The human microbiome contains some of the most fascinating information about our health. Uncovering these scientific connections has required decades of research and dedicated researchers combining new ways of studying, analyzing, and using this information to help improve human health. At Viome, we have used breakthrough science to create our own line of testing kits featuring the first-of-its-kind in whole-body microbiome analysis, Full Body Intelligence™.
Science is also learning how important the oral microbiome is to dental health and our overall systemic health. Our Full Body Intelligence Test and Oral Health Essentials bundle includes saliva collection to assess and analyze the activities of your oral microbiome. By analyzing the microbial and human gene expressions from your saliva, blood, and stool all together, Viome creates the most comprehensive and holistic view of human health.
Recently, breakthrough research in human health has identified the microbial ecosystem of the mouth to be equally as important as the gut microbiome when it comes to systemic health. As many of the microbes found in our gut make their way down from our mouth, understanding how to boost and support the oral microbiome has become instrumental to improving overall human health and building resilience in your body over time.
As scientific research has explored the interactions and impact of the oral microbiome on human health, it has unmasked a host of knowledge regarding microbial activity and oral health conditions. The diverse ecosystem of bacteria within the mouth can impact the health of our gums and mouth, influencing issues such as dental cavities - or caries - and bleeding gums. By optimizing our oral health, we may protect ourselves from these health concerns that can increase the likelihood of bacteria and metabolites entering the bloodstream.
When bacteria from the mouth gain access to our blood, they can impact more than just oral health. They can also interact with our brain, gut, heart, kidney health - and more. This has scientists reevaluating the importance of the oral microbiome, oral health, and hygiene practices.
From Dental Care to Health Care
Modern dentistry is focused on the hygiene and care of our teeth, rather than the active role of our oral microbes in health. In addition to eating a healthy diet and taking your Precision Supplements, good oral hygiene practice is essential to staying healthy and well and extends to full-body health*.
Because there is only a thin barrier between your teeth, gums, and circulatory system, keeping your mouth in optimal health is essential. When the oral microbiome is out of balance, harmful microbes can pass through the gums and into the bloodstream.
So if you’re starting your health journey (or just ready to take it to the next level), it may be best to start from ‘the top of the tube’ as we call it. After all, the key to gut health begins when you put food into your mouth and chew. That makes setting up your oral health - and learning all the tips and tricks for a powerful and personalized daily routine - more critical than ever.
Replacing ‘Adequate’ with ‘Excellent’ Oral Hygiene Practices
We all know manual techniques like flossing and brushing help remove plaque buildup, but is there a right or wrong way to brush? Odds are, if you’re unsure, you’re not alone. It turns out that much of the advice you grew up on could use an update - and yes, that even includes which toothbrush you use!
Recommendation One: Brush teeth at least twice per day
Why? This may not seem so new, but brushing your teeth twice a day helps remove dental plaque buildup from the surfaces of your teeth. Plaque buildup can cause eroding of the enamel, cavities, tooth decay, yellowing of the teeth, and even gingivitis. Bacteria in plaque produce toxins that can erode gums, causing inflammation, swelling, or bleeding. Brushing can also help improve our gums by stimulating the gums and increasing circulation to this tissue, bringing immune cells and nutrients to maintain the health of this protective barrier.
How? Set a timer for 2 minutes (some electric toothbrushes have built-in timers!). Brush each quadrant of the mouth for 30 seconds. Brush all surfaces of the teeth (inner, outer, bite surface, gum line). Pro Tip: though it might feel awkward at first, switching hands during brushing ensures that each side of your mouth gets the same amount of attention. We tend to use our dominant hand only, leading to less attention on the favored side of our mouth due to limitations in our wrist movement!
Special Tip:
Avoid brushing your teeth until 30 minutes after consuming acidic foods or beverages (like coffee or lemon). Acidic foods can temporarily disrupt the protective layer of mucin and enamel around teeth. Brushing teeth while disrupted can damage the enamel further.
With what? Use a soft bristle toothbrush to reach all areas of your mouth without irritation. An electric toothbrush is helpful for those with dexterity issues. Use a natural toothpaste free of the toxins described below in the Clean Eats and Clean Ingredients section.
Recommendation Two: Floss at least once per day
Why? Yes, we still recommend flossing your teeth! Flossing helps remove dental plaque buildup. It is critical for the periodontal space (the space between the teeth) that acts as a reservoir for potentially harmful bacteria where they can begin to impact gum health.
How? Use floss or an electric flosser. When flossing with threaded floss, place the floss between the teeth, make a c-curve with the floss around the tooth and work the floss in an up-and-down motion. Using floss is more effective than a floss pick because it can be contoured around the tooth for greater plaque removal.
