Month: December 2021

Dental Maintenance

Benefits of Oral Probiotics & Best Strains

Delores Baxter

Probiotics are microorganisms (mainly bacteria) that provide benefits to humans – from the prevention of bad breath and cavities to improved gum health. 

Probiotics in oral health are supported by years of research, although the number of human clinical trials is limited. 

Still, many patients are unaware of the potential benefits that dental probiotics can offer. 

What are dental/oral probiotics?

Oral probiotics (or dental probiotics) are specific strains of bacteria known to support a healthy mouth and improve oral health. They encourage the growth of good bacteria and stop the growth of bad (pathogenic) bacteria.

Like the gut, the mouth has its diverse bacterial community known as the oral microbiome. Dental probiotics are similar to gut probiotics in that they use good (commensal) bacteria to improve the health of the microbiome in the mouth. 

However, they’re not the same as gut probiotics — oral probiotics are most effective when delivered directly to the mouth via lozenges, chewable tablets, milk, or probiotic drinks. Oral probiotics in the form of swallowable tablets do not seem to be as effective. Some kinds of toothpaste contain oral probiotics.

Oral probiotic supplements deliver these bacterial strains directly to your mouth so that they can colonize the surfaces in your mouth and form biofilms.

The use of oral probiotics may offer health benefits because of the way they boost the immune system of the mouth. 

Do oral probiotics really work? Yes, oral probiotics work to improve oral health, especially for people who have existing dysbiosis (a disruption in the balance of bacterial communities) in their oral microbiome. 

One study concluded that dental probiotic supplements not only show promise for the prevention or treatment of oral disease but also cause little to no side effects. However, more research is needed to determine the right dosages and delivery for the best results.

Oral vs. Gut Probiotics

The major differences between gut probiotics and oral probiotics are the types of organisms included in each, as well as the method of delivery.

Gut probiotics contain bacterial strains native to the gut. 

They are delivered in capsules designed to resist the powerful gastric juices and acidic pH of your digestive system. 

Survivability is very important when it comes to gut probiotics. That’s why it’s important to choose a high-quality product with a large number of diverse strains and a high number of Colony Forming Units (or CFUs).On the other hand, oral probiotics, contain beneficial strains specific to the oral microbiome (though there may be some overlap with regular probiotics). 

What are the Best Probiotic Strains to Take?

Oral microbiome probiotic strains considered most beneficial to oral health include:

Lactobacillus reuteriLactobacillus salivariusStreptococcus salivarius K12Streptococcus salivarius M18Lactobacillus paracaseiLactobacillus sakei

Oral probiotics are usually given in the form of lozenges, drinks, mouth rinse, or chewable tablets. 

They are meant to sit in your mouth while they dissolve, thus allowing enough time to inoculate your oral microbiome.

However, the mouth is connected to the rest of the body — for instance, good gut bacteria established during birth and infancy may potentially reduce a child’s risk of cavities.

Benefits of Dental Probiotics

The benefits of dental probiotics are evident in every part of the mouth because a healthy oral microbiome is the key to oral health.

Oral/dental probiotics may prevent or address most oral diseases, such as:

CavitiesGingivitis/periodontitisOral thrush (Candidiasis)Bad breathRespiratory infectionsTonsillitisOral cancer

The good bacteria in oral probiotics can create biofilms to replace those created by undesirable bacteria. These new biofilms not only support the health of teeth and gums and reduce inflammation, but they can also block bad bacteria from reaching enamel or gum tissue to wreak havoc.

1. Oral Probiotics for Cavities

Cavities, or “dental caries”, develop when clusters of bacteria, called plaque, form on teeth and feed on sugar molecules, and excrete acids that break down enamel. 

If you address it early in the process, you can reverse some cavities with dietary and lifestyle changes. Left unchecked, this tooth decay can irreversibly damage the dentin and enamel and require a filling, root canal, or tooth extraction.

Oral probiotic supplements may prevent cavities and plaque buildup. 

The best dental probiotics for cavities include:

L. acidophilusL. paracaseiL. rhamnosusL. reuteriL. caseiL. salivariusBifidobacillusS. thermophilus

Research shows probiotics for teeth can prevent cavities by:

Improving the immunity of the mouth Producing antibacterial compounds to fight certain cavity-causing bacteriaPreventing bad bacteria from attaching to the teethAltering the pH of the mouth to stop cavity growthChanging the saliva quality to improve remineralization of enamel

One of the most problematic bacteria in the development of cavities is called Streptococcus mutans. However, an oral probiotic strain called Streptococcus A12can outcompete the harmful version and prevent plaque buildup.

As of mid-2020, 8 randomized, controlled trials on oral probiotics for dental caries have been completed. 75% of these studies found that the use of dental probiotics reduced cavities. 

However, the doses, strains, study methods, and lengths of study were inconsistent. 

It’s not possible to say for sure exactly what dose, probiotic strain, or length of treatment will effectively reverse or prevent cavities.

2. Oral Probiotics for Gingivitis & Periodontitis

Periodontitis (gum disease) is a chronic inflammatory condition that affects 42% of adults in the US. It is associated with higher rates of diabetes, Alzheimer’s, heart disease, and more. 

Once you develop gum recession, you can only halt gum disease, not reverse it. That’s why it’s so important to stop gum disease before it does lasting damage.

At least 11 clinical trials show that oral probiotics may improve gum disease symptoms. 

The best oral probiotics for gum disease are:

L. reuteriL. brevis

Improvements in gum disease from oral probiotics include:

Reduced plaque under the gum lineLess bleeding gumsLower gingival index (a marker of gingivitis)Smaller pocket depth (a measurement your dentist uses to spot periodontitis)

Using dental probiotics as part of your oral care routine may reduce inflammation, stop bleeding gums, and crowd out the bacteria that cause gingivitis. 

