Oral microbiome: why children develop cavities despite brushing their teeth, and how the gut destroys enamel

Біговий захід GoMove в Ужгороді за підтримки Ediens

Hundreds of thousands of parents face the same problem: the child regularly brushes his teeth, uses high-quality toothpastes, limits sweets, but the dentist diagnoses caries again and again. Traditional dentistry often explains this by "bad genetics" or "insufficient hygiene". However, modern evidence-based science and microbiomics prove: caries is not a local problem of one tooth. It is a social and multifactorial disease that is the result of a deep ecological catastrophe on the mucous membranes and systemic dysbiosis of the gastrointestinal tract. In this article, we will analyze the real causes of the destruction of children's teeth, how fungi and bacteria form criminal alliances in the mouth, and why the treatment of caries should begin with the intestines.

PART I. The mouth is not just about teeth: secrets of the microzoo

The oral cavity is the beginning of our gastrointestinal tract (GI), which we often forget. It is an extremely favorable niche for the life of trillions of microorganisms: bacteria, viruses, fungi and protozoa. Saliva is an important nutritional substrate, containing amino acids, proteins, lipids and carbohydrates, and therefore the mucous membranes of the mouth are the most densely populated compared to other niches of the body.

Healthy microflora lives in symbiosis with the host and provides a natural protective barrier. A key player in this protection is the level of our local immunity - in particular, secretory immunoglobulin A (sIgA). Reduced levels of secretory IgA indicate a global decline in local immunity, which instantly makes the mucous membranes more vulnerable to pathogenic bacteria and fungi.

When the balance is disrupted (due to poor diet, antibiotics, or chronic stress), commensal (beneficial) microbes can switch to a pathogenic lifestyle, causing dysbiosis and giving the green light to destructive processes.

PART II. Criminal Alliance: How Bacteria and Fungi Destroy Enamel

For a long time, it was believed that the main and only "villain" that causes caries is the bacterium Streptococcus mutans . But modern scientists, studying the oral microbiome like detectives, have discovered a much more complex picture: bacteria wage local wars and form cunning alliances.

Today, it has been proven that caries is the result of the interaction of many types of microbes. Particularly dangerous is the alliance of the bacteria Streptococcus mutans with microscopic fungi of the genus Candida (in particular Candida albicans ). Despite the fact that Candida can be part of the permanent flora, under certain conditions it quickly turns into an opportunistic pathogen (emerging pathogen). Together with S. mutans, the fungus forms extremely strong two-species biofilms on children's teeth, which become impenetrable to a regular toothbrush or saliva.

What activates this alliance? Our food.

The issue of nutrition is of enormous importance. When we eat, we feed not only ourselves, but also our microbes. Regular consumption of simple carbohydrates, such as sucrose, as well as sweetened juices and fructose-glucose syrups, gives a powerful impetus to the growth of cariogenic bacteria and their interspecific interaction. Ordinary hygiene becomes powerless if a child "feeds" the pathogenic army with fast carbohydrates every day.

PART III. The Mouth-Gut Axis: Why Cavities and Abdominal Pain Go Hand in Hand

The most important discovery of modern 4P medicine is that dental diseases (caries, periodontitis, gingivitis) in children almost never exist in isolation from gastrointestinal problems.

Clinical studies conducted by specialists show that children with diagnosed caries and inflammation of periodontal tissues very often have concomitant pathologies - chronic gastritis and gastroduodenitis. When examining the microbiome of such children, scientists find a terrible picture:

The oral cavity and gingival pockets are dominated by gram-positive cocci (streptococci) and opportunistic enterobacteria ( Klebsiella oxytoca , E. coli).
There is an almost complete absence of beneficial defenders — lactobacilli — both in the mouth and in the intestines.
In the coprofiltrate (in the intestines) and in saliva, immune markers of inflammation (TNF-α, IL-6) are significantly increased, as well as levels of secretory IgA, which indicates an acute inflammatory process.

