By Dr. Deidre Callanan, Public Health Policy and Community Engagement, University of Colorado School of Dental Medicine
Scientists have isolated more than 10,000 human microbial species, over 8 million unique microbial genes. These tiny critters, or microbes, thousands of them, make up what is called the microbiome. Bacteria, viruses, and fungi are examples of microbes.
Of the 10,000 identified species, each one of us has about 1,000 species of microbes that occupy virtually every part of our body—every nook and cranny, inside and out. Our individual microbiome is as unique as our fingerprint and, for the most part, our microbes keep us healthy— the healthier you are, the more variability there is in the mix of species. This ecosystem keeps us healthy, constantly adapting to our physiology. A disruption, or imbalance, of the microbial system has been associated with many diseases like inflammatory bowel disease, diabetes, cancer, allergies, and others.
The microbiome of the oral cavity is an abundant and diverse microbe community. Oral microbes inhabit the hard surfaces of the teeth and the soft surfaces of the mucosa. When this ecosystem is disrupted, the disease-promoting bacteria take over and can cause diseases like caries, gingivitis, and periodontitis. Diseases are even more apparent in people who are immunosuppressed, either through medications or through non-deliberate means, such as malnutrition, infections, and some cancers, in which life-threatening fungal and viral infections are seen in the oral cavity.
The microbiome of the oral cavity is distinctly different from that of the gut, which is distinctly different from the microbiome of the skin, which is distinctly different that of the urogenital system, and so on. While different, each microbiome interacts and influences the other. An example of this is the evidence that human oral bacteria play a role in both oral and gastrointestinal cancers, activating not only alcohol and smoking-related carcinogens, but systemic carcinogens as well.
Clearly, our oral health and overall health are one in the same and keeping our microbiome in homeostasis (as stable as possible) is key. What we eat, drink, and do, physically and mentally, affects our ecosystem. Eating a diet that is high in nutrients, with lots of those delicious fruits and vegetables, staying away from alcohol and tobacco, and keeping stress at a minimum, especially through exercise, helps to maintain a healthy ecosystem.
As scientific evidence increases, appreciating and understanding the microbiome will change the way we care for people. This can lead to a better assessment of risk, improved diagnoses, and personalized treatment of certain diseases. This may be a paradigm shift for interprofessional collaboration and whole body care.
As oral health advocates, we will to continue to be active players in integrated health efforts. The more we can raise awareness about the impact of oral health on whole health, the better. When oral health and our microbiome become part of the natural way that we all look at health, patient and self-care will improve. Because all of the systems of the human body affect each other and contribute to the overall health of the person, more integrated health care, even at the microbial level, will benefit people.