Is there any risk of over-flossing? Pushing too hard and causing excessive bleeding is not recommended for flossing. However, you should floss as often as you feel you need to daily. We recommend flossing at least once daily, with attention to technique, so you don’t damage your gums.
Recommendation Three: Grab a tongue scraper
Why? Now this one might feel unfamiliar. Tongue scraping helps remove leftover food particles and bacteria that may cause cavities or periodontitis from the tongue. It may also be a practical and effective daily habit for preventing halitosis (bad breath) 3
How? Stick out your tongue. Gently press the scraper to the back of your tongue, then drag it to the front of the tongue. Rinse debris from the scraper.
How often? Twice a day, when brushing teeth.
With what? Two good examples would be a stainless steel tongue scraper or a plastic, disposable version. Both can be found online and in retail stores.
Now that you’re set for success with your dental hygiene tips, what do you do in the middle?
Many factors to consider in your day can contribute to tooth damage, and a lot of them stem from food. So, as a final caveat - we have one more recommendation to keep in mind.
Recommendation Four: Avoid foods and beverages that are acidic or high in sugar
Acid is incredibly harmful to our teeth which are covered in enamel, the most mineralized substance in the entire body. It covers every tooth and is highly susceptible to acid, which can erode your teeth, making them sensitive and leading to tooth decay.
Why? Acidic foods pull calcium and phosphorus from teeth, leading to tooth decay4.
Sugar is consumed by microbes in the mouth that live in plaque, causing them to produce organic acids, which decay teeth.Examples: fruit juices, sodas, sweetened tea, and even sparkling water (if a beverage is carbonated, it’s acidic and harmful to your teeth)
Alternatives: still water, unsweetened green, white, herbal tea, low-sugar vegetable juices, milk.
If you can’t resist: a straw will help minimize some of the contact with your teeth. Rinse your mouth well after consuming it.
Special Tip:
There's good evidence that chewing sugar-free gum after a meal is beneficial. It increases saliva production and helps clear away excess food particles. Gums with the ingredient xylitol are great choices to try!
Avoiding all acidic foods can be downright difficult and would mean you would not enjoy some of nature’s healthiest produce, like many fruits, vegetables, and other wholesome foods. Fortunately, nature also has a few natural remedies to help keep acid from sticking around your mouth and teeth. You can use certain foods as ‘natural toothbrushes’ like raw apples, broccoli, or any fiber-rich whole foods, and enjoy alkaline-rich vegetables to help neutralize lingering acid levels in your mouth and saliva.
Clean Eats and Clean Ingredients
When you’re looking to optimize your oral health routine, choosing the right products can make a tremendous difference. Recently, scientists have found several harmful additives used in many traditional oral health products. Consider checking your products next time you’re stocking up and refraining from using the following ingredients:
Sodium lauryl sulfate/sodium laureth sulfate: SLS gives the sensation of foaming in the toothpaste and coolness in the mouth. Have you ever drank water after brushing your teeth and felt that really cold feeling? That’s the SLS!
According to the Environmental Working Group, EWG, SLS is considered a “moderate hazard.” The frequent use of SLS may lead to allergic and toxic reactions and is also a potential endocrine disruptor 5]. Several researchers have reported that the use of toothpaste containing SLS may cause oral lesions (ulcers in the mouth) due to absorption through the mouth6
1,4-Dioxane is a potential carcinogen recently banned in New York state. This toxin is a byproduct of the production of sodium lauryl sulfate and sodium laureth sulfate and is commonly present in products containing SLS.
Resource: EWG: Products that contain SLS
Triclosan
Reports have suggested triclosan, an active ingredient in several kinds of toothpaste, can combine with chlorine in tap water to make chloroform, which the United States Environmental Protection Agency classifies as a probable human carcinogen7.
Resource: EWG: Guide to Triclosan
Saccharin
Research suggests that saccharin decreases oral microbiome diversity and composition8,9.
Long-term saccharin use has been linked to an increased risk of obesity, diabetes, and brain cancer10.
Resource: EWG: Products that contain saccharin
Aspartame
Induces glucose intolerance and reduces microbial diversity. It is also very acidic12.
Parabens
Parabens reduce the total bacterial count in the oral microbiome and may increase the risk of eczema and asthma in children13,14.
Resource: EWG: products that contain Propylparaben
Propylene glycol
Propylene glycol is considered a humectant, meaning it absorbs moisture from its environment. This may have a drying effect on the mouth. Lower saliva content in the mouth is associated with bad breath and an increased risk for gum disease and cavities.
