181. The Oral-Gut Axis | Oral Biofilm Formation, Oral Dysbiosis and Symptoms, The Oral Microbiome and Intestinal Health, and Oral Microbiome Testing
In this episode, we detail the oral microbiome and its relationship with the intestinal microbiome, detailing the oral-gut microbiota axis. We discuss the stepwise development of oral biofilm, the transition from plaque to dental calculus, and potential systemic impacts of oral dysbiosis, while highlighting intestinal health and focusing on Fusobacterium nucleatum. We then detail possible symptoms of oral dysbiosis as well as testing modalities.
Topics:
1. Overview of the Oral Microbiome and the Oral-Gut Axis
- The oral cavity and the gut: microbially dense sites.
- These regions are anatomically distinct but connected and capable of influencing each other.
- The oral microbiome: bacterial species, fungi, viruses, archaea, protozoa.
- Microbial distribution is influenced by the topography and chemistry of various oral surfaces.
2. Oral Cavity Anatomy and Microenvironments
- The oral cavity is divided into the vestibule and oral cavity proper.
- Lined by oral mucosa, which varies in structure.
- These anatomical variations create unique ecological niches that support different microbial populations.
3. Tooth Structure and Relevance to Microbial Colonization
- Teeth are embedded in the alveolar processes of the maxilla and mandible.
- Tooth structure.
- Long-term microbial colonization and biofilm development.
4. Biofilm / Dental Plaque Development
- Biofilm begins with the formation of the acquired pellicle.
- Pioneer species secreting extracellular polymeric substances (EPS).
- Secondary colonizers coaggregate.
- Coaggregation is species-specific.
- Example.
- Aerobes can lower local oxygen levels, creating micro anaerobic niches that support obligate anaerobes.
5. Maturation of the Biofilm
- Biofilm composition shifting to anaerobic, proteolytic species such as P. gingivalis.
- F. nucleatum: a bridge species.
6. Mineralization and Formation of Dental Calculus
- Mineralization, calcium and phosphate deposition.
- Dental calculus.
- Can promote further accumulation and worsen inflammation.
7. Oral Dysbiosis
- An imbalance in the oral microbial community.
- Potential signs and symptoms.
- Halitosis, swollen or bleeding gums, tooth sensitivity, new cavities, dry mouth or altered taste, recurrent infections, coated tongue, plaque buildup near the gumline.
8. Oral-Gut Axis and Systemic Implications
- Physical, chemical, biochemical, and immunological barriers aid in preventing oral bacteria from colonizing the gut.
- Oral bacteria can potentially impact intestinal health.
- F. nucleatum and IBD.
9. Oral Microbiome Testing
10. Multi-Factorial
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