Oral Health and its Link to Immunity
Oral health and its connection to overall immune function are showing us time and time again its symbiotic relationship. As research continues, we discover the multifaceted complexities of the oral flora’s connection to the body’s immune function and what happens when that system goes awry.
In 2013, Pierro and others reproduced a study showing that utilizing streptococcus salivarius k12 (a healthy strep strain), would inhibit the growth of “bad” streptococcus. Using the healthy strep strain prevented the unhealthy strep from colonizing the oral cavity and decreased streptococcal pharyngitis and tonsillitis in adults. This holds true in pediatrics as well! if birthed vaginally, Strep salivarius colonizes a new born within a few hours after birth. These helpful bacteria become some of our body’s first defenses as our immune system continues to mature. Have you ever heard babies under the age of 2 years old typically will not develop strep throat? In theory this is why.
Having an ample amount of good bacteria in the mouth ultimately promotes the development of microbial balance within the body and further supports the immune system.
Mesenchymal stem cells or MHCs live in the vascular spaces of the gums and other tissues. These cells influence immune activity and play a key role in modulating or balancing the immune’s response. MHC’s can activate T cells within the oral cavity. These T cells evolve and differentiate to release CD4 , CD8 and others involved with elimination of pathogens. All of this recruitment can trigger inflammation.
MHCs are responsible for influencing the activity of all components of the immune system. Macrophages, neutrophils, mast cells, complement, B cells, dendritic cells, natural killer cells you name it!
Here’s the connection, MHCs are influenced by their microenvironment. The balance of good bacteria mentioned earlier influences the activation of these cells. When bad bacteria overgrowth is present, MHCs are recruited to stimulate the immune system in its efforts to eradicate the bad bacteria and re-establish balance. If the mouth is in a constant state of bad bacterial overgrowth, this system can not effectively perform its job. It will however continue to recruit immune cells to the problem areas and eventually create significant inflammation.
Burgeoning studies are correlating poor dental/oral health with ailments such as diabetes, heart disease and now suggested connections with Alzheimer’s disease and other bio-behavioral health illnesses. Researchers continue to unveil the complexities and connections of many markers in the saliva as a result of chronic inflammation that correlate with blood levels and conditions such as lupus, diabetes, heart disease and depression. Within the pediatric population and our Lyme disease population, anecdotally, I find bad oral health contributes significantly to poor symptom improvement and difficulties balancing inflammation.
If you really think about it, the oral connection with overall health makes sense. We’ve known for some time now that dental procedures can contribute to transient bacteremia. That’s why we treat heart patients prophylactically with antibiotics prior to any dental procedures. Also, within the ICU setting, there are measures to decreased ventilator associated pneumonia or VAP. Oral hygiene protocols were in development decades ago as a preventative measure.
One researcher described the “anatomic closeness” of these bacteria to the bloodstream via capillaries can “facilitate bacteremia and spread of bacterial products and immune complexes”.
Now that I’ve described doom and gloom, what can you do about it? Knowing that the mouth is the entry of the gastrointestinal system, it’s important to ensure that the right balance of bacteria exists.
Here are some things you can do: (Disclaimer: these are my recommendations as an integrative provider deducing from research what I have learned and what I observe clinically with my patients. These are not derived from the American Dental Association)
1. Brushing at least 2 times daily and after each meal is optimum. I realize that after each meal isn’t reasonable for some but do your best! Rinsing your mouth out with water after a meal can help remove debris when brushing isn’t an option during the day.
2.Flossing daily to clean out those crevices between teeth.
3.Swishing with an alcohol free mouthwash. I like Tom’s brand or Dentalcidin mouth rinse.
4.Taking a daily probiotic that contains saccharomyces boulardii and streptococcal salivarius k12 can help. Strep Salivarius k12 is best in a dissolvable form that you hold in the mouth. I like Biopro ENT chewable tablets.
5.Focus upon biofilms. If you are prone to cavities despite brushing regularly you may be a victim of biofilms. Use natural substances like stevia and xylitol daily. Many times you can find these substances in a dental gum at your local health food store. Products like Biodisrupt from Researched Nutritionals will assist with biofilms in the GI system as a whole. I would caution you all to discuss with your provider to ensure there are no contraindications to using any of these supplements.
6.Hydration is incredibly important! Water is best staying away from sugary, acidic beverages. A rule of thumb, if you don’t feel the need to use the bathroom every 2-4 hours, you aren’t drinking enough.
7. Use a toothpaste without fluoride if you suffer from autoimmune diseases as the added fluoride can trigger additional inflammation. I like charcoal toothpastes, Dentalcidin toothpaste and anything by Tom’s brand. My kids use charcoal toothpaste and think it’s cool when their mouth turns black while brushing! At the moment, we are giving Dentalcidin a try. Its broad spectrum activity assists with removing plaques and biofilms. It also contains substances like quercertin and Coq10 to decreased inflammation of oral tissues.My son is my tricky kid with flavors and textures and finds it tolerable and “not too spicy”.
The take home message no matter your oral health routine is understanding that overgrowth of bad bugs are not compartmentalized to the mouth but can find their way throughout the body.
Li, Kolltveit, Tronstad and Olsen published an article in Clinical Microbiology Reviews titled Systemic Diseases Caused by Oral Infections. It is a great comprehensive read for those in search of additional information!
Be Well !