Prolonged exposure to propylene glycol may be associated with allergies and immunotoxicity15.
Chlorhexidine
The adverse effects of chlorhexidine are reported as an altered taste sensation, peeling of the oral mucosa (skin in the mouth), discoloration of the tongue and teeth, increased plaque formation, and stomach upsets.
Chlorhexidine is a potent antimicrobial that may adversely affect the oral microbiome and increase blood pressure. Chlorhexidine should only be used sparingly or as directed by your dentist/physician 16,17.
Sucralose
Sucralose is an artificial sweetener made by the chemical modification of sucrose. Sucralose has been shown to promote the growth of unfavorable gut bacteria, and its ingestion has been linked to increased risk for diabetes, IBS, Crohn’s, leaky gut, and weight gain.
Resource: EWG: Products that contain sucralose
What about Fluoride?
Lately, we’ve seen a variety of fluoride-free products on the market. However, the ADA still recommends fluoride to reduce cavities. Based on these guidelines, we recommend being mindful of fluoride products or use as directed by your dentist/physician, as negative health consequences can be associated with excessive fluoride intake. However, switching to products with hydroxyapatite can be a suitable replacement.
Takeaways for the Taking
Oral health is more than just what products you use or which foods you eat. Many factors and habits can contribute to your oral health and the health of your oral microbiome.
Certain daily (and nightly) habits can also influence how balanced your oral microbiome is, such as whether you routinely whiten your teeth, grind them, or even snore.
Whitening
The ADA has deemed hydrogen peroxide whiteners safe and effective. Active ingredients in whitening products and UV lights used in whitening procedures are known to be antimicrobial and may be disruptive to the oral microbiome. More research is needed in this area before we can confidently give a recommendation.
Mouthwash
Most mouthwashes are antiseptic or antimicrobial and may support oral health by reducing the overall bacteria count. However, some bacteria in the mouth are worth keeping around. A recent study revealed that an antimicrobial compound found in many types of antiseptic mouthwash, chlorhexidine, has been shown to destroy “friendly” bacteria in the mouth that help reduce blood pressure. Unless recommended by a doctor, steer clear of mouthwashes containing chlorhexidine. Mouthwashes are a great way to freshen your breath but are not intended to replace brushing or flossing.
Grinding, Nasal Breathing, and Other Habits
Many sleep habits have also been closely connected to oral microbiome health, such as whether you’re a nose breather (ideal) or a mouth breather (snore-central). Breathing through your nasal passages has been associated with many benefits, including supporting beneficial and commensal microbes. However, many of us breathe through our mouths - whether we know it or not. Even if you’re not actively snoring, it’s likely you’re still relying on your mouth for airflow. Individuals who experience snoring, difficulty breathing, or bruxism (teeth grinding) may suffer from inadequate breathing through the nasal passage.
If you suffer from teeth grinding, this habit could be dangerous for oral health because it can break down enamel or even break or crack your teeth. Ways you can lessen the impact of teeth grinding include:
Managing your stress levels may reduce teeth grinding
Addressing warning signs; jaw pain, face pain, tooth chipping, headache
Consulting with your dentist for a complete evaluation
Protecting your teeth by wearing a mouthguard to bed or at other times of the day, you are likely to grind your teeth
If you’re looking for ways to help actively support breathing through your nose, check out mouth taping - the latest trend to hit oral health and sleep health - to see if it is right for you.
Other habits can also interact negatively with our teeth and mouth, such as nail biting or chewing the sides of your mouth. Be mindful of times when your fingertips are near your mouth, as they can be a repeat offender of introducing harmful microbes into your body. By transforming these habits, you can maintain the health of your mouth and prevent damage or pathogens from consistently interrupting your oral ecosystem. Additionally, be thoughtful about washing your hands and regularly cleaning items that come in close proximity to your face, such as your cell phone. These, in particular, are notorious for being as dirty as a toilet seat!
And lastly, when in doubt, avoid tobacco products. Tobacco products reduce saliva production (along with all sorts of other side effects). Lower saliva production is associated with bad breath and increases the risk of gum disease and cavities. Furthermore, the use of tobacco has long-term effects on oral health and is associated with gum disease, oral cancers, and tooth loss.
Using these tips, you can maximize the health for your wonderful smile and the incredible oral microbiome that makes it possible. Taking care of your teeth is vital to your health, but it can also say a lot about how you feel. Although you are worth more than whether or not you have a perfect smile, taking the necessary steps to boost your oral microbiome can have some mood-boosting effects. And that’s based on real science too!
Here’s to a happier and healthier mouth!
