Bacteria: Friend or Foe?

Bacteria is everywhere. On me. On you. On your car steering wheel. In hospitals. In fact, as Dr. Tom Nabors reported at the recent AAOSH 2014 Meeting, the human body has more than 1,000,000,000 bacterial genes. And those bacterial genes have 150 times greater influence on us than our human genes. We are more different based on our microbial genomes than our own genes. Bacteria and the biofilm that houses it can impact our development and response to cancer, heart disease, diabetes, and more, and have led directly to the antibiotic resistance crisis we are currently facing. As Dr. Joe Blaes stated in his opening address, dentists hold the primary responsible for reducing the bacterial load in the mouth.

If we are literally covered in bacteria, and have survived this long, why should we bother trying to remove it? We need to differentiate between the good bacteria and bad bacteria. Bad bacteria act as pathogens. As presented by Dr. Nabors, a pathogen is a single species of bacteria whose effect on its community (biofilm) is disproportionately large relative to the number of bacteria. A single species of bacteria with the ability to deregulate inflammation in the body is a pathogen. These “infecting organisms” establish themselves as a dominant species and suppress our “core” bacteria.

As stated by Dr. Mark Cannon, every time we eat or drink, we are either feeding our bacteria or fighting it. Most often, we are feeding it thru our excessive sugar consumption. The average American consumes 22 teaspoons of sugar a day. The American Heart Association recommends no more that 6 to 9. As a result of our sugar overload, 44% of kindergartners have active decay. We also have record high levels of obesity and diabetes.

In addition to feeding the bacteria, we also do a great job sharing it. Mothers pass caries-causing bacteria to children by kissing them and sharing utensils. Partners pass bacteria back and forth. When you fail to treat entire families, bad bacteria is difficult to eradicate. After scaling and root planning, bacteria has been show to return to pretreatment levels 21 – 60 days following treatment. According to Dr. Duane Keller, disturbing the biofilm may actually increase the reproductive capacity of bacteria by 300-400%. As pointed out by Trisha O’Hehir, hygienists can create cross contamination in the mouth when moving a perio probe from one pocket to another. Should we just give up and let the bacteria run rampant in our mouths? No! Lowering the bacteria in the mouth not only leads to better oral health, but can contribute to an overall reduction in bacteria in the body. For example, research by Dr. Yiping Han has shown that reducing the bacterial load in pregnant patients’ mouths can prevent pre-term births as bacteria can be passed from the mother to fetus thru the placenta.

So how do we impact the biofilm and decrease pathogens in the mouth? More options are available every day, but xylitol is one of the most researched on the market. As Trisha O’Hehir shared, xylitol is so effective at interrupting the communication between the bacteria and biofilm that it is now being used to heal diabetic wounds previously considered untreatable and would have required amputation! The chemical structure of xylitol prevents bacteria and yeast from digesting it, inhibiting reproduction. Xylitol can be used to eliminate caries-causing bacteria in the mouth, reduce upper respiratory and ear infections, and reduce calorie-intake when substituted for sugar. What will you do to reduce patients’ bacterial load?