L. reuterican improve symptoms of gingivitis and gum bleeding, while L. brevis seems to reduce inflammation.

3. Oral Probiotics for Candidiasis/Oral Thrush

Oral thrush, or oral candidiasis, is a fungal condition in which candida fungus (usually C. albicans) overgrows and forms white spots on your tongue. Burning, redness, and dry mouth can result.

This fungal overgrowth is a common symptom of dysbiosis in the oral microbiome. 

The best way to combat this condition is to stop consuming the sugars and carbs that feed the candida yeast. Along with a dietary change, high-quality oral probiotics may help prevent or reverse oral thrush.

Changing your diet will stop candida growth, as it will no longer have an adequate food source. The influx of beneficial bacteria from the oral probiotic will crowd out any remaining candida microbes.

The best oral probiotics for oral thrush/candidiasis are:

Lactobacillus spp.S. salivarius K12

Lab research shows that dental probiotics including Lactobacillus species can stop candida from forming a biofilm in the mouth. 

A 2020 clinical trial found that 30 days of the oral probiotic S. salivarius K12 decreased oral thrush symptoms. It also improved inflammation of oral tissue caused by denture stomatitis, a bacterial overgrowth on dentures. 

4. Oral Probiotics for Halitosis/Bad Breath

3 studies on dental probiotics for halitosis found that good probiotics can reduce VSCs (volatile sulfur compounds) that cause bad breath. An additional study saw no VSC improvement although breath odor improved. 

Oral probiotics are a much better remedy for bad breath than mouthwash. Most mouthwash kills not only bad bacteria but good along with it.

Dental probiotics may stop bad breath by reducing the compounds that cause halitosis.

The best dental probiotics for bad breath include:

S. salivarius K12L. salivariusL. reuteriL. casei

5. Oral Probiotics for Respiratory Infections

Respiratory infections are infections of the respiratory tract caused by a variety of viruses or bacteria. Common examples include the common cold, sinusitis, strep throat, and bronchitis.

Oral probiotics may reduce the risk of respiratory infections, particularly in children.

The best oral probiotics for respiratory infections are:

S. salivarius K12S. salivarius M18L. reuteriL. sakeiL. paracaseiL. gasseri

A 2016 animal study found that L. gasseri was able to crowd out significant Group A Streptococcus bacteria responsible for infections like strep throat, scarlet fever, and sore throat. 

Animals who received the oral probiotics contracted Group A strep infections 4 times less frequently and were 15 times less likely to die from the infections than the control animals.

An oral probiotic supplement containing 5 strains of probiotics reduced the risk of children getting a respiratory tract infection by 76% in a 2018 clinical trial.

6. Oral Probiotics for Tonsillitis

Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat.

Oral probiotics may reduce symptoms of recurrent tonsillitis.

The best probiotic for tonsillitis is S. salivarius K12.

In a 2020 clinical trial, an oral probiotic given for 30 days provided “rapid relief” for symptoms of recurrent tonsillitis. It also resulted in a marked improvement in the microbiome of the upper respiratory tract.

7. Oral Probiotics for Oral Cancer

Oral cancer may develop, in part, due to harmful bacteria in the mouth. 

Correcting dysbiosis of the oral microbiome may decrease the risk of developing oral cancer, although no clinical trials with human patients have confirmed this theory.

According to two reviews published in 2020, oral probiotic strains that may stop oral cancer growth include:

L. rhamnosus GGL. plantarumAcetobacter syzigiiL. salivarius REN

More research is needed to draw serious conclusions.

There is no scientific evidence that oral probiotics can treat or reverse oral cancer in humans. 

How long do oral probiotics take to work?

Depending on the severity of your dysbiosis, oral probiotics may begin working in as little as 1 week.

Most studies on oral probiotics have been conducted for 2-4 weeks. Studies tracking cavity development have been longer, from 9-12 months.

When advising a patient to take oral probiotics, I generally recommend 2-3 months as a baseline treatment period.

How to Take Oral Probiotics

The most effective ways to take probiotics are via chewable tablets or lozenges. These allow the beneficial bacteria to be delivered directly to the surfaces of your mouth where biofilms are formed by bacteria.

For good bacteria to thrive, you must also eat plenty of prebiotics. Prebiotics are fibers that feed probiotic bacteria. 

Prebiotic foods include:

OnionsRaw dandelion greensGarlicArtichokesBananas (especially unripe)Chicory rootAsparagus LeeksRaw jicamaApplesCocoaFlaxseeds

Taking probiotics is unlikely to be effective without prebiotics present in the mouth. In other words, you must consume prebiotics every day for your probiotics to work.

Q

Should I take oral probiotics in the morning or at night?

A

The best time to take oral probiotics is in the morning after finishing your oral hygiene routine.

How to Choose the Best Oral Probiotic

When choosing an oral probiotic supplement, look for products with a high strain count, which is measured in colony-forming units (CFUs). Find a supplement with at least 3 billion CFUs.

Keep in mind, though, that oral probiotics will usually have a lower strain and CFU count than regular probiotics. 

Look for a probiotic with beneficial strains, such as S. salivarius K12S. salivarius M18L. rhamnosus, and L. reuteri.

Oral probiotics should not be swallowed but chewed or made to melt in the mouth.

You can buy dental probiotics on Amazon or directly from manufacturers. Most oral probiotics are not available at local drugstores or grocery stores.

Probiotic Foods

You may also try adding foods that contain probiotic bacteria to your diet to enhance the benefits of oral probiotic supplements. 