References:
Flossing reduces bacteria causing periodontal disease, twin study shows. (2008). British dental journal, 205(5), 228.
Reichert, S., Schlitt, A., Beschow, V., Lutze, A., Lischewski, S., Seifert, T., Dudakliewa, T., Gawe, R., Werdan, K., Hofmann, B., Schaller, H. G., & Schulz, S. (2015). Use of floss/interdental brushes is associated with lower risk for new cardiovascular events among patients with coronary heart disease. Journal of periodontal research, 50(2), 180–188.
Outhouse, T. L., Al-Alawi, R., Fedorowicz, Z., & Keenan, J. V. (2006). Tongue scraping for treating halitosis. The Cochrane database of systematic reviews, (2), CD005519.
Saads Carvalho, T., & Lussi, A. (2020). Chapter 9: Acidic Beverages and Foods Associated with Dental Erosion and Erosive Tooth Wear. Monographs in oral science, 28, 91–98.Lee, A. Y., Yoo, S. H., Oh, J. G., & Kim, Y. G. (2000). 2 cases of allergic contact cheilitis from sodium lauryl sulfate in toothpaste. Contact dermatitis, 42(2), 111.
Tuncer Budanur D, Yas MC, Sepet E. Potential hazards due to food additives in oral hygiene products. J Istanb Univ Fac Dent. 2016 Apr 1;50(2):61-69. doi: 10.17096/jiufd.72103. PMID: 28955568; PMCID: PMC5573534.Rule, K. L., Ebbett, V. R., & Vikesland, P. J. (2005). Formation of chloroform and chlorinated organics by free-chlorine-mediated oxidation of triclosan. Environmental science & technology, 39(9), 3176–3185.
Cheng, X., Guo, X., Huang, F., Lei, H., Zhou, Q., & Song, C. (2021). Effect of different sweeteners on the oral microbiota and immune system of Sprague Dawley rats. AMB Express, 11(1), 8.
Sünderhauf, A., Pagel, R., Künstner, A., Wagner, A. E., Rupp, J., Ibrahim, S. M., Derer, S., & Sina, C. (2020). Saccharin Supplementation Inhibits Bacterial Growth and Reduces Experimental Colitis in Mice. Nutrients, 12(4), 1122.Azeez OH, Alkass SY, Persike DS. Long-Term Saccharin Consumption and Increased Risk of Obesity, Diabetes, Hepatic Dysfunction, and Renal Impairment in Rats. Medicina (Kaunas). 2019 Oct 9;55(10):681. doi: 10.3390/medicina55100681. PMID: 31601053; PMCID: PMC6843803.
Borsani, B., De Santis, R., Perico, V., Penagini, F., Pendezza, E., Dilillo, D., Bosetti, A., Zuccotti, G. V., & D'Auria, E. (2021). The Role of Carrageenan in Inflammatory Bowel Diseases and Allergic Reactions: Where Do We Stand? Nutrients, 13(10), 3402.
Suez, J., Korem, T., Zeevi, D., Zilberman-Schapira, G., Thaiss, C. A., Maza, O., Israeli, D., Zmora, N., Gilad, S., Weinberger, A., Kuperman, Y., Harmelin, A., Kolodkin-Gal, I., Shapiro, H., Halpern, Z., Segal, E., & Elinav, E. (2014). Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 514(7521), 181–186.
Steinberg, D., Hirschfeld, Z., Tayeb, I., Ben-Yosef, S., David, A., & Friedman, M. (1999). The effect of parabens in a mouthwash and incorporated into a sustained release varnish on salivary bacteria. Journal of dentistry, 27(2), 101–106.
Jackson-Browne MS, Henderson N, Patti M, Spanier A, Braun JM. The Impact of Early-Life Exposure to Antimicrobials on Asthma and Eczema Risk in Children. Curr Environ Health Rep. 2019 Dec;6(4):214-224. doi: 10.1007/s40572-019-00256-2. PMID: 31745828; PMCID: PMC6923583.
Andersen, K. E., & Storrs, F. J. (1982). Hautreizungen durch Propylenglykol [Skin irritation caused by propylene glycols]. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 33(1), 12–14.
Daly, B., Sharif, M. O., Newton, T., Jones, K., & Worthington, H. V. (2012). Local interventions for the management of alveolar osteitis (dry socket). The Cochrane database of systematic reviews, 12, CD006968.
Brookes, Z., Belfield, L. A., Ashworth, A., Casas-Agustench, P., Raja, M., Pollard, A. J., & Bescos, R. (2021). Effects of chlorhexidine mouthwash on the oral microbiome. Journal of dentistry, 113, 103768.