Oral bacteria can "travel" throughout the gastrointestinal tract, provoking systemic diseases, and vice versa - intestinal dysbiosis instantly destroys immunity in the mouth. That is why treating a tooth at the dentist, ignoring constant bloating, constipation or enterocolitis in a child - is a waste of time.

PART IV. The Scientific Approach to Treatment: How Pharmabiotics Work

Classic mass-market pharmacy probiotics often provide only a short-term effect, temporarily suppressing S. mutans , but not solving the problem systemically.

Modern evidence-based medicine offers an innovative way - the use of targeted pharmabiotics based on clinical data. Thus, Ukrainian scientists have developed a specialized composite biopreparation " ProfiLactor " , created specifically for children with caries and concomitant gastroduodenal disorders.

How does it work?

The preparation contains live strains of beneficial lactobacilli ( Lactobacillus plantarum and Lactobacillus casei ), which were isolated from a healthy microbiome and fermented according to the traditional recipe of sauerkraut. These strains are characterized by high acid resistance, which allows them to pass through the stomach and act both in the oral cavity and in the intestines. They have a pronounced antimicrobial effect: they specifically inhibit the growth of pathogenic bacteria and fungi ( Candida , Streptococcus , E. coli ).

According to clinical trials, after a 14-day course of using "ProfiLactor" (in the form of capsules or powder dissolved in liquid):

The level of cariogenic streptococci in saliva and on the gums decreased significantly.
Our own beneficial lactobacteria appeared in the oral cavity.
The opportunistic pathogenic biota in the intestines decreased, abdominal pain and flatulence disappeared.
The level of local immunity (sIgA) normalized to the physiological norm.

Conclusion: Dental caries in children is an indicator of a systemic ecological catastrophe in the body. Only a comprehensive approach, which includes reducing simple carbohydrates in the diet, proper hygiene, and the use of clinically proven pharmabiotics to restore the oral and intestinal microbiota, can stop the destruction of enamel and ensure a healthy future for the child.

❓ CLINICAL Q&A: 4 questions about the microbiome and dental caries in children

1. Why does a child brush their teeth regularly, but caries still constantly appear?

Caries is a multifactorial disease that does not depend only on the mechanical cleaning of the enamel. The main cause is an ecological imbalance (dysbiosis) in the oral cavity. If a child consumes a lot of simple carbohydrates and sugar, this creates an ideal environment for pathogenic bacteria ( Streptococcus mutans ) and fungi ( Candida ). They form strong biofilms that are difficult to remove with a toothbrush and secrete acids that destroy the tooth. Hygiene is important, but without changing the diet and microflora, it will not stop the disease.

2. What is the connection between stomach problems (e.g. bloating) and tooth decay?

The oral cavity is the beginning of the gastrointestinal tract (GI). The oral and intestinal microbiomes are closely interconnected. Studies show that children with caries often have concomitant gastroduodenal disorders, such as gastritis or enterocolitis. Inflammation in the intestine reduces the overall local immunity (level of protective secretory IgA), which makes the oral mucosa defenseless against aggressive bacteria. Pathogens can "travel" throughout the GI tract, so the entire system must be treated.

3. Why do regular probiotics from the pharmacy often not help protect teeth?

The effect of mass probiotic preparations on oral health is often short-lived. Many of them only temporarily suspend the activity of individual bacteria (for example, S. mutans ) in saliva, but are not able to destroy the complex bispecific biofilms that bacteria form together with fungi (such as Candida albicans ). For real treatment, specially developed pharmabiotics (with strains of Lactobacillus plantarum and Lactobacillus casei ) are needed , which have proven their ability to specifically suppress the entire complex of caries pathogens and simultaneously restore the intestinal microbiome.

4. What is "ProfiLactor" and how does it help children?

This is a specialized niche pharmabiotic (dietary supplement) developed on the basis of clinical studies of the microbiome of children. It contains a high concentration of live beneficial lactobacilli isolated from a healthy microbiome. The course of administration lasts 14 days and can be used both in capsules and dissolved in warm liquid (for the smallest). The drug not only reduces the number of cariogenic bacteria in the mouth, but also treats concomitant digestive disorders (bloating, abdominal pain), normalizing the child's local immunity.