Common probiotic foods include:

KombuchaKimchiYogurtMisoNattoSauerkrautKefir

There are no published studies that prove these foods will act the same as targeted probiotic supplements for oral health. However, they may offer general benefits to your oral and overall health.

Side Effects of Dental Probiotics

Dental probiotics should not cause side effects. One of the benefits of dental probiotics is that they are “extremely safe” for human use.

Gut probiotic side effects include stomach upset and bloating. No symptoms have been identified for oral probiotic side effects.

If you have a condition that compromises immunity, such as HIV/AIDS, cancer, or inflammatory bowel disease, always talk to your doctor and/or dentist before starting a new probiotic regimen.

The Oral Microbiome

Your oral microbiome is made up of over 700 known species of bacteria that live in the biofilms of your mouth (on the teeth, lips, tongue, and upper/lower palates). 

It serves as your mouth’s immune system — a healthy oral microbiome can reduce rates of tooth decay, periodontal disease, oral thrush, and bad breath. Dysbiosis (imbalance) of the oral microbiome can result in inflammation and a higher risk for any oral disease.

There’s a lot of talk about the gut microbiome and how important it is to your whole body and digestive health, but your oral microbiome may be equally as important.

Balancing your oral microbiome has benefits beyond your mouth, too. Healthy microbial colonies in the mouth can reduce your risk of many systemic diseases. A dysbiotic oral microbiome is associated with problems like:

CancerDiabetesHeart diseaseAdverse pregnancy outcomes (APOs) like miscarriage, preeclampsia, and low birth weightObesityAlzheimer’s diseaseCOPDPneumoniaCognitive impairment

There are specific strains of oral microbes associated with each of these diseases. With predictive testing, your dentist can even test for the presence of these in your mouth and identify if you have an increased risk for these diseases.

Your oral microbiome is the gateway to the rest of your body. Everything that goes in through your nose and mouth passes through your oral cavities, which are home to millions of microbes that make up your oral microbiome.

In addition to the microbes that live in your mouth, you swallow over one trillion microbes every single day. These pass through your oral microbiome and travel down to your gut microbiome, in the process inoculating and reseeding both.

Depending on the health of your oral microbiome, certain microbes make it through this initial checkpoint and have a major say in your overall health. 

This just speaks to the importance of a healthy oral microbiome. 

I can’t state this enough: Whether your mouth maintains an ideal ratio of good-to-bad bacteria directly determines your oral and dental health, as well as the health of your entire body. 

re dental/oral probiotics right for you?

Using oral probiotics for dental health cannot replace oral hygiene, a healthy diet, or 6-month cleanings. However, used with other oral care strategies, dental probiotics can provide a significant benefit to your oral and overall health.

The health of your oral microbiome impacts the rest of the body in ways we are only just beginning to fully understand. Your body is a complex system of interactions, none of which are isolated from the rest of the body. 

As I always say, what happens in the mouth happens in the body.

