According to the World Health Organization’s March 25th, 2020, report on oral health, dental caries remains the number one dental issue globally to this day. While we are seeing a decrease in dental caries in both fluoridated and non-fluoridated communities in Canada, there is still much work to be done.
Dental decay occurs when the acid burden in our mouths overwhelms the buffering capacity of our saliva. If there are inadequate minerals from saliva, the acid is then buffered from the minerals contained in our tooth structure to reach equilibrium, leading to dental caries.
While it has long been accepted that external sources like acidic food and drink can lead to erosion in our mouths, the health of our internal systems may play a bigger role in dental decay than previously thought. One such system being our digestive tracts.
The oral-gut connection
Dental pathogenic bacteria have been found to influence the microbiome of the gut. A (2019) article in the Journal of Oral Microbiology discusses how Porphyromonas gingivalis can influence the microbiome in a negative way, in addition to oral Streptococcus species contributing to dysbiosis and leaky gut syndrome. A study published in the Caspian Journal of Internal Medicine found that some Candida species commonly found in our guts also produce acid themselves and play a role in the formation of cariogenic biofilms by producing exopolysaccharides that act as the matrix and glue of the biofilm, leading to decay.
The food we put into our bellies plays a key role in our gut health. The high sugar Standard American Diet (SAD) is becoming more prevalent in Canada as our population shifts to an increasingly processed industrial diet of convenient foods. This type of diet wreaks havoc on our digestive tracts by altering the microbiome and subsequently leading to inflammation and loss of the protective barrier of our guts. High sugar diets fuel microorganisms which lead to the acid burden.
Herbicides such as glyphosate/roundup, which can now be found in our food supply, are shown to contribute to this inflammation and dysbiosis. In addition, the use of antibiotics and other pharmaceuticals as well as residual amounts found in our meat, farmed fish and shellfish only add to insult.
A holistic approach
While oral health professionals have long been encouraging patients to adopt good oral hygiene habits like regular brushing and flossing to maintain their oral health, suggesting they avoid foods that cause inflammation and/or overgrowth of bacteria is less common. And yet patients can surely benefit from understanding how their gut health plays a key role in their oral health. The next time you have the flossing talk with your patients, perhaps you’ll consider integrating the oral-gut connection.
About the Author
Dr. Young is a general dentist and Managing Partner at Orijin Integrated Dentistry in Calgary, Alberta. He is highly involved in giving back to communities and is particularly proud of his work with children’s charitable initiatives, including the Tooth Fairy Children’s Foundation, the Alex Dental Health Bus and the ADA&C Start School Smiling program. He holds a Doctor of Dental Surgery (DDS) degree from the University of Alberta.