OUR GUT HEALTH: THE CONNECTION BETWEEN ORAL HEALTH AND SYSTEMIC WELLNESS

Renata Castro, BS, RDH

Optimal oral health depends on many factors. For instance, periodontal disease is a disorder which is not solely due to bacteria etiology, but is also a host inflammatory response to the sub gingival bacteria responsible for tissue damage and, most likely, progression of disease. The contributing factors to periodontal disease, caries, and oral pathologies often lie in the health and appropriate balance of bacteria in the gut. A single drop from our colon contains over a billion bacteria. (1)

Think of your gut and microbiota as a life system just as complex as a rain forest. This ecosystem lives in the environment that is your body, just like some rain forests live in the environment that dictates the health of the ecosystem. If the rain forest has an environment with plenty of rain, it will thrive; if there is a prolonged drought, the rain forest can die. Your gut (the ecosystem) and the body (the environment).(2)

Likewise gut health is determined by the balance of bacteria and the combination of many organs working in harmony to sufficiently carry out essential functions of the GI tract, such as eating and digesting food with ease. Also, gut health plays a central role in immune system homeostasis, constantly interacting with bacteria, viruses, fungi, protozoa, and helminths, as well as other toxic substances or useful flora. More than 70% of our immune response comes from the cells within the gut.

Our gut bacteria reveal much about us, including your parents’ health, how and where you were born, and what you have eaten (as well as whether your first sips were breast milk or formula). Also, where you have lived, your occupation, personal hygiene, past infections, exposure to chemicals and toxins medications, hormone levels, and even your emotions (stress can have an intense effect on the microbiome).(3)

Recent insights into gut health present an abundance of information that support a link between a healthy or unhealthy gut and a person’s oral health.(2)

When trying to determine what factors are contributing to a patient’s disease, the health of the gut microbiome is vital to assess given its critical role in many physiologic processes:

● Converting sugars to short-chain fatty acids (SFCAs) for energy

● Crowding out pathogens

● Digesting food and absorbing nutrients such as calcium and iron

● Keeping pH balanced

● Maintaining the integrity of the gut lining

● Metabolizing drugs

● Modulating genes

● Neutralizing cancer-causing compounds

● Producing digestive enzymes

● Synthesizing hormones and vitamins ● Training the immune system to distinguish friend from foe.

The gut health key connection between oral and systemic wellness is less discussed than the proven relationship between periodontal disease and Alzheimer’s disease, diabetes, cardiovascular disease, and pre-term births. However an unhealthy gut is a major contributor to many diseases.(2)

Supporting a healthy gut Consume probiotics Good bacteria convert the sugar molecules in the food into lactic acid that protects the fermented food (i.e. yogurt, pickled fruits and vegetables, kimchi, sauerkraut, fermented meat, fish and eggs) from being invaded by pathogenic bacteria because it creates an environment with low pH( acidic environment), which kills bacteria with a higher pH.

Go Low-Carb, embrace high-quality fat Fat, not carbohydrate – is the preferred fuel of human metabolism and has been for all of human evolution, choose high quality fats like extra–virgin olive oil, coconut oil, ghee, avocados, olives, nuts and seeds.

Fibers, Fruits and Vegetables Create short-chain fatty acids (SCFAs) and lower the inflammatory reaction. Eat a variety of fresh low-sugar fruits like avocados, tomatoes, lemons, limes and vegetables like leafy greens and lettuces, spinach, broccoli, kale, onions, mushrooms and garlic.

Enjoy wine, tea coffee and chocolate.

They contain nature’s best medicine (flavonoids and polyphenols) for supporting our health.

Choose foods rich in prebiotics Like chicory, Jerusalem artichoke, garlic, onions, leeks and jicama or Mexican yam; they are ingredients the gut bacteria love to eat to fuel their growth and activity. They effectively lower the pH in the gut which inhibits the growth of potential pathogens or damaging bacteria. And they enhance immune function.

Drink filtered water To avoid the gut-busting chemicals like chlorine found in tap water. Make sure the filter you choose removes chlorine and other potential contaminants.

