The mouth is our first microbiome

Our first microbiome forms in the mouth at birth. Around 700 different types of bacteria live on the tongue, teeth, interdental spaces, and cheeks. Here, the bacteria find an excellent basis for life because it is moist and warm.

If saliva flow decreases, for example, due to medication, stress, or menopause, plaque-forming bacteria multiply significantly faster. The mucous membranes become more sensitive, and pathogenic germs can proliferate.

Saliva even contains a pain-relieving substance that is six times stronger than morphine.

This makes saliva the most important factor in the mouth. Saliva can buffer acid attacks, remineralize teeth, and transport antibodies and enzymes.

Our microbiome also changes with food: sugar promotes the growth of caries-active bacteria. A diet rich in nitrates or fiber, on the other hand, feeds beneficial bacteria. Bacteria in the mouth can produce nitric oxide from green leafy vegetables, which in turn ensures healthy, elastic blood vessels.

Diversity as the Foundation of Health for the Oral Microbiome

Humans have roughly as many bacteria as their own cells. Because we now better understand this coexistence, the approach to oral hygiene has fundamentally changed.

The old mantra of trying to kill 99 percent of bacteria with an aggressive mouthwash is obsolete. Studies confirm that daily chlorhexidine rinses can measurably increase blood pressure. Anyone who wants to eliminate all bacteria also removes the good ones, thereby losing an important protective mechanism.

Diversity is the foundation of health. This applies to all microbiomes, especially our gut microbiome. The healthiest and oldest people have a diverse, species-rich microbiome.

Biofilm, Quorum Sensing, and Systemic Consequences

What happens if we stop brushing our teeth or neglect interdental hygiene? After a few days, the biofilms organize into a firm, dense matrix, where pathogenic germs gain the upper hand.

Bacteria can communicate over long distances. Science calls this quorum sensing. Because more and more bacteria are developing resistance to antibiotics, a new research approach aims to disrupt precisely these communication pathways of bacteria.

The most common oral diseases, caries and periodontitis, have a bacterial origin. Caries involves irreversible loss of tooth hard tissue. Periodontitis leads to bone loss but also has systemic effects on the body. Periodontitis can induce silent inflammation and be a silent nutrient thief. Periodontitis bacteria can spread in our body in two ways:

1. via the direct bloodstream from inflamed gum pockets
2. via the stomach into the intestine with every swallow.

These bacteria have even been found in the brains of Alzheimer's patients and in plaque on blood vessels and heart valves.

A new, interesting research approach discusses the persistence of viruses in oral biofilms. This is believed to significantly indicate the severity of periodontitis. Therefore, the question arises to what extent the oral cavity is a source for the spread of viruses.

The MALT System: How the Mouth Communicates with the Body

However, we are not defenseless against these microorganisms. Our immune system reacts to them. It possesses a sophisticated system, MALT. This lymphatic tissue is located directly in and under the body's mucous membranes. It helps the immune system tolerate harmless microorganisms and actively fight pathogens.

Thus, information from the gut microbiome reaches all body regions, including our oral microbiome directly. An imbalance in the gut microbiome can also manifest as painful aphthae on the oral mucosa or lips.

The Special Position of the Lips: Perioral Dermatitis and Ingredients

They form the boundary to the skin, are soft, thin, and sensitive. A persistent skin condition, the cause of which is currently unclear, affects precisely this area around the mouth: perioral dermatitis. It is characterized by redness and small nodules.

An impaired skin barrier due to over-care is suspected. The therapy involves refraining from all cosmetics. However, omitting fluoride-containing toothpastes is also advisable, as these can also imbalance the microbiome.

Toothpaste ingredients are receiving increasing attention. The main criticisms are directed at:

• Strongly foaming surfactants like sodium lauryl sulfate (SLS)
• Artificial colors and flavors
• Preservatives
• Disinfecting ingredients
• Sorbitol

These can cause irritation in sensitive individuals and make the mucous membrane barrier more permeable. Precisely because of these ingredients, when practicing oral hygiene, care should be taken that the saliva mixture does not come into contact with the skin, as it could irritate it.

Recommendation for Your Dental Care Routine

Observe the order: first brush your teeth, then proceed with facial care.

1. Clean interdental spaces with dental floss or interdental brushes.
2. Brush teeth, preferably with a sonic toothbrush.
3. Clean the tongue with a separate tongue scraper.
4. Instead of mouthwash, rinse your mouth with coconut oil.

The ancient tradition of Ayurvedic oil pulling, preferably with coconut oil, has been described for many centuries and is gaining increasing popularity. Studies also confirm the effectiveness and positive effect of the oil on the biofilm. If you want to skip a step and are in a hurry, you can also use an oil-containing toothpaste.

Outlook: Rediscovering the Oral Cavity

Microbiome research is only at the beginning. We are just rediscovering the oral cavity. This is also due to microbiome research. In the coming years, our understanding of health will certainly change fundamentally.