For a variety of reasons, people with diabetes are more susceptible to periodontal (gum) disease than the general public. Periodontal disease can affect both the soft tissues and the bone surrounding the teeth. While keeping blood glucose under control can help limit the risk of dental and oral problems, as can regular brushing and flossing, many people with diabetes would benefit from taking some extra steps to maintain a healthy mouth.
This is where oral probiotics may help. Most of the buzz about probiotics in recent years has been about their potential to aid in digestive health. But there’s another type of probiotics, called oral probiotics, that help manage the health of the mouth. This article takes a look at what oral probiotics are, how they work, and what their benefits might be.
What’s in your mouth, and why
Your mouth was more or less sterile when you were born. The first time someone kissed your tiny lips, he passed his germs on to you. If this person had a lot of cavities or fillings, he probably gave you some harmful, cavity-causing forms of bacteria. If he had periodontal disease, he may well have given you the bacteria that cause periodontal disease. As you grew up, you continued to acquire new mouth bacteria — and to share yours — through such activities as sharing eating utensils and kissing.
One type of bacteria that is particularly problematic is Streptococcus mutans, often shortened to S. mutans. (The Streptococcus genus of bacteria also includes S. pneumoniae, which can cause strep throat, ear infections, and bacterial pneumonia.) Once inside the mouth, S. mutans settles in and starts to pump out a sticky substance that protects the colony of bacteria on the teeth, gums, cheeks, and tongue. This sticky coating, known as a biofilm, is designed to resist disruption by substances like toothpaste and mouthwash. The coating also allows communication between bacteria that live together. As the colony grows, other species of bacteria and other organisms (such as yeasts) are invited in. Up to 700 species of microorganisms are known to reside in the mouth of every person. Some of these species contribute to disease, while others are neutral or may even clean the place up a bit.
Depending on the particulars of your immune system (which is affected by many factors, from your genes to who kissed you first), you may be naturally susceptible or resistant to different oral diseases. If your immune system is great at fighting against cavity-causing germs but not against those that cause periodontal disease, or vice versa, you may have one but not the other. Natural immunity also explains how you can be cavity-free while your sibling, who eats the exact same diet as you and brushes better, still gets cavities. Mechanical removal of biofilm is just one factor at play in the prevention of oral disease.
Brushing and flossing are effective at breaking up the colonies in the mouth, but even people who are excellent at mechanically removing biofilm cannot reach everywhere, so there are always varying amounts of germs left on the teeth and gums. Germs are very small, and an entire colony can survive within a very small piece of biofilm. Because it’s so hard to manage biofilm through mechanical removal alone, it is important to look beyond brushing and flossing. And one of the newest options to support oral health is oral probiotics.
According to the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, probiotics are live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut. They are also called “friendly bacteria” or “good bacteria.” Probiotics are available to consumers in both foods and dietary supplements. Yogurt and other fermented foods are the main sources of naturally occurring probiotic bacteria both in the United States and throughout the world.