Probiotics, Prebiotics, & Oral Health

bacteriaMost all of us grow up being taught that “germs” cause disease and that the best defense is to kill them. But science has shown that this is an oversimplification.

We know that the environment in which pathogens exist makes a big difference in whether they thrive or not – just as soil quality and other environmental factors determine whether a plant thrives or not.

We also know that our bodies contain more bacteria than human cells. We’re beginning to understand how the makeup of our microbiome can affect our health for better or for worse. As microbiological John G. Thomas has put it,

The accepted concept today is that there are multiple organisms with the ability to interact in multiple ways. The means of bringing these biofilm communities back into balance is best achieved not through use of antimicrobials, but by reestablishing a normal flora, aided by probiotic agents.

You already probably know a bit about probiotics – bacteria that support good health. You can get them naturally through fermented foods, yogurt, and some cheeses. You can also get them through supplements or foods fortified with them. So far, the research on their dental benefits in particular has been quite promising, showing how probiotics may stave off caries (tooth decay), periodontal (gum) disease, bad breath, and more.

Meanwhile, the focus has shifted away from “killing germs” to supporting the balance of helpful and harmful bacteria in the mouth. Indeed, it would be impossible – let alone desirable – to remove all microbes from the mouth, or even just the bad ones. There are billions of them in even the cleanest mouth, representing several hundred different species.

What we want is for the good to outweigh microbes like P. gingivalis and S. mutans that generate oral disease. Probiotics may help, and so might prebiotics.

Where probiotics are the actual healthy bacteria, prebiotics are non-digestible carbohydrates that help probiotics work their magic. Again, Dr. Thomas:

Prebiotics are food ingredients that stimulate the growth and/or activity of bacteria in the digestive system, in ways claimed to be beneficial to health. Marcel Roberfroid offered a refined definition in the Journal of Nutrition stating, “A prebiotic is a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon host well-being and health.” Prebiotics effectively stimulate the colonization of the probiotic microorganisms, providing an initial advantage to their adherence.

Earlier this year, scientists writing in the Journal of Clinical Periodontology identified two compounds that could be effective as oral prebiotics specifically.

Two compounds, beta-methyl-d-galactoside and N-acetyl-d-mannosamine, could be identified as potential oral prebiotic compounds, triggering selectively beneficial oral bacteria throughout the experiments and shifting dual species biofilm communities towards a beneficial dominating composition at in vitro level.

Our observations support the hypothesis that nutritional stimulation of beneficial bacteria by prebiotics could be used to restore the microbial balance in the oral cavity and by this promote oral health.

Even though much research remains to be done on prebiotics for oral health, some hygiene products have begun to emerge. It’s a bit too early to gauge how helpful they may be.

Stay tuned for further developments…

Can Your Microbiome Defend You from Antibiotic Abuse & Overuse?

antibioticsConventional medicine is going through a profound paradigm shift with respect to treating pathogenic bacteria with antibiotics. The new health frontier lies in the quest to discover how our microbiome can maintain a state of health in our bodies.

The timing couldn’t be better. Antibiotics, long thought to be the “health care miracle of the last 500 years,” have become increasingly ineffective. Microbes such as MRSA, C. diff, and E. coli have become increasingly resistant to drugs.

How did antibiotics lose their magic? One place to look is the meat on your dinner plate. Industrial food-animal production is largely to blame. Confined Animal Feeding Operations (CAFO) that use antibiotics as growth promoters account for 60 to 80% of all antibiotic use in the US. According to the authors of Antibiotic Drug Abuse,

In North Carolina alone, the estimated volume of antibiotics used to make food animals grow faster exceeds all U.S. use of antibiotics for human medicine. The result is an ever-increasing prevalence of antibiotic-resistant strains of disease- causing organisms that erode the effectiveness of antibiotics in curing disease in humans.

Of course, human medicine plays a part, too. For years, prescriptions for antibiotics were not only handed out causally, but taken causally. Although they’re only effective for bacterial infections, antibiotics are often prescribed to patients with viral diseases.

Even when prescribed correctly, patients often stop taking them once they start to feel better – before the course of treatment is through, before all the pathogenic bacteria are killed. What doesn’t kill those bugs makes them stronger.

But just when it looks like we’ve completely squandered this “miracle drug,” researchers are beginning to lasso and identify key microbes in the human microbiome. The hope is that a microbiome with just the right diversity might have enough of its own mojo to defend the body against pathogens.

It’s strange to think that we contain more microbes than human cells, but that’s what science has shown. As gastroenterologist and neuroscientist Dr. Emeran Mayer notes in The Mind-Gut Connection,

The new science of the microbiome shows, we humans are truly supra-organisms, composed of closely interconnected human and microbial components, which are inseparable and dependent on each other for survival.

Because the microbial component is so closely connected through a shared biological communication system to all the other microbiomes in the soil, the air, the oceans, and the microbes living in symbiosis with almost all other living creatures, we are closely and inextricably tied into the earth’s web of life. The new concept of the human microbial supra-organism clearly has profound implications for our understanding of our role on earth and for many aspects of health and disease.

While Mayer’s microbiome research is specifically focused on the gut-brain relationship and disorders such as depression, autism, and dementia, the CDC is actively investing in research to discover and develop new ways to prevent antibiotic resistant infections and their spread. A key factor in accomplishing their goal is the ability to unlock the mysteries of the microbiome, while encouraging antibiotic stewardship.

Clearly, we all need to engage in better stewardship of antibiotics. We need to ask better questions of our farmers, our doctors, and ourselves. Ask your health care provider how to repopulate your microbiota after antibiotic use. Though antibiotics are life-saving medicines designed to be used only if need is clear and unavoidable, they will change, unbalance and disrupt your microbiome. And when that happens, resistant bacteria can colonize, leaving the body unable to defend itself against infection.

While science has yet to definitively determine the best way to develop and reestablish a diverse microbiome, these 12 steps look like our best options for now.

Image by Practical Cures