I got my first cavity when I was seventeen years old, and let me tell you—I was devastated. I was adamant about brushing my teeth twice a day, and flossing as well. I limited sweets and was an overall healthy person. What I didn’t find out until over a decade later, however, was that my cavity wasn’t the result of poor hygiene habits, but rather, it had developed because of my use of Invisalign dental trays.
If you’re unfamiliar with Invisalign, they are clear, plastic, molded retainers that are designed to shift teeth over the course of time. As a teenager, I had some mild crowding on the top and bottom, so my dentist recommended a 9-month course of using these dental trays to gently shift my teeth instead of having metal orthodontic braces put in. My dentist counseled me about the importance of keeping my teeth clean so that food particles didn’t get trapped underneath, and I took him seriously. But what he failed to mention and what I failed to realize is that the Invisalign trays were also keeping important things out, and that is how my cavity developed: saliva and oxygen.
Our mouths are living ecosystems. Just like “bad bacteria” causes cavities, good bacteria produce beneficial chemicals that protect our teeth and keeps our mouths functioning normally. Healthy saliva continually bathes our teeth and gums, protecting the enamel and maintaining an optimal chemical environment so that good bacteria can grow and bad bacteria cannot. When I was wearing the Invisalign, the saliva in my mouth was blocked from reaching my teeth, which influenced the type of bacteria that were able to grow. Without that natural cleansing, bad bacteria developed.
In addition to saliva, oxygen exposure is essential for a healthy mouth. Oxygen allows certain types of beneficial bacteria to grow and kills bad bacteria, which tend to die when exposed to air and oxygen. This is also part of the reason that flossing is important because in addition to removing stuck food, flossing introduces oxygen between teeth so that bad bacteria can’t grow, and so that saliva can get in to bathe and protect our teeth. My Invisalgn dental trays were also blocking my teeth from oxygenation, which favored the growth of anaerobic species of bacteria, which ferment and produce acid as byproducts, eroding enamel and leading to cavity formation and rot.
Obviously, it’s bad news when cavities form. A generally healthy lifestyle is needed for good dental health, and it’s also important to take steps to preserve the dental microbiome. Here are some strategies from functional medicine that you can take to help support your dental health and preserve your oral microbiome.
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Here’s How to Support Your Oral Microbiome through Functional Medicine
- Stop using plastic dental trays. As I outlined above, plastic dental trays prevent oxygen and saliva from reaching your teeth which leads to unfavorable shifts in the dental microbiome. It also damages gums and can worsen receding and inflammation. Instead of Invisalign and related products, opt for traditional wire braces. Likewise, instead of plastic retainers, use either a wire retainer or consider palate expansion so that the teeth naturally stay in place without the need for the constant pressure of a retainer.
- Ditch sugar. Sugar favors the growth of bad bacteria in your mouth. It also is the fermentable substrate that bacteria consume, converting into acid and alcohol byproducts that erode enamel. You should also be mindful of foods that break down into sugar, like crackers which become wet and form a paste, sticking to teeth and holding sugar against them over the course of time. These pasty carbohydrates can get wedged into small grooves and cracks in teeth and contribute to cavity formation over time, even if they aren’t sweet foods with sugar added.
- Use hydroxyapatite toothpaste. This is a natural way to rebuild enamel and protect your teeth if you have had exposure to damaging substances over time. Avoid toxicants like fluoride, which harm the balance of good and bad bacteria in the mouth (fluoride is toxic to good bacteria.) You should also avoid products like hydrogen peroxide which can damage enamel and harm the microbiome by killing beneficial bacteria.
- Consume probiotic foods. Fermented foods like yogurt, kombucha, kimchi and natural pickles seed the mouth with beneficial probiotics. They also naturally stimulate saliva production which helps keep teeth and gums clean and moistened. You should have probiotics foods with every meal.
- Avoid alcohol-based mouthwash. Alcohol-based mouth washes are not only drying, but they also kill beneficial bacteria in the mouth. This is a problem because the oral microbiome is there for a reason! Instead, use herbal mouth rinses like the Tooth & Gums Tonic from Dental Herb Company.
- Fix mouth breathing. When we are sleeping (or awake), we should be breathing through our noses, with our mouths shut, unless we are eating, drinking or talking. Mouth breathing dries out the mouth and contributes to decay by shifting the oral microbiome and drying out teeth. This can worsen gum inflammation, lead to break down of enamel, and disrupt the oral microbiome. Mouth breathing can be challenging to fix, but I recommend having a comprehensive evaluation of why your body tends to use that method of breathing. Are you dealing with undiagnosed allergies? Do you have a restricted airway? Do you need dental expansion? I recommend working with an airway dentist to have a thorough examination.
- Take oral probiotics. In my functional medicine practice, I have somewhat of an eclectic approach to gut health and proboitic use. I am absolutely an advocate for consuming probiotic foods when appropriate (individuals with some histamine problems and overgrowth patterns may not tolerate probiotic supplementaiton.) In general, I prefer for people to not need to take probiotics in order to be healthy. However, as a consequence of our food system and because of some of the problems outlined in items 1-6 on this list, sometimes probiotic supplementation is necessary. Apart from correcting imbalances as outlined in functional medicine stool microbiome testing, I often recommend the E.N.T. Biotic from Protocol for Life Balance or Adult ENT-Pro from Biotics Research Company. What’s unique about both of these formulations is that they are not capsules; rather, they are lozenges that are meant to slowly dissolve in the mouth and “seed” the oral and sinus cavities with beneficial bacteria.
- Use Red Light Therapy. If you are dealing with chronic imbalances in your oral microbiome or chronic problems with gum inflammation (gingivitis), consider using red light dental trays to administer red light therapy to your gums to facilitate healing and reduce cavity formation. Red light limits the growth of harmful bacteria and facilitates the growth of beneficial bacteria to balance the microbiome. This strategy is also a natural method for tooth whitening that does not use harsh chemicals or erode enamel like peroxide does.
Other Strategies for Dental Health
In addition to maintaining the above strategies to support the dental microbiome, an overall health lifestyle is essential for good oral health. It’s not just as simple as brushing and flossing, though those are obviously important too.
In order to maintain your dental health, I also recommend eating a low glycemic index, nutrient-dense diet. Dental health requires micronutrients like chromium, copper, zinc, selenium, magnesium, calcium, vitamin D, vitamin C, and B vitamins. While you could certainly supplement these factors, there are additional nutrients far too numerous to list in a blog post that can only come from a diverse and abundant diet. Please also be sure to include quality animal products in your diet to support your long-term health.
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I’m Dr. Alexandra MacKillop, a functional medicine physician, food scientist and nutrition expert.
I specialize in women’s health & hormones, addressing concerns like fertility, PCOS, endometriosis, dysmenorrhea (painful periods), PMS symptoms like bloating and mood changes and more.
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