The human body is host to more bacteria than the number of cells it comprises. These miniature ecosystems, known as microbiomes, are constantly at work — in our mouths, in our gut and even on our skin.

The mouth has a unique community of bacteria that perform important functions such as transporting ionic minerals from saliva to the surface of the teeth — a process that essentially eliminates free radicals from the tooth surface.

The oral microbiome can behave quite differently depending on its state. When in balance, the bacteria are mostly aerobic — they rely on oxygen to survive — forming a thin, clear and odourless film on the inside of your mouth and on your teeth. When off kilter, you can feel a thick, sticky and smelly coat on your teeth — typically on waking in the morning.

But doctors and scientists tend to avoid labelling the human microbiome “good” or “bad” nowadays. “Rather, it’s just bacteria that behave well (probiotics), or those that behave poorly (pathogens), depending on the condition of their terrain,” says Gerry Curatola, a biological dentist with a background in alternative medicine. “A number of species of bacteria in the mouth associated with tooth decay and gum disease are totally benign in a balanced oral microbiome,” he adds.

“Constant disturbances to this essential ecology in the mouth can cause the oral microbiome to be in a continual state of imbalance. Disturbances can include harmful oral-care products, a diet high in refined carbohydrates and sugar, a low pH in the mouth, and stress.”

While refined carbohydrates and sugar are obvious culprits, stress can also place strain on one’s oral health. Stress leads to a decrease in the flow of saliva, which is essential for the oral immune system and continuous remineralisation of teeth. Medications such as antihistamines, painkillers and antidepressants can also reduce the crucial flow of saliva.

More concerning is the link between poor oral hygiene and heart disease. Bacteria and other germs from your mouth can spread to other parts of your body through the bloodstream. When these bacteria reach the heart, they can attach themselves to any damaged area and cause inflammation.

Dentist office chair with brushes, tooth probe on mirror handle and lamp.
Dentist office chair with brushes, tooth probe on mirror handle and lamp.

Oral hygiene is akin to to a city’s waste-collection system. In good working order, waste is properly disposed of, preventing the spread of disease; uncollected it festers and can eventually enter the water supply. Similarly, failing to floss, pick, or brush your teeth regularly leads to various bacteria multiplying beyond control. Even a tiny scratch on gums creates an entry point for that bacteria, now pathogenic, to enter the bloodstream. From here, it can make its way to the heart or brain, and greatly increases your chances of a heart attack or stroke.

Tooth decay and gum disease are caused by the imbalances in their environment (microbiome), which means that disease is less about the seed (bacteria) and more about the soil (microbial terrain). Bear in mind that we are made up of microbes; they run us — not the other way around. To stay healthy, we need to understand these microbes and their needs. Here is what you can do:

  • Choose your oral care products carefully. Those that claim to remove plaque or that label bacteria as foreign invaders that need to be eliminated should arouse your suspicion. Use a probiotic toothpaste. Avoid ingredients such as sodium laurel sulphate (SLS), sodium fluoride, artificial sweeteners, propylene glycol, triclosan, microbeads and diethanolamin (DEA).
  • Take stock of what you’re eating. Eat alkalising and anti-inflammatory foods rich in antioxidants such as fruit and vegetables daily; eat fermented foods and organically raised, protein-rich foods such as fish, poultry, and eggs regularly. Consume tea and coffee in moderation.
  • Lastly, exercise! It is proven to reduce stress levels and increase circulation (including the gums) and will improve your general immune system.
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