A Healthy Oral Microbiome Is A Key To Better Health And Longevity

What Does It Do?

I get asked this question a lot in my clinic and on social media, and it’s hard to cover everything the oral microbiome does. Let’s cover the most important three things.

The community of microbes in your oral mucosa serves several important functions, such as:

• Aids in digestion: Certain oral bacteria facilitate the intestinal digestion process by breaking down food and converting it into more usable forms that are easier for the human body to absorb.
• Strengthens immunity: Your oral microbiome interacts with your immune system in multiple ways, helping your body to distinguish between harmless and harmful objects.
• Supports dental health: A balanced oral microbiome is crucial for preventing dental cavities, gingivitis, and bad breath. Certain bacteria contribute to subgingival and dental plaque formation, while others can aid in controlling plaque’s growth.

LISTEN: The Oral Microbiome - Ask the Dentist 

What Throws It Out of Balance?

A disruption in the homeostasis of your oral microbiome — AKA bacterial dysbiosis — can lead to a cascade of systemic diseases, including cardiovascular disease, mental health problems, and widespread inflammation. That’s why it’s important to balance the bacteria in your mouth.

Your oral microbiome may be negatively impacted by a variety of factors, including:

• Lack of oral hygiene: If you don’t brush your teeth, scrape your tongue, and floss daily, you’re allowing dangerous pathogens to proliferate and damage your teeth. More bad bacteria may increase your risk for heart disease, autoimmunity, and a lot more.
• Poor diet: Carbohydrates (especially sugars) contribute to poor oral health and an unbalanced microbiome. Sticky foods can also promote harmful plaque formation and impact oral microbiome diversity. A lack of healthful foods (think calcium-rich, magnesium-rich, vitamin-rich) can be deleterious, too.
• Chronic stress: When you’re stressed, your body releases cortisol, the stress hormone, which is a healthy immune reaction in the short term. However, if you are constantly stressed, long-term exposure to cortisol sends your body into dysfunction, including throwing your oral microbiome out of balance.
• Antibiotics: Although antibiotic medications kill bad bacteria, they also get rid of beneficial bacteria. Overuse of antibiotics is a leading cause of oral microbiome imbalance. A lot of conventional doctors overprescribe antibiotics.
• Alcohol: Not only is alcohol an antiseptic that kills bacteria, including good bacteria, drinking alcohol may also dry out the mouth, creating a great environment for harmful bacteria to grow. Alcohol is also a toxin that leads to a lot of health problems.
• Smoking: Tobacco products and vaping are terrible practices for your oral microbiome. Cigarettes and vape pens can both increase your risk of oral cancer and other diseases. (1, 2)
• Conventional mouthwash: Similar to the way antibiotics deplete your gut bacteria, conventional, alcohol-based mouthwashes eliminate both the good and bad components of your oral microbiome, setting the stage for dental and all-body health issues. Dr. Burhenne warns, “I tell all of my patients to steer clear of typical antiseptic mouthwashes except in very specific circumstances, such as immunocompromised individuals with gum disease preparing for a scaling and root planing.”

Connections Between The Mouth, Gut, And Brain

In the world of functional medicine, my colleagues and I have come to appreciate the interconnectedness of our body systems. The oral microbiome, though physically separate, has an intimate relationship with the gut microbiome and even the brain. Meet the oral-gut-brain axis. (3)

A whole area of research exists to understand the influence of the oral-gut microbiome axis on overall health. (4) The balance within our oral microbiome contributes to gut health, and in turn, the gut influences the oral environment.

The gut-brain axis is well-established, even in conventional research. (5) A healthy gut is paramount to achieving a healthy brain and nervous system.

Dysbiosis (microbial imbalance) of the mouth, gut, or brain impacts the other microbiomes. For example, an imbalance in the oral biome can cause an overgrowth of harmful bacteria that are swallowed and negatively affect the gut.

Due to the profound influence of this omnidirectional relationship, imbalances in the oral microbiome have been linked to conditions seemingly unrelated to oral health, including:

• Neurological and psychiatric disorders (6)
• Inflammatory bowel disease (7)
• Respiratory infections (8)
• Liver cirrhosis (9)
• Certain autoimmune disorders (10)
• Certain cancers (11)

10 Overall Health Problems That May Start in the Oral Microbiome

I have seen patients who have an oral imbalance that leads to shocking ripples across their whole body health. I have read about even more. Below are 10 surprising overall health problems I’ve come across or that I discussed with Dr. Burhenne that are impacted by a dysbiotic oral microbiome.

1. Dental Caries (Cavities)

Dental caries, which turn into cavities when ignored, are basically little holes in your teeth, formed when harmful biofilm on your teeth is not addressed regularly with brushing, flossing, and dental cleanings. Good oral hygiene practices can go a long way to preventing cavities, but healthy oral hygiene does not always negate an imbalanced microbiome.