ReferencesLaleman, I., & Teughels, W. (2015). Probiotics in the dental practice: a review. Quintessence Int, 46(3), 255-64. Full text: https://pdfs.semanticscholar.org/56ce/6fca0dc78db04ee023991384650b23d6748c.pdfBonifait, L., Chandad, F., & Grenier, D. (2009). Probiotics for oral health: myth or reality?. Journal of the Canadian Dental Association, 75(8). Full text: https://www.cda-adc.ca/jcda/vol-75/issue-8/585.pdfAnanya, B., Rani, S. L., & Brundha, M. P. (2020). Knowledge and attitude of probiotics among outpatients visiting dental operatory. Drug Invention Today, 14(2). Abstract: https://web.a.ebscohost.com/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=09757619&AN=142963164&h=0nGPW0bD6kP4QHhY21PmF0FPXkSIc7rqid%2fjhWJd57%2fBVPkwhw7tWtb6oSKLX5vnPAw946FY1enN8SdMvVG0FA%3d%3d&crl=c&resultNs=AdminWebAuth&resultLocal=ErrCrlNotAuth&crlhashurl=login.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype%3dcrawler%26jrnl%3d09757619%26AN%3d142963164Darwazeh, T., & Darwazeh, A. (2011). Probiotics and oral disease: An update. Smile Dental Journal, 110(422), 1-6. Abstract: https://platform.almanhal.com/GoogleScholar/Details/?ID=2-21358#Mahasneh, S. A., & Mahasneh, A. M. (2017). Probiotics: a promising role in dental health. Dentistry journal, 5(4), 26. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806962/Dewhirst, F. E., Chen, T., Izard, J., Paster, B. J., Tanner, A. C., Yu, W. H., … & Wade, W. G. (2010). The human oral microbiome. Journal of bacteriology, 192(19), 5002-5017. Full text: https://jb.asm.org/content/jb/192/19/5002.full.pdfJindal, G., Pandey, R. K., Singh, R. K., & Pandey, N. (2012). Can early exposure to probiotics in children prevent dental caries? A current perspective. Journal of oral biology and craniofacial research, 2(2), 110-115. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942020/Chugh, P., Dutt, R., Sharma, A., Bhagat, N., & Dhar, M. S. (2020). A critical appraisal of the effects of probiotics on oral health. Journal of Functional Foods, 70, 103985. Full text: https://www.sciencedirect.com/science/article/pii/S1756464620302097Shakib, P., Rouhi, S., & Zolfaghari, M. R. (2020). The role of probiotics in preventing dental caries. Plant Biotechnology Persa, 2(1), 55-58. Full text: http://pbp.medilam.ac.ir/article-1-40-en.pdfHuang, X., Palmer, S. R., Ahn, S. J., Richards, V. P., Williams, M. L., Nascimento, M. M., & Burne, R. A. (2016). A highly arginolytic Streptococcus species that potently antagonizes Streptococcus mutans. Applied and environmental microbiology, 82(7), 2187-2201. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807514/Krasse, P., Carlsson, B., Dahl, C., Paulsson, A., Nilsson, A., & Sinkiewicz, G. (2006). Decreased gum bleeding and reduced gingivitis by the probiotic Lactobacillus reuteri. Swedish dental journal, 30(2), 55-60. Abstract: https://pubmed.ncbi.nlm.nih.gov/16878680/Riccia, D. D., Bizzini, F., Perilli, M. G., Polimeni, A., Trinchieri, V., Amicosante, G., & Cifone, M. G. (2007). Anti‐inflammatory effects of Lactobacillus brevis (CD2) on periodontal disease. Oral diseases, 13(4), 376-385. Abstract: https://pubmed.ncbi.nlm.nih.gov/17577323/Matsubara, V. H., Wang, Y., Bandara, H. M. H. N., Mayer, M. P. A., & Samaranayake, L. P. (2016). Probiotic lactobacilli inhibit early stages of Candida albicans biofilm development by reducing their growth, cell adhesion, and filamentation. Applied microbiology and biotechnology, 100(14), 6415-6426. Abstract: https://pubmed.ncbi.nlm.nih.gov/27087525/Passariello, C., Di Nardo, F., Polimeni, A., Di Nardo, D., & Testarelli, L. (2020). Probiotic Streptococcus salivarius Reduces Symptoms of Denture Stomatitis and Oral Colonization by Candida albicans. Applied Sciences, 10(9), 3002. Abstract: https://www.mdpi.com/2076-3417/10/9/3002Mansour, N. M., & Abdelaziz, S. A. (2016). Oral immunization of mice with engineered Lactobacillus gasseri NM713 strain expressing Streptococcus pyogenes M6 antigen. Microbiology and immunology, 60(8), 527-532. Abstract: https://pubmed.ncbi.nlm.nih.gov/27301486/Campanella, V., Syed, J., Santacroce, L., Saini, R., Ballini, A., & Inchingolo, F. (2018). Oral probiotics influence oral and respiratory tract infections in pediatric population: a randomized double-blinded placebo-controlled pilot study. Eur Rev Med Pharmacol Sci, 22(22), 8034-8041. Full text: https://www.researchgate.net/profile/Jamaluddin_Syed/publication/329573879_Oral_probiotics_influence_oral_and_respiratory_tract_infections_in_pediatric_population_A_randomized_double-blinded_placebo-controlled_pilot_study/links/5c22138c458515a4c7f71fd9/Oral-probiotics-influence-oral-and-respiratory-tract-infections-in-pediatric-population-A-randomized-double-blinded-placebo-controlled-pilot-study.pdfIlchenko S.I., Fialkovskaya A.A., & Ivanus S.G. (2020). EFFICIENCY OF THE RESPIRATORY PROBIOTIC STREPTOCOCCUS SALIVARIUS K12 IN CHILDREN WITH RECURRENT TONSILLITIS. Actual Infectology, 8(2), 25-29. Abstract: http://ai.zaslavsky.com.ua/article/view/199732La Rosa, G. R. M., Gattuso, G., Pedullà, E., Rapisarda, E., Nicolosi, D., & Salmeri, M. (2020). Association of oral dysbiosis with oral cancer development. Oncology Letters, 19(4), 3045-3058. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7079586/Kamaluddin, W. N. F. W. M., Rismayuddin, N. A. R., Ismail, A. F., Aidid, E. M., Othman, N., Mohamad, N. A. H., & Arzmi, M. H. (2020). Probiotic inhibits oral carcinogenesis: a systematic review and meta-analysis. Archives of Oral Biology, 104855. Abstract: https://www.sciencedirect.com/science/article/abs/pii/S0003996920302338Stowik, T. A. (2016). Contribution of Probiotics Streptococcus salivarius Strains K12 and M18 to Oral Health in Humans: A Review. Full text: https://opencommons.uconn.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1484&context=srhonors_thesesLim, Y., Totsika, M., Morrison, M., & Punyadeera, C. (2017). Oral microbiome: a new biomarker reservoir for oral and oropharyngeal cancers. Theranostics, 7(17), 4313. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5695015/Leishman, S. J., Lien Do, H., & Ford, P. J. (2010). Cardiovascular disease and the role of oral bacteria. Journal of oral microbiology, 2(1), 5781. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3084572/Teixeira, F. B., Saito, M. T., Matheus, F. C., Prediger, R. D., Yamada, E. S., Maia, C. S., & Lima, R. R. (2017). Periodontitis and Alzheimer’s disease: a possible comorbidity between oral chronic inflammatory condition and neuroinflammation. Frontiers in aging neuroscience, 9, 327. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649154/Olsen, I. (2015). From the acta prize lecture 2014: The periodontal-systemic connection seen from a microbiological standpoint: Summary of the Acta Odontologica Scandinavia Price lecture 2014 presented at the meeting of the IADR/Pan European region in Dubrovnik, September 10–13. 2014. Acta Odontologica Scandinavica, 73(8), 563-568. Abstract: https://pubmed.ncbi.nlm.nih.gov/25891035/Kumar, V., Bhatia, M., & Kumar, A. H. (2020). Microbes from mouth to gut impacting probiotics to antibiotics. Journal of Natural Science, Biology and Medicine, 11(2), 83. Abstract: http://www.jnsbm.org/article.asp?issn=0976-9668;year=2020;volume=11;issue=2;spage=83;epage=84;aulast=Kumar

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Dental Care

The Top 3 Manual Toothbrushes I Recommend to Patients

Delores Baxter

Q

What’s the best manual toothbrush?

