Rebalancing You

Yesterday was the start of National Smile Month, a campaign to promote good oral health. Top tips include:

• Brushing your teeth last thing at night and at least one other time during the day (I brush mine in the morning before breakfast)
• Cutting down on sugary foods and drinks
• Visiting your dentist on a regular basis

The aim is to maintain a healthy mouth which can help us to achieve good physical and mental wellbeing. Sounds simple but it’s so much more than fresh breath and a bright smile.

There’s a fascinating link between oral health and overall health and for such a small part of the body it can have quite an impact when things aren't going so well.

We know that the mouth is important, after all how else is the food we love to eat going to get into our bodies? Interest is growing as researchers uncover previously unappreciated evidence about the oral microbiome and the effects on overall health.

Just like our guts have microbiomes, so do our mouths. This ecosystem of bacteria is called the oral microbiome and exists in your oral cavity which also includes your ears, nose, and throat. Good oral health, like brushing and flossing your teeth and eating the right foods help to keep this in balance. These are the main ways that the oral microbiome can affect our overall health:

• It can alter the gut microbiome – Our mouth is the beginning of our gastrointestinal system which means undesirable bacteria in the mouth can travel directly into our gut increasing the number of unwanted bacteria in the stomach and intestines. ¹ The gut microbiome is the foundation of our health, when this is out of balance it can result in problems with our immune system, mood and sleep. ²
• Bacteria can enter the blood stream via our gums - Studies have linked changes in the oral microbiome to heart and brain health. Of the two the most surprising is the link with brain health. Unwanted bacteria in the blood stream can trigger an immune response which results in our bodies releasing cytokines (the cells that help fight infection) when there are too many cytokines over a long period of time, they can cross the blood brain barrier and start to affect our memory and brain function. ^{3 4} The immune response also triggers inflammation, too much inflammation can cause damage to blood vessels resulting in small clots and potential risk of heart attacks or strokes. ⁵
• It can change the composition of our saliva which can affect our digestion - This means that the food we eat isn’t broken down as easily, making it harder for our bodies to extract all the nutrients that we need for good health. ⁶
• It can directly affect our upper respiratory health – the good bacteria in our oral microbiome can help to stop irritants like dust and pollen from triggering ear, nose and throat infections. ⁷

Another area of interest is joint and muscle pain particularly as we age. People with arthritis and osteoporosis are more at risk of gum disease and generally suffer with poor oral health. It's unclear whether this is due to mobility issues which might make it difficult to practice good oral hygiene or down to inflammation in the body that happens with muscle and joint conditions. ⁸

All considered we can see that keeping our oral microbiome as balanced as possible can help us stay healthy. In return we can nurture our microbes by eating a microbe friendly diet, reducing our sugar intake (the not so good bacteria love sugar), practicing good oral hygiene and visiting our dentist regularly. Remember it’s not just for our oral health but for our overall health!

1. Hajishengallis, G. (2014). The inflammophilic character of the periodontitis-associated microbiota. Molecular Oral Microbiology, 29(6). doi: 10.1111/omi.12065
2. Shreiner, A.B., Kao, J.Y., Young, V.B. (2015). The Gut Microbiome in Health and in Disease. Current Opinion in Gastroenterology, 31(1). doi: 10.1097/MOG.0000000000000139
3. Nangle M, R, Riches J, Grainger S, A, Manchery N, Sachdev P, S, Henry J, D: Oral Health and Cognitive Function in Older Adults: A Systematic Review. Gerontology 2019;65:659-672. doi: 10.1159/000496730
4. Shoemark D.K., Allen S.J. (2015). The Microbiome and Disease: Reviewing the Links Between the Oral Microbiome, Aging, and Alzheimer's Disease. Journal of Alzheimer's Disease, 43(3). doi: 10.3233/JAD-141170
5. Publishing, H. (2020) Gum disease and the connection to heart disease - Harvard Health, Harvard Health. Available at: https://www.health.harvard.edu/diseases-and-conditions/gum-disease-and-the-connection-to-heart-disease (Accessed: 18 May 2020).
6. Tiwari, M. (2011). Science Behind Human Saliva. Journal of Natural Science, Biology and Medicine 2(1). doi: 10.4103/0976-9668.82322
7. Pierro, F. D., Donato, G., Fomia, F., Adami, T., Careddu, D., C., & Albera, R. (2012). Preliminary Pediatric Clinical Evaluation of the Oral Probiotic Streptococcus Salivarius K12 in Preventing Recurrent Pharyngitis and/or Tonsillitis Caused by Streptococcus Pyogenes and Recurrent Acute Otitis Media. International Journal of General Medicine, 2012(5). doi: 10.2147/IJGM.S38859
8. Kelsey, J. L., & Lamster, I. B. (2008). Influence of musculoskeletal conditions on oral health among older adults. American journal of public health, 98(7), 1177–1183. https://doi.org/10.2105/AJPH.2007.129429