There is a HUGE connection between our oral health and the health of the rest of the body including the gut and of course a connection between our gut health and our oral health – no one way streets here.    

Gum disease not only causes problems in the gut but is also linked to chronic diseases such as diabetes type 2, cardiovascular diseases, kidney disease, rheumatoid arthritis, Alzheimer’s, cancer and maybe even more severe COVID 19 symptoms, Gum disease is also linked to adverse pregnancy outcomes (one of the reasons why dental care is free in pregnancy in NZ). (1)

This is why it is paramount that we take care of our oral health. 

Bad Breath

Up to 90% people have some form of gum disease or gum inflammation which can be a sign of oral dysbiosis which leads to bad breath. (2)

Many of the products used to freshen the breath actually do more harm than good. There is some evidence suggesting that alcohol based mouthwashes may cause oral cancer in people who smoke  or drink alcohol routinely.  Acetaldehyde is a metabolite of alcohol and is a known carcinogen (cancer causing chemical). It is thought that alcohol over time causes ‘leaky gums’ which allows carcinogens to pass through the gums (oral mucosa) and into the bloodstream. There may be potential risks for cancer in long-term and frequent users of mouthwash. (3, 4)

Using chewing gums and strips only mask the smell for a short period of time only and some of them contain chemicals that can exacerbate gut symptoms such as diarrhoea and cramping and many of the synthetic sugars can disrupt the gut microbiome.  

Plaque

Reducing plaque (some plaque is important but not too much) is important because microbes live in layers of the plaque and different microbes live in the different layers of plaque. As the plaque builds up it becomes more anaerobic which results in more different types of bacteria living in the plaque that shouldn’t be living there. 

Many of those anaerobic loving microbes (they don’t require oxygen to survive) produce toxins and by-products and acid, which damage the teeth causing decay.  They also create high amounts of inflammation and inflammatory chemicals that end up being passed into the bloodstream. This can then cause inflammation elsewhere in the body and that’s how chronic disease can start…most chronic disease has chronic inflammation as the cause and driver. 

Brushing your teeth is helping to breakdown those plaque layers – brushing for 2 minutes will break down 55% of plaque. (5)

A company called  ‘Microbiome Labs’ have 2 products – enzymatic mouthwash to remove odours for several hours, they are also in the process of launching a product that breaks down plaque to reduce oral dysbiosis and therefore inflammation, 

 

The mouth is home to about 700 species of bacteria and numerous other microorganisms such as fungi, viruses and protozoa. It’s the 2nd largest home to a diverse group of microbes, the gut being the first. Something like 22% is found in the oral cavity. We have a core microbiome (predominant species) and then we have variable microbiome (individual to us and our environment). (6)

Research has started to show that some of the bacteria that are in the mouth  are specifically linked to specific health conditions such as: 

• Alzheimers
• Atherosclerosis
• Pancreatic Cancer
• SIBO/IBS
• Oral cancer
• Colorectal cancer
• Aspirated pneumonia

 

Colorectal Cancer

High levels of a bacteria called  Fusobacterium nucleatum found in the mouth can be swallowed. Usually stomach acid would destroy this bacterium but if you have low stomach acid (maybe due to omeprazole or antacid use) then the fusobacterium can travel through the small intestine intact into the colon, causing inflammation and triggers colorectal cancer development. (7)

Lupus

Fusobacterium can also pass into the lymph via the mesenteric lymph where they can stimulate the development of lupus (there are other bacteria associated with lupus too). (8) 

 

Atherosclerosis

Many bacterium in the mouth can pass through the gums into the bloodstream and colonise on the lining of the blood vessels, stimulate an inflammatory response creating plaques which then causes atherosclerosis. (9) 

 

Alzheimers 

LPS a toxin found on the outside of specific bacteria can also pass through the gums into the bloodstream (this happens with ‘leaky gut’) and travels to the brain causing inflammation in the brain which is associated with Alzheimers. (10 -12)

 

Pancreatic Cancer

Researchers are now able to predict the risk of pancreatic cancer based on the type of bacteria in the mouth. Porphyromonas gingivalis had an overall 59 percent greater risk of developing pancreatic cancer than those whose microbiomes did not contain the bacterium. Similarly, oral microbiomes containing Aggregatibacter actinomycetemcomitans were at least 50 percent more likely overall to develop the disease. (13, 14)

 

What can also happen is that inflammation in the gums caused by dysbiosis (imbalance of bacteria types and numbers) stimulates an immune response causing a ‘bystander effect’ where the immune cells try and attack the bacteria in the gums and as a result start attacking your own gum tissues which may lead to auto immune type reactions. 

As in gut dysbiosis – it’s important to support the microbes that are beneficial to health and that are meant to live in the mouth so they can keep in check (outcompete) the bacteria that is not beneficial that drives disease. 

 

Vicious Cycle Driven by What we Eat

When we eat, our mouth microbes eat before us. Our beneficial microbes metabolise the sugar in carbohydrates, then they produce acid which supports the growth of ‘not so beneficial’ microbes such p.gingivalis which produce their own by-products which then are toxic and cause problems such as inflammation. 

To summarise, our beneficial microbes eat sugar,  make by-products which support the growth of bad bacteria, who produce by-products which support growth of bad bacteria etc etc. you then end up with dysbiosis, plaque development and inflammation. 

 

Gut Dysbiois and Leaky gut cause Oral dysbiosis and Leaky Gums

When you have a ‘leaky gut’, certain compounds such as LPS will pass through the gut barrier and end up in your bloodstream, circulate and they can end up going into the soft tissues in the mouth, causing inflammation in the mouth which then causes dysbiosis – another vicious cycle. So it’s paramount that we work on fixing the gut imbalance at the same time as the mouth imbalance. 

 

Top Tips

1. Fix the gut – whole food Mediterranean diet rich in fibre rich and prebiotic foods, fermented foods and beverages, lots of plants – 30+ plants a week (the more variety in your diet the more variety in your gut), healthy fats. 
2. Reduce smoking, alcohol use and alcohol based mouthwashes 
3. Reduce sugar based beverages and sugar rich ‘foods’. 
4. Brush teeth after eating
5. See your dentist regularly – don’t ignore any oral infections, inflammation or pain
6. Try Microbiome Lab products to reduce plaque development and eliminate bad breath
7. Keep an eye out for oral testing – not available in NZ yet but is on its way. 

 Head over to YouTube and watch my video on this topic: https://youtu.be/c3JxDro0760 if you prefer watching rather than reading. 

 

References

1. https://www.dental-nursing.co.uk/news/treat-your-gums-gum-health-day-2022-focuses-on-new-guidelines-for-gum-disease-prevention-and-treatment
2. https://www.ncbi.nlm.nih.gov/books/NBK554590/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982979/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752930/
5. https://jdh.adha.org/content/jdenthyg/83/3/111.full.pdf
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503789/
7. https://www.sciencedirect.com/science/article/pii/S1936523319300233
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804979/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024159
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827158/#:~:text=This%20review%20proposes%20that%20lipopolysaccharide,that%3A%20Gram%2Dnegative%20E.
11. https://www.nia.nih.gov/news/large-study-links-gum-disease-dementiahttps://www.ifm.org/news-insights/oral-microbiome-and-brain-health/
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789059/
13. https://gut.bmj.com/content/67/1/120

Email me at sarah@sarah-brenchley.com or book a free discovery call to discuss how I can help you and go to https://sarah-brenchley.com/links for free resources andand join the best Facebook Group ever  – Women’s WellBeing Circle.