What should you know about dental microbiology?

A better understanding of dental microbiology can help you halt the growth of tough pathogens in your patients mouths, resulting in better overall oral health.

Deep below the gum line, where no dental equipment or laser can reach, lives a complex community of bacteria and fungi, whose activities can either promote the health of their host or lead to tissue damage and destruction.6 How can we promote the health of our patients’ dental microbiology, and what determines a healthy outcome versus an eventual tooth extraction?

As a microbiologist, having worked on environmental and healthcare-related microbial biofilms since 1998, I can attest to their durability, dynamism and complexity. It turns out that antibiotics, antiseptics, detergents, ozone, enzymes and physical scaling/planing only make a slight dent in affecting the subgingival biofilm.4 The secrets to biofilm management are much easier than killing the microbes. Rule number one – it is easier to influence the microbial strains that call the biofilm home. Rule number two – the easiest factor to influence is what these strains eat.5,7

Pathogens – they’re tougher than you think

We are all taught about the pathogens, such as Porphyromonas gingivalis, Treponema denticola, Catonella morbi, and others that activate the innate immune system and wreak havoc on the periodontal ligament and the gingival tissue. These organisms have a diverse repertoire of defense mechanisms that make them difficult to effectively combat with ozone, antibiotics, antiseptics and enzymes.6 Surrounding the periodontal ligament, neurons, and blood vessels, they are too deep to be lasered or scraped away.

The biggest side effect of these approaches is that the beneficial, health-promoting commensal microbes that also inhabit the subgingival biofilm are really sidelined and unable to do their job of limiting pathogens, regulating healthy immunity and helping to maintain gingival integrity of their host.1-3

An innovative solution

So, what can you do to help your clients? Believe it or not, the most effective approach is to affect what the dental biofilm can eat. We have been working on an approach for harmful biofilms for over 13 years with demonstrated clinical success in humans and pets. Our approach, Selective Microbial Metabolism Regulation Technology (SMMRT)®, uses clinically-validated molecular nutrition to apply nutrient pressure to microbes in a biofilm – specifically designed to: (i) selectively favor the growth of beneficial microbes in the mouth and subgingiva, and (ii) to halt pathogen growth and the production of pathogenic factors that are driven by sugar fermentation. The end result can be best demonstrated in non-toxic dental pathogen reduction (Figure 1) with positive clinical outcomes (Figures 2), ClinicalTrials.gov Identifier: NCT03693027, and for dogs (Figure 3).

Figure 1. Six week endpoint dental microbe levels in gingivitis patients. In an NIH-funded placebo-controlled, double-blinded study, older adults with confirmed gingivitis were administered placebo (sugar alcohols) or TESSIDENT (a patented molecular nutrition combination), three times daily. Baseline and endpoint microbiology was assessed using sterile swabs. The MyPerio Path quantitative polymerase chain reaction (qPCR) test was performed by OralDNA Labs (Eden Prairie, MN). Data represent the average endpoint comparisons between placebo and TESSIDENT groups (n=24 per cohort). Error bars represent the standard deviations of each cohort. Aa = Aggregatibacter actinomycetemcomitans, Pg = Porphyromonas gingivalis, Tf = Tannerella forsythia, Td = Treponema denticola, En = Eubacterium nodatum, Pi = Prevotella intermedia, Cr = Campylobacter rectus, Pm = Peptostreptococcus micros, Ec = Eikenella corrodens.
Figure 2. Six week endpoint gingivitis clinical scores. In an NIH-funded placebo-controlled, double-blinded study older adults with confirmed gingivitis were administered placebo (sugar alcohols) or TESSIDENT (a patented molecular nutrition combination), three times daily. Baseline and endpoint gingivitis was assessed using the bleeding on probing (BOP) technique. Data represent the percent of bleeding upon probing in the placebo or TESSIDENT cohorts at six weeks, compared to baseline BOP scores.
Figure 3: Images of an 11 year old West Highland Terrier with periodontal disease and bad breath. Baseline image shows severe inflammation of the gingival tissue and advanced supragingival and tooth calculus. Day 14 image shows a significant reduction in gingival swelling, a noticeable gain of tissue vascularization and a significant reduction in calculus after daily administration of Protektin42™.

For more information on dental microbiology and SMMRT, visit teefhealth.com.

References

1https://www.sciencedirect.com/science/article/abs/pii/S0011853216301318?via%3Dihub

2https://journals.sagepub.com/doi/10.1177/0022034517735295

3https://journals.sagepub.com/doi/10.1177/0022034517742139

4https://www.sciencedirect.com/science/article/abs/pii/S0753332217350990?via%3Dihub

5https://www.cell.com/trends/microbiology/fulltext/S0966-842X(17)30213-5?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0966842X17302135%3Fshowall%3Dtrue

6https://mmbr.asm.org/content/78/3/510

7https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12679

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Emily Stein, PhD
Emily Stein, Ph.D. founded Primal Health (TEEF for Life) in 2017 to focus on improving the dental health of both humans and animals by producing oral microbiome modulation products. She has spent 12 years developing Selective Microbial Metabolism Regulation Technology (SMMRT™) at Primal Therapies, Inc., which is focused on using metabolic influencers to re-engineer disease-causing bacterial biofilms into those that are health-promoting, to decrease inflammation and to improve outcomes. Prior to that, she spent 7 years as a research fellow at Stanford University in Rheumatology and Immunology focused on the neuro-endocrine-immune axis in autoimmune and chronic inflammatory diseases. She holds a Ph.D. in Microbiology from the University of California at Berkeley where she studied inter- and intra-cellular signaling pathways involved in stress response and community development in bacteria and received her B.S. in Microbiology and Immunology at the University of Iowa where she studied the interaction between M. tuberculosis and innate immune cells.

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