A

I get asked this a lot. For something as basic as brushing twice daily, we sure have made it complicated!

Here, I’ll walk you through…

1. What actually matters when choosing a brush

2. The three that I most commonly recommend

What matters when choosing a brush

The things I look for, in order of importance:

Soft (or extra) soft bristles: This is priority number one. Medium and hard bristles can cause gingival abrasion or create microabrasions in enamel, which can leave the teeth more susceptible to cavities, gum recession, and sensitivity.Quality bristles: This is a must-have because of the potential for bristles to do major damage. I’ve seen this damage first-hand in my patients. When a manufacturer takes shortcuts, the result is low quality bristles with sharp or jagged edges which damage teeth.STOP using medium or hard bristles, which can cause gingival abrasion + create microabrasions in enamel.

Bristles should be
1. soft
2. quality
3. replaced often@AmerDentalAssn seal of acceptance is a good guide for determining bristle quality

— Dr. Mark Burhenne (@askthedentist) February 21, 2021

How Important is the ADA Seal?

The ADA Seal of Acceptance lays out a good framework for how to judge whether bristles are safe. That said, there are some great toothbrushes out there that couldn’t afford going through the ADA Seal process even though they meet the requirements—two of these is included in my list below, the Oral-B and the Nimbus. To qualify for the seal, the manufacturer must provide evidence that their bristles are “free of sharp or jagged edges and endpoints” as well as pay a fee to be able to use the seal in their marketing.

In other words, if you’re in a hurry, the ADA Seal is a good shortcut. But, there aren’t that many brushes that have it. If in doubt, consult your dentist to ask if a brush has quality bristles or not.

Ask the Dentist is supported by readers. If you use one of the links below and buy something, Ask the Dentist makes a little bit of money at no additional cost to you. I rigorously research, test, and use thousands of products every year, but recommend only a small fraction of these. I only promote products that I truly feel will be valuable to you in improving your oral health.

Which Manual Brushes I Recommend

Best Manual Toothbrush for People Who Brush Too Hard

Radius Source

The wide massaging head helps prevent doing enamel and gum damage, since the forces are spread over a great surface area.The Radius Source reduces toothbrush waste by 93%. You keep the same handle and just change the replacement heads.The super-soft vegetable nylon bristles are great for bleeding, receding, or sensitive gums.Personally, I love the grip on this one. This is my personal go-to that I use daily. I also travel with the Radius Travel, which has the exact same head as the regular model.

Best Budget-friendly Manual Toothbrush

Oral-B Cross Action Manual Toothbrush

I gave these out in my private practice for over 30 years, so I’ve seen the long term effects of this brush, so I trust it implicitly. This is the old standby, you can’t go wrong.This brush works out to be just under $2.50 per brush.The value pack size is something I hope will encourage you to replace your toothbrush often (every 4-6 weeks to prevent bristles from wearing out and doing damage).I like to keep these on hand for guests who forgot their toothbrush.

Best Manual Toothbrush for Bleeding or Receding Gums

Nimbus Extra Soft Toothbrushes

This brush does NOT have the ADA Seal of Acceptance, simply because they are a small business that hasn’t paid for it. But it certainly meets the requirements. This is a great example of why the ADA Seal of Acceptance is a good shortcut, but it certainly misses a lot of great brushes.Invented by a periodontist, designed to get in between spaces, which is especially great for people with gingivitis or gum recession.The first time you use this brush, you might notice your teeth don’t feel as clean. Give it time to adjust—your teeth are getting clean without the harsh scrubbing, I promise.The beauty of the Nimbus is that it alerts you to areas in your mouth where you have recession or gingivitis. You’ll notice tenderness whenever the Nimbus bristles come to an area of the gums that inflamed—alerting you to focus a bit more on that area. I noticed this the first time I tried the Nimbus on myself—it caused tenderness in all of my usual areas of inflammation. By knowing the areas I needed to work on, over time, those areas got better! What wonderful feedback to be getting from a toothbrush, and a manual one at that!

So, there you have it. Those are my go-to manual toothbrush recommendations, but certainly not the only great manual brushes to choose from.

To recap, bristles should be…

SoftQuality (Use ADA Seal of Acceptance guidelines to determine this—not necessarily the Seal itself, which is pay to play)Replaced often (every 4-6 weeks, because even the best quality toothbrush will wear out and become too sharp for enamel)

Hope that simplifies things for you a bit! For further reading, I recommend my guide How to Brush Your Teeth to improve your technique as well as my guide to the best electric toothbrushes. 

Referenceshttps://www.mouthhealthy.org/en/ada-seal-products/category-display/compare-products/product-report?productid=3987&company=Radius+Corp.https://www.ada.org/en/member-center/oral-health-topics/toothbrushesAmerican National Standards Institute/American Dental Association. Standard No. 119 Manual Toothbrushes. Chicago, IL: American Dental Association; 2015.https://www.ada.org/en/science-research/ada-seal-of-acceptance/how-to-earn-the-ada-seal/general-criteria-for-acceptance

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Dental Care

New Study: How Does P. Gingivalis Colonize the Mouth?

Delores Baxter

A new study, conducted by a team at the University of Buffalo, reports that a bacterium called Veillonella parvula plays a supporting role in causing gum diseases by inducing the multiplication of the pathogen Porphyromonas gingivalis.

The aim of the study, published in The ISME Journal, was to understand the ways by which P.gingivalis forms colonies inside the mouth.

The question was how this pathogen could populate without growth molecules. The researchers found out that it obtained growth molecules from Vparvula, a common bacterium of our oral microbiome.

