The oral cavity is not only home to teeth and gums. It also contains a complex ecosystem of microorganisms, known as the oral microbiota or microbiome.
This community includes bacteria, fungi, viruses, and other microorganisms that permanently inhabit the oral cavity and play a key role in maintaining health or developing disease. Most of these microorganisms are therefore harmless to humans. The problem arises when this balance is disrupted.
What is oral microbiota?
The microbiota is a community of microorganisms that live on the skin and mucous membranes of humans. Each part of the body has its own specific microbiome. The oral cavity is one of the most diverse environments in the body. In terms of the number of microorganism species, it is surpassed only by the intestine.
Today, we estimate that more than 700 different types of microorganisms live in the oral cavity.
The oral cavity is an ideal environment for them to live in because of
constant humidity
stable temperatures
constant supply of nutrients
numerous attachment surfaces, such as teeth, gums, and tongue
Microbiota is not the same everywhere
The composition of the microbiota varies depending on the exact location in the oral cavity. Different communities of microorganisms live on
language
dental
cheek mucosa
hard and soft palate
tonsils
tooth surfaces above and below the gum line
Each of these surfaces has different conditions, so a different microbial community develops there.
Biofilm: an organized community of bacteria
Microorganisms in the oral cavity do not live individually. They organize themselves into biofilms. These are complex colonies where bacteria live in mutual connection.
Biofilm consists of
bacteria that live in symbiosis
intercellular matrix produced by bacteria themselves
protective structure that enables bacteria to survive
Dental plaque is an example of biofilm. This biofilm can be healthy or pathological.
Balance means health
When beneficial microorganisms predominate in the oral cavity, we refer to this as balance. Such microbiota helps
protect tooth surfaces
prevent the colonization of harmful bacteria
keep your gums healthy
When this balance is disrupted, dysbiosis occurs. Harmful bacteria then begin to dominate.
Dysbiosis leads to the development of diseases such as
dental caries
gingivitis
periodontitis
inflammation around implants
Oral microbiota also affects overall health
The oral cavity is connected to the entire body. Microorganisms and inflammatory processes in the mouth can also affect systemic diseases such as
diabetes
cardiovascular diseases
autoimmune diseases
Therefore, oral health is not only important for teeth, but for the entire body.
How we can influence oral microbiota
The composition of oral microbiota is influenced by numerous factors. The most important ones are
oral hygiene
diet
use of oral disinfectants
antibiotics
probiotics and prebiotics
lifestyle
Proper oral hygiene helps maintain a healthy balance of microorganisms. Improper hygiene allows harmful bacteria to develop.
Candida: a fungus that is almost always present
Scientists know of around 200,000 species of fungi that live on the skin, mucous membranes, and in the digestive tract. Most are harmless. One of the most common is Candida albicans.
Candida is present in the mouth and on the skin of most healthy people. It usually coexists peacefully with its host. It exists in the form of yeast, but can transform into hyphae, which allows it to spread. When it grows too much, oral candidiasis occurs.
Oral candidiasis refers to the growth of fungi in the oral cavity. It can be asymptomatic or cause:
mouth pain
burning sensation
painful swallowing
sensitive mucosa
It occurs more frequently in:
immunocompromised individuals
patients with diabetes
systemically ill persons
How to recognize it
Candidiasis occurs in several forms:
Pseudomembranous candidiasis or sor
The most well-known form. White patches are visible and can be removed.
The mucous membrane becomes intensely red and sensitive.
Visible white changes that cannot be easily removed.
Why does overgrowth occur?
The main cause is a change in the microenvironment in the mouth. This happens due to:
taking antibiotics
use of corticosteroids
smoking
reduced saliva secretion
diabetes
weakened immune system
Saliva has an important protective function. When there is less of it, protection is reduced.
How to treat candidiasis
Treatment is effective. Fluconazole is most commonly used. It is an antimycotic that inhibits the growth of fungi. It is available in tablet or gel form.
It also helps:
antiseptic mouthwash
adequate fluid intake
balanced diet
natural probiotics
Probiotics help restore the balance of microflora.
Viruses in the mouth: common but often overlooked
Fungi are not the only microorganisms in the mouth. Viral infections are also common.
Herpes simplex virus type 1 causes herpetic gingivostomatitis. This is one of the most common viral infections of the oral mucosa.
Human papillomavirus, or HPV, is very widespread. At least 250 genotypes are known. At least 25 of these can cause cancer.
The Coxsackie virus causes inflammation in the mouth and on the skin.
Paramyxoviruses cause diseases such as mumps and rubella.
The HIV retrovirus severely weakens the immune system, increasing the risk of infections in the mouth.
SARS CoV 2 also affects the oral mucosa and immune response.
Conclusion
Oral microbiota is a complex and important part of oral health. It is not about removing all bacteria. The goal is to maintain a healthy balance.
With regular and proper oral hygiene and professional dental care, we can maintain healthy microbiota, healthy gums, and healthy teeth.
This balance is the foundation of long-term oral and overall health.
