Fluoride Action Network


States of oral health and disease reflect the compositional and functional capacities of, as well as the interspecies interactions within, the oral microbiota. The oral cavity exists as a highly dynamic microbial environment that harbors many distinct substrata and microenvironments that house diverse microbial communities. Specific to the oral cavity, the nonshedding dental surfaces facilitate the development of highly complex polymicrobial biofilm communities, characterized not only by the distinct microbes comprising them, but cumulatively by their activities. Adding to this complexity, the oral cavity faces near?constant environmental challenges, including those from host diet, salivary flow, masticatory forces, and introduction of exogenous microbes. The composition of the oral microbiome is shaped throughout life by factors including host genetics, maternal transmission, as well as environmental factors, such as dietary habits, oral hygiene practice, medications, and systemic factors. This dynamic ecosystem presents opportunities for oral microbial dysbiosis and the development of dental and periodontal diseases. The application of both in vitro and culture?independent approaches has broadened the mechanistic understandings of complex polymicrobial communities within the oral cavity, as well as the environmental, local, and systemic underpinnings that influence the dynamics of the oral microbiome. Here, we review the present knowledge and current understanding of microbial communities within the oral cavity and the influences and challenges upon this system that encourage homeostasis or provoke microbiome perturbation, and thus contribute to states of oral health or disease.



*Full-text study online at https://europepmc.org/article/MED/34463991#free-full-text

7.2. Toothpaste

The effects of toothpaste on the oral microbiota have been investigated more thoroughly than the effects of toothbrushes. In the same study as previously described,33 the researchers also compared the oral and toothbrush microbiotas of participants who used either traditional Chinese medicine toothpaste or antibacterial toothpaste. While both types of toothpaste effectively reduced the numbers of a selection of pathogenic bacteria, they also suppressed oral S salivarius and L salivarius, both of which are considered beneficial. The toothpastes reduced bacterial numbers to differing degrees: ingredients in the Chinese toothpaste, such as honeysuckle, pseudo?ginseng, and mint, which replace antibacterial ingredients like sodium fluoride, permitted growth of higher numbers of bacteria. Other toothpaste formulations have been developed formulated to shift oral ecology, rather than to completely decimate the microbiota. ZendiumTM contains proteins designed to promote oral health and limit disease?associated organisms. Amyloglucosidase, glucose oxidase, and lactoperoxidase are added to promote production of hydrogen peroxide and hypothiocyanite, both of which exert antibacterial activity against plaque?forming species. Zendium also contains lysozyme, lactoferrin, and IgG. A randomized clinical study comparing Zendium toothpaste with a control toothpaste containing fluoride showed that brushing with Zendium increased the abundance of organisms associated with gum health and decreased the numbers of those associated with periodontal disease. These results prove an important concept, namely that oral ecology can be manipulated via the introduction of biochemical mediators. Future studies in this area will probe the metabolic output of these restructured communities, providing a more complete picture of the potential benefits shown in these preliminary results.34


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