The presence of V. parvula alone is not harmful. It is their proliferation, which occurs in a mouth with poor hygiene, that kickstarts the replication of P. gingivalis.

Highlights of The Study

The researchers at the UB School of Dental Medicine investigated Pgingivalis for around two decades. The study could be summarised as follows:

The study was conducted on a pertinent mouse model and in vitro culture systems and was focused on understanding how the growth molecules controlled the growth and colonization of P. gingivalisFive bacterial species that are prevalent during gum disease were selected and the interaction between the growth molecules of these bacteria with P. gingivalis was tested.Of the five types of bacteria, it was noticed that only the growth molecules of V. parvula influenced the multiplication of P. gingivalis.Another interesting finding was that P. gingivalis stopped multiplying when V. paravula was eliminated from the microbiome. However, the presence of V. paravula was not enough as the replication of P. gingivalis was triggered only when V. paravula existed in a large population.The study suggested that P. gingivalis enjoyed a unidirectional relationship with V. paravula as the sharing of growth molecules brought no obvious advantage to the latter.Apart from the growth molecules, V. paravula forms heme (blood) that served as an excellent source of iron for P. gingivalis.The unidirectional relationship was further confirmed by an increase in periodontal bone loss caused by P. gingivalis in the presence of V.paravula.It remains unclear if the growth-stimulating molecules produced by P. gingivalis are similar to that of V.paravula and more research is needed.

Why This Matters

Over 47% of adults above 30 years of age have some form of gum disease, according to the CDC.

Researchers could formulate specific therapies to manage periodontitis with the help of a deeper insight into the relation between Vparvula and Pgingivalis. Here are a few points that the investigators came up with:

In a person with good oral health, P.gingivalis forms a very small percentage of the microflora inside the mouth and it cannot multiply.On the other hand, in individuals with poor oral hygiene and minimal plaque control, V.parvula multiplies at a rapid rate and produces sufficient growth molecules that can trigger the replication process of Pgingivalis

Therapies that aim at removing V. parvula from the oral microflora can prove beneficial in keeping gum diseases at bay. However, we should bear in mind that their presence alone is not harmful. It is their proliferation, which occurs in a mouth with poor hygiene, that kickstarts the replication of P. gingivalis. Hence, plaque control and maintenance of good oral hygiene are certainly the best ways of preventing and treating periodontal disease.

ReferencesAnilei Hoare, Hui Wang, Archana Meethil, Loreto Abusleme, Bo-Young Hong, Niki M. Moutsopoulos, Philip D. Marsh, George Hajishengallis & Patricia I. Diaz (2020). The ISME Journal Multidisciplinary Journal of Microbial Ecology. A cross-species interaction with a symbiotic commensal enables cell-density-dependent growth and in vivo virulence of an oral pathogen. Full text: https://www.nature.com/articles/s41396-020-00865-y

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Dental Care

‘Heal Your Oral Microbiome’ Book Review

Delores Baxter

Many health-related articles and websites point to having a healthy gut microbiome as the key to living an overall healthy lifestyle. However, before the gut microbiome comes into the picture, it’s the oral microbiome that is at the forefront of keeping you and your immune system in good condition. 

Maintaining a healthy oral microbiome is a major focus of my dentistry, so I am always looking for resources that will help guide people in taking the best care of their mouths.

That’s where the book, Heal Your Oral Microbiome, by Cass Nelson-Dooley comes in. This book focuses exclusively on the oral microbiome and teaches you how your mouth paves the way towards full-body health, as well as important steps to take in order to heal and balance your oral microbiome.

It’s the first book of its kind. During 40 years of dental practice, I had never before read information like this- all in one place. Yet, as dentists, we are working with the oral microbiome every day. I’m so happy this information is finally available to patients and dentists alike. This is why I call Heal Your Oral Microbiome a “pillar book.” It’s one of my top four most highly recommended books.

These “Pillar Books” Are Game-Changers in the Field of Dental Health

Heal Your Oral MicrobiomeVitamin K2 and the Calcium ParadoxTongue-TiedJaws

What is Heal Your Oral Microbiome about? 

Heal Your Oral Microbiome dives into the world of bacteria contained within your mouth and offers science-based tips on how you can improve your health by first fixing your mouth-gut microbiome connection. 

Qualified Author

The author, Cass Nelson-Dooley, M.S., began her career in the field of science and natural medicine after she studied medicinal plants in the rain forests of Panama, in 2003. She researched the pharmacology of medicinal plants at the University of Georgia and AptoTec, Inc, and then started a career in laboratory testing at Metametrix Clinical Laboratory. She has over a decade of experience teaching doctors about integrative and functional laboratory results. She owns Health First Consulting, LLC, a medical communications company with the mission to improve human health using the written word. In addition to Heal Your Oral Microbiome, Ms. Nelson-Dooley has published case studies, book chapters, and journal articles about natural medicine, nutrition, and laboratory testing.  

What This Book Will Tell You

From the start of her book, Nelson-Dooley aims for the reader to recognize that the oral microbiome is made up of 99 percent “good,” or necessary, bacteria and only about one percent “bad,” or infectious, bacteria, and the key to having a healthy oral microbiome is actively nourishing those good bacteria instead of trying to kill off the tiny amount of bad ones.

The author highlights the essential roles that the good bacteria in your oral microbiome perform, including protecting you from pathogens, regulating your immune response, making vitamins, and even helping you lose weight. But most importantly, the good bacteria in your oral microbiome help you build up a resistance to infections from any bad bacteria that manage to slip past your defenses. 

Amidst an informative tour of the oral cavity and easy-to-understand scientific descriptions of the most common oral diseases, Heal Your Oral Microbiome focuses on the natural, safe things you can do to optimize your oral microbiome.