Even if you’re avoiding sugar, a poor balance of microflora in your mouth can contribute to an increased risk of cavities. (12, 13)

There’s good news on this front, though! Dr. Burhenne shared, “I’ve told patients for years that many small cavities can be reversed rather than filled, extracted, or root canaled. And guess what? It’s true! It takes intentionality and time, but I’ve found that patients willing to put in the work to their oral hygiene and diet are thrilled with the fact that they get to keep their natural tooth structure intact.”

2. Periodontitis (Gum Disease)

Periodontal disease (such as the earliest stage called gingivitis) can often be prevented with healthy oral hygiene practices, but a dysbiotic microbiome can contribute to periodontal disease nonetheless.

Also called gum disease, periodontal disease has been associated with an imbalance of microbes in the human oral cavity — independent of your oral hygiene routine. (14)

Even before I worked as a healthcare provider, it always felt odd to me that people often accept bleeding gums as a fact of life. But they are actually a sign of a systemic problem.

I resonate with the way Dr. Burhenne put it: “If you were putting lotion on your arm and noticed that there was blood mixed with the lotion, that would freak you out, right? It’s the same with blood you see mixed with the toothpaste you spit out after brushing — it should bother you! There is nothing normal about bleeding gums.”

3. Halitosis (Bad Breath)

Although it sounds less severe than diseases of the heart or brain, bad breath can greatly impact your social life and self-esteem.

An imbalance in your oral microbiome increases your risk for bad breath, due to the overgrowth of volatile sulfur compounds (VSCs). (15)

4. Gut Issues

Your gut and mouth are inextricably connected. Gut issues, especially inflammatory bowel disorder (IBD), are more likely to occur when your oral microbiome is out of whack. (7)

Reducing stress and taking probiotics are two great ways to heal your gut, but you also need to focus on restoring the balance to your oral microbiome.

Learn more by buying my book, Gut Feelings, in which I share a 21-day plan to heal your gut. I’ve used it myself!

5. Immune Dysfunction

Most of your immune system is in your gut, so when the gut is dysfunctional, your immune system doesn’t function properly. Your gut and mouth are linked, so your mouth and immune system are linked.

Recent research has linked an imbalance in your oral microbiome with immune dysfunction and autoimmune disorders, such as rheumatoid arthritis, Sjögren’s syndrome, and type 1 diabetes. (10)

Read Next: Burning Mouth & Autoimmunity

6. Heart Disease

Cardiovascular disease is the number one cause of death in Americans. One of many risk factors for heart disease is an imbalance in oral microbial communities. (14) This 2022 study states, “Cardiovascular health can also be highly affected by oral microbiota functions and metabolites.” (16)

Check out what doctors like myself eat to keep a healthy heart.

7. Alzheimer’s Disease

Your brain is at risk when your mouth isn’t in balance. The characterization of neurodegenerative diseases like Alzheimer’s has been linked to oral microbiome dysbiosis. (14) New research has linked oral dysbiosis with the buildup of amyloid-beta plaque, the main sign of Alzheimer’s progression. (17)

From Dr. Burhenne: “I know it’s surprising to hear gum disease connected to Alzheimer’s. For most patients I discuss it with, it’s a total shock. But I’ve been following the research for the better part of two decades, and it’s clear that gingival disease caused by a dysbiotic oral microbiome is, at the least, a contributing factor to the development of Alzheimer’s — if not a root cause of the disease.”

8. Anxiety & Depression

When the oral cavity doesn’t have a good balance of beneficial bacteria, your mental health suffers. Anxiety and depression have been strongly associated with oral microbiome problems. Certain salivary bacteria have been associated with anxiety and depression symptoms. (18)

The Lancet published a study in 2023 describing the link between dysbiosis and depression, as well as “the potential health benefits of…dietary interventions, fecal microbiota transplantation, probiotics, prebiotics, synbiotics, and postbiotics.” (19)

Check out this high-quality PROBIOTIC supplement I use myself.

9. Obesity

Metabolic disorders start in the mouth. One such disorder that is bidirectionally associated with oral microbiome problems is obesity.

Simply put, if you have microbial dysbiosis in your oral cavity, you are more likely to be obese. The reasons are multi-faceted, including oral bacteria’s impact on taste perception and link to fat tissue inflammation. (20)

Struggling with a sluggish metabolism? Consider The Metabolic Recharge, your path to metabolic wellness and healthy weight loss.

10. Pregnancy Dysfunction

An imbalance in your oral microbiome has been linked to both problems getting pregnant and complications during pregnancy.

