By Mark Butcher, PhD student in Oral Science with the Oral Science Research Group at the University of Glasgow. Mark has worked closely with Prof. Gordon Ramage since 2018 in the field of biofilm control and management across multiple disciplines such as oral healthcare, wound management, and marine biofouling.
Sensationalist title, I know. The spoiler here, and what many already understand, is that there is no simpler, more effective way to prevent or reduce complications brought about by tooth decay or gum disease than by brushing your teeth with fluoridated toothpaste. No need to set the toothbrush down just yet. Indeed, there’s no feeling quite like brushing away that fuzzy film on the surface of your teeth after one too many bourbons, chocolate or otherwise. But the sheer effectiveness and relief of brushing your teeth may, in fact, pose something of a complication.
As technology and microbiological research have evolved, the concept of the “microbiome” has become something of a household term. The coining of the term has been attributed to nobel laureate Joshua Lederberg circa 2001, but the concept of ecological microbial niches has existed far longer. Commercially, products such as probiotics have been available since the early 1900s and touted as bringing balance to gut health and expanding longevity. Inversely, we understand that the destruction of the microflora, through exposure to antimicrobials, can result in dysbiosis of the microbiome and lead to the proliferation of pathological organisms. It is this concept of “balance” which returns us to the root of our potential issue in the oral cavity.
It is often stated that there are over 700 species of unique bacteria within the oral cavity, and this can largely be attributed to the diversity of substrates present to allow the formation of ecological pockets, from epithelial and keratinised mucosal tissues to the hard, mineralised enamel of the teeth. Additionally, as the body’s primary nutritional portal of entry, the environment of the oral cavity is ever-changing and continually exposed to numerous external factors such as dietary changes, smoking, and alcohol consumption. As such, the oral microbial “balance” is constantly being influenced by our day-to-day behaviours in ways that may increase the risk of developing pathologies such as tooth decay and gum disease. To address this, the act of toothbrushing functions as a sort of pathological “reset” button, removing the build-up of microbes, or “plaque”, in a wholesale and non-discriminatory way. In doing so, is it not plausible that we are proverbially “throwing the baby out with the bathwater” by removing organisms which would otherwise contribute to eubiosis (a healthy and balanced ecosystem of microbial populations) or microbial harmony?
A significant aspect of my academic journey has been to examine publicly available microbiome data and examine whether we can reliably predict and manage pathological conditions and the changes in organisms present. Largely, this has been through observing the effects of different nutrients, such as simple starches and sugars, as well as introducing different organisms, such as fungi, and even through the introduction of antimicrobial compounds. This work is still ongoing but has developed some interesting insights into the potential for predicting and preventing oral disease. If interested, you can access some of the published results of this work via the following QR code:
The work I am currently conducting here at GCU hopes to address some of the points I have raised while also introducing some fantastically novel methods for testing them. Amongst this is the introduction of novel antimicrobial compounds into 3D, resin-printed, dental prostheses which act by inhibiting communication between bacteria to reduce the recruitment of bugs to a surface. This has the potential to slow the rate at which organisms proliferate, build biofilms, and form that dreadful “fuzzy feeling”. This also has implications for the prevention of oral dysbiosis in a brushing-independent manner which may be more nuanced to the development of a healthy oral microbiome.
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