Key Tips from the Book

Here are a few key takeaways from Heal Your Microbiome that I found to be the most helpful and that you can easily apply to your day-to-day life. 

Eat more prebiotic-rich foods such as vegetables and fruits to build your oral microbiome

A diet that is low in sugar and refined carbohydrates can encourage a healthier oral microbiome. Sugar and packaged foods (those containing refined carbohydrates) promote dysbiosis of the oral microbiome, which show up as cavities, gum disease, or root canal infections. To feed your healthy oral bacteria with the prebiotics they crave, it’s best to eat whole foods rich in fiber, and eat the rainbow of fruits and vegetables. But you can also take prebiotics in a powder form or a chewable, like Hyperbiotics’ Prebiotic.

Boost your dental health and say goodbye to the bacterium that causes stomach ulcers, Helicobacter pylori

It’s hard to believe that brushing and flossing can reduce stomach ulcers, but Nelson-Dooley shows that the mouth is intimately linked to the gut in Heal Your Oral Microbiome. People who get regular dental cleanings can get rid of ulcers and H. pylori more effectively than those who don’t. The benefits of dental hygiene for whole-body health don’t stop there. Brushing and flossing can also lower inflammatory markers in your blood and reduce the risk of heart attacks.

Stay away from antiseptic mouthwashes

Bacteria that live in your mouth help you make a chemical called nitric oxide, which plays a critical role in your cardiovascular system by making blood flow smoothly. However, using antiseptic mouthwash usually kills both the bad and good bacteria in your mouth. And once the good bacteria is damaged, it can no longer produce nitric oxide, and your blood pressure can increase.

Final Thoughts on Heal Your Oral Microbiome

Heal Your Oral Microbiome is a must read if you truly want to understand oral health and how it affects the health of your overall systemic wellbeing. I have been practicing dentistry for 40 years and I think this should be required reading in dental schools. Easily read by both the layperson and professional, this book is a healthcare gem, and will, by reading it, greatly improve the quality of your life. An essential read for better health!

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Dental Services

Best Black Friday Deals on Oral Care Products

Delores Baxter

Happy Thanksgiving!

This entire week is a great time to get deals on electric toothbrushes, hydroxyapatite toothpaste, and much more.

Many of you have asked me via Instagram for a round-up of the Black Friday deals for my favorite oral care products, so here we go:

Boka Holiday Kit

Best All-in-One Deal with Everything I Recommend

Black Friday Deal: Use the link here and save an additional 15% by using the code ASKTHEDDS at checkout.

What It Is: Overall, this is the best deal with the full suite of everything I recommend: a sonic electric toothbrush which outperforms oscillatory electric brushes at getting into the in-between spaces, two replacement heads two tubes of hydroxyapatite toothpaste, and two manual brushes and floss.

Why I Like It:

This is the hydroxyapatite toothpaste I use daily, which has cured my sensitivityThe active ingredient, hydroxyapatite, is as effective as fluoride in re-mineralizing tooth structure, but without the toxicity concerns of fluorideThe refills program, because so much of gum recession and sensitivity is caused by not replacing toothbrush heads as often as we should (every 4-8 weeks)

Sonicare DiamondClean

Best Sonic Brush with App

Black Friday Deal: Get it here for 11% off starting today

What It Is: Rechargeable electric toothbrush with Bluetooth connectivity

Why I Like It:

Sonic brushes are better than oscillatory at reducing gingival inflammation and reaching in between the teeth and gumsThe connected app has good UX and shows you which areas you missed, which is the next best thing to getting a dentist’s live feedback on your brushing

Oral-B Vitality

Best for Staining

Black Friday Deal: Get it here for 29% off starting today

What It Is: The best budget electric toothbrush that I recommend for anyone with a high-carbohydrate diet, lots of plaque and/or stain buildup)

Why I Like It:

If you don’t care about any of the bells and whistles, and just want an electric toothbrush that does a quality job with no gimmicks, this is itReduces plaque and gingivitis more than manual toothbrushes, without any injury to gums

For Babies, Toddlers & Kids

Melissa & Doug Dentist Kit

Best Kids Gift

Black Friday Deal: Get it here for 27% off starting today while supplies last

What It Is: Dentist Kit with pretend play set of teeth and dental accessories (26 Toy Pieces)

Why I Like It:

For years, I’ve wanted to get my granddaughter a dental play kit. But all of them are way too scary—except for this one, which launched just last month. Kids learn via play, and this play kit teaches habits they’ll carry into adulthood.Eases fear and anxiety for positive, stress-free dentist visits

RiseWell Hydroxyapatite Kids Toothpaste

Best Fluoride Alternative

Black Friday Deal: Get it here and save 10% by using the code ASKTHEDENTIST upon checkout

What It Is: A hydroxyapatite toothpaste for kids made of 100% safe and natural ingredients that effectively clean and protect the teeth

Why I Like It:

Made with naturally-derived hydroxyapatite, a mineral that makes up 90% of our tooth enamelAs effective as fluoride in re-mineralizing tooth structure without the concerns of fluorideMy granddaughter loves the birthday cake flavor

Jordan Step 1 Baby Toothbrush

Best Baby Brush

Black Friday Deal: Get it here for 33% off starting today

What It Is: My favorite toothbrush for babies 6-12 months old

Why I Like It:

Soft bristles ensure a positive experience from day oneLarge rubber handle is easy for babies to hold, hard to choke on

DrFormulas Nexabiotic Powder

Best Probiotic Supplement

Black Friday Deal: Get it here for 21% off starting today

What It Is: Probiotic powder for babies and kids

Why I Like It:

Formula contains both prebiotics and probiotics, both of which are needed to properly support bacterial diversity in a developing oral microbiomeCan be mixed in with both formula or breast milk

FLOSS

RiseWell Hydroxyapatite Floss

Best for Chronic Cavities

Black Friday Deal: Get it here and save 10% by using the code ASKTHEDENTIST upon checkout

What It Is: World’s first and only hydroxyapatite-infused dental floss, letting you get hydroxyapatite to the areas in-between teeth where cavities are most likely to occur in most cases

Why I Like It:

Delivers re-mineralizing hydroxyapatite to overlooked tight spots between teeth (which is where most cavities develop)Floss glides comfortably and smoothly, while expanding slightly for more effective cleaning

SLEEP

Somnifix Mouth Tape

Best Mouth Tape

Black Friday Deal: Use this link to get 15% off the one-pack and three-packs, plus 33% off auto ship

What It Is: Mouth taping is the best health hack out there, in my opinion. By mouth taping nightly, you’ll improve your sleep quality, snoring, dry mouth, immunity, nitric oxide production, and even your susceptibility to cavities.

Why I Like It:

Does not hurt when it comes offSticky enough to keep your lips closed during sleep, while allowing for your mouth to easily open if you have serious issues breathing through your nose at night

Nexcare Mouth Tape

Best Budget Mouth Tape

Black Friday Deal: Get it here for 6% off starting today

What It Is: Best budget mouth tape

Why I Like It:

OK, it’s only 6% which isn’t much, but if you’re on a budget, this is the best budget alternative to SomnifixDoes not hurt when it comes off

Good Morning Snore Solution

Best for People with Large Tongues

Black Friday Deal: Get it here and save 30% off by using the code BFBOGO for Good Morning Snore Solution Multi Packs

What It Is: Tongue retention device

Why I Like It:

Helps to open up the airway for better sleep breathing by holding the tongue out of the way and preventing it from collapsing during deep stages of sleepIt’s a non-invasive way to see if you benefit from airway-related therapies

Molekule Air Purifier

Black Friday Deal: Get it here and save up to $300 by using the code EARLYACCESS for all their products (except filter parts and Air Pro RX)

What It Is: These purifiers are quieter than most and with their PECO (Photo Electrochemical Oxidation) technology, it actually destroys pollutants, including VOCs and mold.

Why I Like It:

No matter how you eat or how much you exercise, none of it matters if you’re not breathing properly, and that is largely affected by the quality of the air you breatheMy wife and I have one in every room of the house and have noticed the difference in congestion levels during the dayReducing congestion is essential to better nasal breathing, and thus, better sleep quality, which I’m even more obsessed with after reading (and collaborating on) James Nestor’s book, Breath (a must-read!)

Naväge Nasal Care

Black Friday Deal: Get it here for 9% off

What It Is: Nose cleaner and 20 salt pods

Why I Like It:

Flushes everything out for all-important nasal breathing during sleepWorks for fast, all-natural relief from allergies and sinus congestion without the use of drugs

The post Best Black Friday Deals on Oral Care Products appeared first on Ask the Dentist.

Dental Care

Literature favours air purifiers as COVID-19 transmission risk mitigant

Delores Baxter


LEIPZIG, Germany: The pandemic has been a trying time for dentists, particularly for owner-dentists who must make decisions that may influence the safety of their treatment team. Recent studies have found that the rate of SARS-CoV-2 transmission in dental settings has been lower than what was expected when the pandemic was declared, and the literature has shown that air purifiers could play a role in keeping transmission rates down.
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Dental Services

Evidence suggests triad of symptoms most common in COVID-19 patients

Delores Baxter


BRASILIA, Brazil: From the start of the pandemic, the oral cavity has been highlighted as a potentially relevant infection axis with further inflammatory response in surrounding tissues. This has resulted in heightened international interest in investigating the issue. A current study confirms the previous findings, namely that xerostomia, taste dysfunction and oral mucosal lesions currently manifest most commonly in patients with COVID-19.
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Dental Care

Women in dentistry: Meet chemist and awarded dental materials inventor Dr. Sumita Mitra

Delores Baxter


As the second candidate for a series portraying outstanding women in dentistry, Dental Tribune International (DTI) interviewed Dr. Sumita Mitra. During her career at 3M, she developed a unique nanomaterial-based dental filler, for which she received the European Inventor Award 2021. This material and numerous other inventions of hers in the field of dental materials have been patented. DTI spoke with Mitra about how a bunch of grapes inspired her research efforts, about the greatest advantages of her developed material and about how she gives back to the next generation of inventors.
Did you miss our previous article…
https://www.cosmeticdentists-usa.com/?p=351

Dental Care

3D printing: Current applications and perspectives

Delores Baxter


MILAN, Italy: Digital technologies are rapidly spreading in dentistry. Tools such as intra-oral and laboratory scanners, CBCT, computer-aided design and computer-aided manufacturing (CAD/CAM) software, as well as innovative manufacturing procedures such as 3D printing and laser sintering, are changing the way we treat our patients. Therapies are increasingly personalised, and the tools available allow more predictable results with levels of diagnostic precision and manufacturing accuracy that were previously unthinkable.
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Dental Care

Select sessions of WDC to be featured on FDI Oral Health Campus

Delores Baxter


SYDNEY, Australia: From 26 to 29 September, the Australian Dental Association and FDI World Dental Federation will present a special edition of the World Dental Congress (WDC). Owing to COVID-19 travel restrictions, the congress will be completely virtual for the first time. This year’s WDC will bring together leaders from across the world in dental practice, research, academia and industry to present quality, innovative and effective continuing education.