Fast every season The human body is able to convert fat into vital fuel during starvation.

The recommendation is fasting at least four times a year; fasting during seasonal changes is an excellent habit to keep.

Exercise It helps to reduce stress and get adequate sleep . For example weightlifting increases SCFAs and reduces inflammation.

Reduce chemical exposures.

Exposures to environmental chemicals can disrupt your microbione.

Minimize the use of canned, processed and prepared foods and opt for local farmed organic foods.

Products with no or the least amount of pesticides and herbicides.(4)

Supplements.

Probiotics , DHA, Tumeric, Coconut oil, Alpha-lipoic acid and /Vitamin D.

Inflammation.

Inflammation is the key player in most disease processes including periodontal diseases and the diseases of the gut, e.g., Crohn’s, celiac, and IBS. (4)

When bacteria invade the sulcus lining of the tooth pocket, it travels through the body This can trigger an immune response, which prompts the production of inflammatory cytokines in the pocket, which then can also enter into the systemic circulation, causing chronic systemic inflammation. (5)

The bacteria in the mouth (whether by traveling from the mouth through the digestive tract or from seeping into systemic circulation), then arrive in the gut causing additional inflammation. The dysbiosis (improper balance of bad vs. good bacteria) of the gut microbiota is one of the first reactions that can happen after periodontal disease. Once these pathogens become predominant, they wreak havoc in the gut microbiome, causing inflammation and organ dysfunction. Oral pathogens such as P. gingivalis have been proven to show inflammatory changes in adipose tissue and liver, decreased gut barrier-function, and significantly alter microbial communities in the gut, showing higher numbers of pathogenic bacteria and less diversity in the microbiome.

By affecting the gut, oral pathogens thus affect all the functions the gut carries out. When the gut is unhealthy, it is unable to perform these operations efficiently. The immune system is compromised and is unable to defend the body against pathogenic microbiomes, including those in the mouth.

The oral environment is likewise affected by the dysbiosis of the gut microbiome. The overgrowth of harmful bacteria can cause local and systemic inflammation, contributing to oral health issues. The mouth will often be the first presentation of disease, which can be true of poor gut health as well. For example, a swollen tongue can be a sign of vitamin deficiency or immune imbalance. Overgrowths of certain bacteria or fungi can present as lesions or Candida infections. Red and inflamed gums that are not bacterial biofilm-induced can be indicative of poor mineral absorption. All of the oral dysfunctions point back to gut health. (6,7)

Though oral hygiene habits are a big part of the picture, periodontal diseases happen as a result of many things. Many periodontal diseases can be easily remedied by diligent home care and enacting protocols, but for the disease that is not reduced or eliminated, other factors must be considered and discussed. This includes how the gut contributes to disease, how oral pathogens can affect the gut, and how we can improve the gut microbiome, and therefore our oral health.

The research of and connection between these two systems is growing, providing us with more evidence and information to further propel us toward better systemic and oral health. References

1)McHill, Carrie, Gut health: a key link between oral and systemic wellness. RDH July 2021.

2)Ruscio, Micheal, Healthy Gut, Healthy You, Ruscio Institute, LV, Nevada, 2018.

3)Chutkan R. The Microbione Solution: A Radical New Way to Heal your Body from Inside Out. 2015; Penguin Random House LLC.

4)Perlmutter, MD, David, Loberg, Kristin, Brain Maker 2015.

5)Preshaw PM, Taylor JJ., How has research into cytokine interactions and their role in driving immune responses impacted our understanding of periodontitis? J Clin Periodontal 2011:38 (Suppl

11): 60-84 https://pubmed ncbi nim. Nhi.gov21323705.

6) Nakajima M, Matsu K, Kato T, et al. Oral administration of P. gingivalis induces dysbiosis of gut microbiota and impaired barrier function leading to dissemination of enterobacteria to the liver. PloS One 2015;10(7): e)134234.

7) Arimatsu K, Yamada H, Miyazawa H, et al., Oral pathobiont induces systemic inflammation and metabolic changes associated with alteration of gut microbiota. Scientific Reports Open Access May, 2014.