The Oral Microbiome | Research
It has been speculated for centuries that dental health can impact our whole being, but now research confirms the role that the oral microbiota can play in systemic health and disease (1). Locally, periodontal diseases and dental caries are one of the most prevalent health problems worldwide (2,3).
The mouth is one of the most heavily colonised parts of our bodies, harbouring an estimated 600+ different bacterial species (4). A balanced oral microbiota protects the mouth from infections and contributes to the maintenance of oral health (5). However, the oral microbiota can easily be disturbed by factors such as poor oral hygiene, dietary habits, smoking, immunodeficiency, and ageing (6,7,8). These disturbances can cause dental carries and periodontal diseases, such as gingivitis and in more severe cases periodontitis (gum disease) (9). Furthermore, an association has been found between the composition of the oral microbiota and systemic disease, such as cardiovascular disease and pregnancy complications (10,11).
Oral diseases start with the growth of dental plaque, a biofilm formed by the accumulation of bacteria and their toxins, together with saliva (9). Current treatment of plaque and oral diseases involve mouthwashes and professional teeth cleaning, and in more advanced cases, antibiotics or surgery (4). However, with ever increasing antibiotic resistance and their unwanted side effects such as antibiotic-associated diarrhoea, there is an increased need for novel therapies that do not involve conventional antimicrobial agents.
Several meta-analyses have found significant effectiveness for the use of probiotics in the management of oral health and gingivitis (12,13). Studies highlight the capacity to inhibit growth of periodontal pathogens and to modulate inflammatory pathways.
References1. Scannapieco, F. (2013) The Oral Microbiome: Its Role in Health and in Oral and Systemic Infections, Clinical Microbiology Newsletter, 35(20):163-179
2. Iheozor-Ejiofor, Z., et al. (2015) Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 6:CD010856
3. Dye, B. (2012) Global periodontal disease epidemiology. Periodontol 2000 58(1):10-25
4. Paster, B., et al. (2001) Bacterial diversity in human subgingival plaque. Journal of bacteriology 183:3770-83
5. Devine, D., et al. (2009) Prospects for the development of probiotics and prebiotics for oral applications. Journal of Oral Microbiology 1:1
6. Laleman, I., et al. (2014) Probiotics reduce mutans streptococci counts in humans: a systematic review and meta-analysis. Clin Oral Investig. 18:1539-52
7. Hasslöf, P., et al. (2013) Early intervention with probiotic Lactobacillus paracasei F19 has no long-term effect on caries experience. Caries Res. 47:559-65 8. Killian, M., et al. (2016) The oral microbiome - an update for oral healthcare professionals. Br Dent J. 221(10):657-666
9. Marsh, P. (2006) Dental plaque as a biofilm and a microbial community - implications for health and disease. BMC Oral Health 6 Suppl 1:S14
10. Beck, J., et al. (2005) Systemic effects of periodontitis: epidemiology of periodontal disease and cardiovascular disease. J Periodontol 76:2089-100
11. Xiong, X., et al. (2006) Periodontal disease and adverse pregnancy outcomes: a systematic review. Brit J Obstet Gynaecol 113:135-43
12. Martin-Cabezas, R., et al. (2016) Clinical efficacy of probiotics as an adjunctive therapy to non-surgical periodontal treatment of chronic periodontitis: a systematic review and meta-analysis. J Clin Periodontol. 43(6):520–30
13. Gruner, D., et al. (2016) Probiotics for managing caries and periodontitis: systematic review and meta-analysis. J Dent. 48:16– 25