Microbial imbalance has been linked to both male infertility and female infertility. (21, 22)

“A balanced oral microbiome is vital for a healthy pregnancy. [Disruptions] in the oral microbiome composition can contribute to pregnancy complications,” says a 2021 study published in the Journal of Reproductive Immunology. (23)

LISTEN: Dr. Nicole Sparks: Pregnancy & Postpartum Pro-Tips + The Powers Of Witch Hazel 

How To Care For Your Oral Microbiome

While standard oral hygiene practices are essential, the scope of your oral health should include more than just brushing and flossing.

1. Test Your Oral Microbiome

When it comes to making the right changes for your health, I believe knowledge is power, and testing gives you a clear understanding of your baseline.

I personally love Bristle Health and recommend their oral microbiome test to my patients.

2. Switch To Natural Oral Care Products

Switching to natural products helps you avoid harmful ingredients like sweeteners, dyes, and other unnecessary ingredients that have been linked to bacterial dysbiosis in your oral microbiome.

Fluoride is a popular chemical in many conventional oral care products, such as toothpaste and mouthwash, but it’s likely a hormone disruptor. Try to avoid fluoride and other unnatural ingredients. Dr. Burhenne recommends hydroxyapatite toothpaste to prevent cavities without a toxic ingredient.

3. Be Mindful Of What You Eat

Your gut microbiome is influenced by what you eat, but so is your oral microbiome.

Recent studies have found a direct link between certain foods like sugar, dairy, farmed animal meat, vegetable oils, processed cereals, etc. and negative changes in the oral microbiome responsible for certain oral diseases. (24)

What foods help keep your oral microbiome healthy? There is no “one-size-fits-all” diet, but a safe bet is a clean, whole-food diet. Eat healthy fats, calcium-rich foods, and high-fiber foods.

4. Scrape Your Tongue

Tongue scraping is a practice rooted in ancient Ayurvedic medicine that uses a special tool to gently clean the surface of the tongue to remove bacteria, dead cells, and food particles that have accumulated there during the day.

Studies have found that daily tongue scraping can significantly improve bad breath immediately after use and can have a positive effect on bacterial balance in your mouth by reducing overall bacterial load. (25, 26) Dr. Burhenne said many of his patients also report that their food tastes better and that they can tell the nuanced differences between flavors after they start scraping (which definitely sounds like a win to me!).

5. Try Mouth Taping

Yes, you read that correctly. Taping your mouth shut while you sleep has a variety of health benefits, including enhanced oral health. By encouraging you to breathe through your nose while you sleep, mouth taping helps eliminate dry mouth.

When your mouth is dry, it ends up changing the acidity levels in your saliva and throwing off the pH balance in your mouth. This can lead to tooth decay, gum disease, and other dental problems.

6. Do Oil Pulling

Another practice with roots in Ayurvedic medicine, oil pulling involves swishing oil (most commonly coconut oil) around in your mouth, letting the oil bind to bacteria and debris, before spitting the oil into the trash. While traditional oil pulling is done for 15-20 minutes, Dr. Burhenne suggests just 30-60 seconds at a time for ideal benefits.

I recommend using coconut oil due to its antimicrobial properties. Coconut oil pulling has been linked to less dental plaque, healthier gums, and reduced harmful oral microbial activity. (27)

In fact, one study published in the Journal of International Society of Preventive & Community Dentistry found that oil pulling coconut oil was just as effective as chlorhexidine in reducing Streptococcus mutans — the most common dental problem-causing organisms. (28)

7. Try Oral Probiotics

Probiotics for the mouth use different compounds than gut-friendly strains for the most effective benefits. They’re also chewable, rather than a supplement you swallow.

Oral probiotics not only help prevent and reverse cavities and gum inflammation, but they can also help with a wide variety of other health problems. One study even found they helped reduce the instance of respiratory tract infections in children! (29)

Read Next: Chronic Sinus Infections? Here's How To Stop Them For Good 

Dr. Burhenne did a fantastic write-up of the extensive research on oral probiotic strains and their benefits that you can read here.

8. Heal Your Gut

As we’ve learned, the gut-mouth axis is very real and is directly linked to your oral health. If you are struggling with poor gut health or stubborn oral health problems, focusing on this end of the gut-mouth axis can be key to finally overcoming both issues for good.

Probiotics, bone broth and other nourishing superfoods, and targeted supplements are all tools that can be used to promote gut healing. Check out my complete guide to healing your gut here.

Dental Health Isn’t Separate From Overall Health!

The more we study oral microbiology, the more we see the important role it plays in maintaining good human health beyond just dental hygiene. The mouth can impact your brain, your heart, your sexual function, and especially your gut.

Once you recognize the oral cavity’s unique connection to your body — particularly to the gut and brain — you can enhance your overall health with dietary and lifestyle changes that address those root causes of oral dysbiosis.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. Schedule your first consultation today!