When we think of the human microbiome, we typically think of the gut microbiome in the lower gastrointestinal tract. However, research has discovered many unique microbiomes throughout the body, such as the mouth, urogenital tract and the skin. Each of these microbiomes exists to provide a protective health benefit for their specific location and to support the immune system by decreasing inflammation from elevated cytokines.

The oral microbiome has fascinated researchers. Besides being the second-largest microbiome (after the gut), the oral microbiome presents an incredibly biodiverse collection of microorganisms. When microbiomes are well-balanced, the beneficial probiotic bacteria effectively compete with pathogenic bacteria. When unbalanced, the microbiome becomes unhealthy, which research links to several diseases, including cardiovascular, stroke, nitric oxide imbalances, pneumonia and rheumatoid arthritis. It is thought that the dysbiotic bacteria in the mouth increase the risk of these diseases either by direct invasion or by causing an immune-inflammatory response that extends into the systemic circulation.

One study revealed that stroke risk was 400 percent higher in people with periodontitis (gum disease). Coronary heart disease and endocarditis (inflammation of the inner lining of the heart’s chambers and valves) risks are also elevated. In cardiovascular disease, direct bacterial invasion can increase complications, as well as an indirect activation of inflammation. Therefore, a healthy oral microbiome is a key component to sustained health and plays a significant role in preventative medicine.

The Unique Oral Microbiome

The primary uniqueness of the oral microbiome is its diversity. This microbiome features a vast array of bacteria, viruses, yeast and microorganisms. More than 1,000 species of bacteria live within the oral microbiome. These groups include the commonly known lactobacillus, bifidobacteria and streptococcus bacteria. These beneficial probiotic bacteria work to keep the oral biofilm healthy and balanced, while acting as a preventative measure against the many possible diseases that can affect the oral cavity.

An imbalance between the good and bad bacteria, as well as environmental factors (such as diet and smoking) can cause dysbiosis, a disruption to the microbiome resulting in an imbalance. This unevenness can lead to a broad array of dental health complications, including caries (tooth decay), periodontitis, endodontic (root canal) infections, alveolar osteitis (dry socket) and tonsillitis.

One such example is the bacteria Streptococcus mutans. S. mutans is a typical inhabitant of the oral microbiome and does not necessarily pose a threat when the microbiome is healthy and balanced. When the amount of S. mutans becomes excessive, it, along with other bacteria, form biofilms on the teeth, commonly known as dental plaque. The bacteria within the biofilm metabolize sugars and produce acids that break down or demineralize tooth enamel and dentin, leading to decay. So, a person’s diet, specifically the amount of sugar in their diet, can create an environment where pathogenic bacteria thrive, causing an imbalanced microbiome and increasing the risk of periodontal disease, tooth decay and damage and possible tooth loss.

Supplements that Support Oral Microbiome

Because the oral microbiome impacts the health of the entire body, addressing microbial dysbiosis can help repair damage to the oral cavity and protect against further systemic health complications. One such method of supporting the oral microbiome is supplementation with probiotics. Research has shown an increase in protection against tooth decay and a decrease in the overgrowth of S. mutans when supplementing with various probiotics.

For example, taking oral dissolving tablets containing Lactobacillus salivarius—a thoroughly studied probiotic strain—has been shown to inhibit the growth of S. mutans. When Epigallocatechin gallate (found in green tea) was administered alongside L. salivarius, the beneficial effect was even more substantial. Research found that this anti-inflammatory and antioxidant combination was also effective for inhibiting P. gingivalis, a pathogen with a relationship to rheumatoid arthritis, indicating the systemic benefit of supporting the oral microbiome. Lactobacillus reuteri, another probiotic strain of bacteria, has also been found to provide tangible benefits. Based on extensive research, oral tablets appear to be an extremely effective way to target and support the oral microbiome.

In the case of the oral microbiome, supplementation with probiotics and nutraceuticals is imperative to maintain balance. The oral microbiome plays a crucial role in the health of the entire body, and individuals should take measures to preserve their dental health and, hence, their systemic health.

Dr. Gary Kracoff is a naturopathic doctor and registered pharmacist at the Johnson Compounding and Wellness Center, located at 577 Main St., Waltham. For more information, call 781-893-3870 ext. 111, email [email protected] or visit NaturalCompounder.com.