fact, caries is one of the most prominent diseases of the entire mankind – with more or less dramatic consequences, as an open tooth equals an open gate for germs of all kinds and brings a number of secondary diseases with it, when not treated. Malnutrition and lacking oral hygiene cause a biofilm called plaque, which is the basis for caries. An intake rich in carbohydrates, especially sugary food, is the most common cause for that biofilm. As a first consequence the oral pH value drops under 5.5 and results in a demineralization and damaging of the tooth hard tissues.

Why are our teeth so sensitive?

For most regions of our body goes “less is more”. Often, people living close to nature serve as an example that the highly complex system of our microbiome is at best left alone. But as we compare the oral health of the developing countries, where dental hygiene is not yet standard, we find caries in the same extent (or even more) than in industrialized countries. And a 21stcentury human is facing the caries issue just like the old Egypts did 3.000 years ago. Also Ötzi, the famous ice mummy had a better gut micriobiome that we have today, but was still suffering from caries (read more: Ötzis Microbiome better than ours).

Well, in general, it is right that natural nutrition free from industrially processed “pap” is polishing the teeth a bit more. But still, since we consume cooked food and carbohydrates (which is what we are doing for a couple of thousand years now), we are much more prone to suffer from caries and dental hygiene is a must. Our microbiome is adjusting only very slowly to modern amenities like cooking.

Correct dental care – a short summary

So, let’s face it. Our oral microbiome needs special attention. What we know since we were kids – brushing teeth twice a day, ideally after every meal – is a good start. Toothpaste should contain fluoride for strengthening the teeth. Electric toothbrushes outperform brushing manually, while at the same time, our gingiva is suffering from over-ambitious pressure. The consequence are painful exposed tooth necks, and tooth neck caries. Cleansing has to be thorough, but at the same time smooth. Sugar harms your teeth, as every child knows. But who would have thought that also the acids of fruit or juice can seriously damage the enamel? Brushing teeth immediately after the consumption of fruit or juice can even do more harm than help. For a while, electric mouth washes were in fashion. Today, we rather refrain from using those as germs can be pumped under the subgingiva instead of being removed. In addition to brushing, the use of dental floss is recommended, along with regular professional dental cleaning.

Caries is not a blemish, but an unpleasant finding and can result in a number of even more unpleasant secondary diseases. So, healthy teeth are not only a social flagship, but fundamentally important for our overall state of health.

Lisa Keilhofer
Lisa Keilhofer

Lisa Keilhofer studied at the University of Regensburg. She works in internationalization and as a freelance editor.

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