Article: A Shocking Shift in Dental Health—How Good Is Flouride, Really?

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Brush with fluoride toothpaste, rinse with antiseptic, and drink fluoridated water!

All these appeals to oral health stem from a foundational belief in the dental field that bacteria in the mouth cause gum disease and dental cavities, also known as caries. Moreover, the dental field believes that killing all the microbes in the mouth will prevent cavity formation. However, the robust belief in the connection between oral sanitation with fluoride and antiseptic mouthwashes now faces a tremendous challenge from recent scientific discoveries powered by new genetic sequencing techniques and artificial intelligence.

In an article in the prestigious scientific journal Nature, author Kristina Campbell describes the new science around the oral microbiome and health. Research now clearly demonstrates that a healthy microbiome protects teeth and gums from cavities and disease. Moreover, wiping out the microorganisms in the mouth with antiseptics may lead to the very tooth decay they are designed to inhibit. (nature.com) The human body lives in a dynamic relationship with a vast microscopic world. This world, called the microbiome, contains billions of tiny organisms, from bacteria and fungi to protists and viruses. Depending on the conditions on the skin, mouth, or intestinal tract, such as temperature, moisture level, and nutrient availability, different combinations of microorganisms live and interact with each other.

In the human mouth, researchers have found over 700 different types of microorganisms cultured from mouths in various countries. Most people have around 250 different species of microbes in their mouths. Early studies on the cause of cavities implicated a bacteria called Streptococcus mutans, which produces acid that can cause cavities. Early research depended on scientists swabbing a subject’s gums or teeth to collect bacteria and then trying to culture it in the lab to figure out what microbes lived on the different surfaces of the mouth. The fact that not all microorganisms grow well in a petri dish led to a massive underestimation of the complexity of the microbiome.

Today, techniques such as DNA sequencing and artificial intelligence help researchers get a much more accurate measure of the diversity of microbes in the mouth. It turns out that certain microbes in a healthy mouth will control and even eliminate those that cause tooth decay. Other research gathered over the past 20 years has implicated certain unhealthy microbes in diseases not just limited to the mouth. For example, in a review paper published in Microorganisms titled “The Human Oral Microbiome in Health and Disease: From Sequences to Ecosystems,” the authors highlight the connection between the bacteria Porphyromonas gingivalis with such diseases Alzheimer’s disease, cardiovascular disease, rheumatoid arthritis, periodontitis, and pancreatic and esophageal cancers. (mdpi.com)

The crucial role of the microbiome in oral as well as overall health continues to emerge as scientists continue to gain insights into the complicated world of interactions of microbes in both healthy and diseased individuals. Since early studies linked the acid production of one bacteria, known as Streptococcus mutans, to cavities, the essential dogma of dentistry suggested using antibacterial agents to clean the mouth to prevent tooth decay. Whereas more recent research suggests that a healthy balanced oral microbiome protects the teeth and gums, regularly wiping out the microbiome could create conditions that allow unhealthy microbes to flourish. A recent visit to the dentist and a quick internet search for dentist recommendations for oral health indicates that the new science of oral health has not yet reached the mainstream. It remains full steam ahead on the intense use of antiseptic rinses without regard to maintaining a healthy oral microbiome.

Interestingly, the yogurt and health supplement sections of the supermarket have a wide array of probiotic offerings promising to improve gut health. Still, it remains a scorched earth policy just upstream from the gut in the mouth. More work is needed to convince generations of dentists that dental health does not depend on wiping out the complex world of microbes in a healthy mouth.

Dr. Smith’s career in scientific and information research spans the areas of bioinformatics, artificial intelligence, toxicology, and chemistry. He has published a number of peer-reviewed scientific papers. He has worked over the past seventeen years developing advanced analytics, machine learning, and knowledge management tools to enable research and support high-level decision making. Tim completed his Ph.D. in Toxicology at Cornell University and a Bachelor of Science in chemistry from the University of Washington.

You can buy his book on Amazon in paperback and in kindle format here.