Probiotics! The Future of Dental Treatment?

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History of Treatment For Dental Caries

For over 200 years it has been known that the cause of dental caries, a disease more commonly known as cavities, was due to pathogens adhering themselves to the tooth surfaces. While the exact disease process might not have been understood to early researchers such as Levi Parmley, G.V. Black or W.D. Miller, they were, nonetheless, aware that certain bacteria were involved in the decay process. What is important, however, was the progression of treatment of the diseased tooth.

A surgical approach was always taken since caries was looked at as a gangrenous process and with gangrene, amputation was most always the remedy where other parts of the body were affected, therefore, it followed that the removal of the tooth was the logical approach. Later, only the decayed portion of the tooth was removed in order to save the tooth - and saving the tooth at any cost was considered most beneficial where it was possible to do. As you know, drilling is still done today and not much has changed beyond advancement in filling materials, due largely to public demand, I imagine. Laser technology is also used on both caries and in periodontal treatments and though I would consider this an advancement over the drill and the scalpel, the concept remains the same.

As a child in the 1960s I recall listening to a radio talk show where a microbiologist was being interviewed. He was talking about an oral rinse which would clean up the 'bad' bacteria and save us all from cavities and periodontal diseases. I thought this was great news because then I wouldn't have to brush anymore, just rinse and spit. Unfortunately, my parents missed the interview and hygiene wasn't all that simple anyway, but that was my introduction into an emerging concept in treating dental diseases with antimicrobials. The use of both antimicrobials and antibiotics sprung forth in treating these diseases but the dental profession has not embraced this approach while totally giving up on the surgical route. Antimicrobial solutions may normally be used in conjunction with the surgical concept, since surgery alone does not remove the pathogen culprits - only the diseased affects of the pathogens. (Lasers actually do a better job on the pathogens than simply drilling at a specific site, but what about the rest of the mouth?)

Problems arise with the use of antimicrobials and antibiotics in that they are not terribly selective and tend to kill off a wide selection of organisms. We know that the same issue arises when we are treating other bodily infections with antibiotics. For example, while treating a snus infection we may be killing off flora beneficial to digestion. Some of us will take it upon ourselves to replace them with yogurts, cheeses or other dairy products with 'active cultures' or straight out supplements of L. acidophilus. When we treat our mouths with antimicrobials we are never positive that we are thoroughly removing the specific harmful organisms we mean to be going after. Are we also preventing these organisms from returning? And if we kill off the good ones with the bad, which ones take over when re-introduced into the mouth, or in this case, to the tooth surfaces or under the gum line? What happens if those pathogens mutate and become resistant to their familiar antibodies, antimicrobial solutions or herbal preparations?

We know that the mouth is not a sterile environment, nor is that the objective. We simply need to have more control over the bad organisms so that they do not re-populate, form bio-film (plaque), mutate and begin the disease process all over again.

The Introduction of the Probiotic

While there is certainly merit in going after an infection with the use of antimicrobials and antibiotics - we certainly need to stop an infection in its tracks as quickly as possible to prevent any (further) damage to tissue and prevent the possibility of spreading - there is also merit in respecting and maintaining the biological balance, or ecology, of the mouth. A probiotic would be a specific organism which would prevent the growth and spread of a specific harmful organism while not upsetting the biology of the mouth. A gardener, for example, would apply this concept by employing ladybugs, praying mantises, frogs and certain snakes in the garden to go after insects which would be harmful to the vegetation, as opposed to the use of insecticide chemicals which would wipe out a broader range of insects, including those beneficial ones. Since insecticides need to be continually re-applied to keep bad bugs away, they may be harmful to beneficial creatures and upsetting to the ecological balance of the garden.

The use of a specific probiotic, in a dental sense, would remove a Strep. mutans organism, take up residence in the mouth and crowd out the culprit were it re-introduced, which is nearly always likely. In doing so, the probiotic, perhaps a specific strain of Lactobacillus, would leave the other hundreds of harmless bacteria alone while doing its job. In other words, it halts the disease process and prevents it from starting back up again without any collateral damage. To me, the aspect of prevention is the most important part of the concept. Interesting to note that certain probiotics already exist for use in effective treatment of both dental caries and periodontal diseases. Research on probiotics has being going on for decades but it may be a long time before your dental team sends you home with a supply. Laser applications for teeth and gums were seriously looked at as early as the 1960s but it took nearly a half a century to see their broad application within the dental profession.

How Probiotics Work

For pathogens to become harmful in the first place, they must take up residence in an already crowded space. They must remain and set up their 'bio-housing' communities, for which they enlist other organisms to help. Once they are settled in and multiply their acidic by-product begins to take effect in the form of decay of the tooth enamel with a little help from the host. Other pathogens destroy gum and connective tissue as they settle in and we refer to that as gingivitis, which advances on to periodontal or gum disease. They also destroy good organisms, and can even create carcinogens out of certain noxious substances.

Probiotics are able to neutralize certain toxic substances or those made toxic by undesirable organisms and work to actually replace the 'settled' pathogens and prevent them from taking up residence. Like cells in our bodies, these good guys do age, weaken and must be replaced in order to remain effective. The struggle for survival is ongoing so it is necessary to replenish probiotics through supplementation. For digestion, it is simple: Eat yogurts or other dairy products with the right active cultures. For healthy teeth and gums it is a little trickier since the best strains for teeth and gums don't necessarily come in your kafir. For teeth and gums it is a little different as there are no specific foods with the proper organisms... but there are supplements.

Putting It All In Perspective

I would not conclude that all you have to do about your aching tooth or oozing gums is to toss your toothbrush, put your irrigator in the yard sale, lose your dentist's phone number, start eating good bacteria and get on with your life. Not quite, anyway. I see the use of probiotics as an integral part of the fight for a healthy mouth - certainly when it comes to prevention. I see the use of probiotics as a far better alternative to the mass fluoridation of society. And I see probiotics as a final step in the mechanics of repairing already decayed teeth and gum tissue - in fact, it looks to me like these favored organisms are the final missing link in the process of bringing bad teeth and gums to a desirable, healthy and sustainable state.

Perhaps we need a little drilling or laser treatment to repair a bad tooth. Perhaps we need a course of antibiotics or an antimicrobial as an emergency measure to deal with a deep, infected periodontal pocket. Perhaps, however, once the repair work is done, let us look at the introduction of the right probiotic to help keep us free from allowing those unhealthy conditions from re-emerging in the future.

Better yet, let's look at keeping an already healthy and disease-free mouth... healthy and disease-free with the right hygiene and the right biology. It is certainly the most natural and affordable approaches to dentistry today and one which you and your family can have direct control over.

-Tom Cornwell
OraMedia

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