The following article was written by Mary McGrath, RDH, in completion of requirements to become an IABDM Certified Biological Hygienist. Congratulations, Mary!
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There are many natural approaches to the oral cavity, which I feel are more accessible to most individuals. The natural approaches which I will be focusing on are oil pulling, probiotics, and ozone therapy. Many natural products, which are safe, and cost effective, are gaining popularity. These products are available for self treatment or prevention, helping bring awareness to oral health in conjunction with overall health.
Oil Pulling
Oil pulling is a procedure that involves swishing oil in the mouth for oral and systemic health benefits. Oil pulling claims to cure about 30 systemic diseases ranging from headache and migraine to diabetes and asthma. Oil pulling has been used extensively as a traditional Indian folk remedy for many years to prevent decay, oral malodor, bleeding gums, dryness of throat, and cracked lips, and for strengthening teeth, gums and the jaw. [1]
Oil pulling is believed to be a powerful detoxifying Ayurvedic technique that has recently become very popular as a remedy for many different health ailments. For some, using this method could prevent surgery or use of medication for a number of chronic illnesses. Oil pulling therapy is believed to be preventative as well as curative. The exciting aspect of this healing method is its simplicity. Oil pulling is advised to purify the entire system; it is thought that each section of the tongue is connected to a different organ such as to the kidneys, lungs, liver, heart, small intestines, stomach, colon, and spine, similarly to reflexology and TCM. [2]
A study conducted by Asokan (2009) to evaluate the effectiveness of oil pulling with sesame oil to chlorhexidine mouthwash on plaque-induced gingivitis. [1] This study took 20 age-matched adolescent boys with plaque-induced gingivitis and divided them randomly into the study or oil pulling group (Group I) and the control or chlorhexidine group (Group II), with 10 subjects in each group. Plaque index and modified gingival index scores were recorded for the 20 subjects, and baseline plaque samples were collected. From this they found a statistically significant reduction of the pre- and post-values of the plaque and modified gingival index scores in both the oil pulling and chlorhexidine groups. The oil pulling therapy showed a reduction in the plaque index, modified gingival scores, and total colony count of aerobic microorganisms in the plaque of adolescents with plaque-induced gingivitis. My thought on this study is that if oil pulling has the same results as prescription mouthwash and is more widely available, this is a much better option for patients as an easy and safe approach to maintaining gingival health along with the systemic health benefits. [1]
Probiotics
Probiotics are living microorganisms (e.g., bacteria) that are either the same as or similar to organisms found naturally in the human body and may be beneficial to health. Current research has shown that the balance between beneficial and pathogenic bacteria is essential in order to maintain oral health. Probiotics usage could be beneficial for the maintenance of oral health, due to its ability to decrease the colony forming units (CFU) counts of some oral pathogens. [3]
One of the most promising benefits of oral probiotics is in treating malodor. About 25% of people suffer from malodor, and it has many social implications that affect a person’s overall confidence and well-being. [6] With many causes for bad breath, 85% of the time breath malodor arises from insufficient oral hygiene, this conditions in the mouth favor the formation of offensive smelling volatile sulfur compounds (VSCs). [5] This is where dental probiotics can help to combat bad breath in a way that has not been widely considered.
Dental probiotics focus on promoting the growth of good bacteria in the oral cavity and curtailing the growth of pathogenic bacteria. [5] With dental probiotics, daily exposure helps to colonize the oral cavity with bacteria that do not produce VSCs. Research has shown that 85% of people who took oral probiotics for one week experienced a significant reduction in volatile sulfur compounds.[7] Even more impressive is the fact that the majority of study participants maintained a reduced level of VSCs for two weeks following exposure to oral probiotics. With this treatment, there is potential for a more long-term solution to bad breath.
This same study also considered the benefits of oral probiotics on caries control and periodontal health. While these probiotics promote good bacteria that lowers VSCs to aid in controlling malodor, these probiotics also reduce the plaque/bacteria that release acid that lowers the pH of the oral cavity which allows for caries to develop. S. Salivarius M18 reduces caries development by increasing PH and reducing plaque formation. With reduced plaque formation, the reduction of gingivitis is also a benefit. [7]
Dental probiotics are different from the probiotics needed for digestion. The Streptococcus salivarius strains K12 and M18 have been found to be especially beneficial when it comes to the health of the oral cavity. [7] Oral probiotics are typically in the form of a lozenge that is chewed or sucked on after normal oral care. Using a lozenge provides longer exposure time than other methods so that more bacteria are able to colonize the oral cavity. Thus an affordable and easily accessible additional option to optimize oral health.
Ozone Therapy
While not as easily accessible as oil pulling or probiotics, ozone therapy’s use and results are proving more beneficial than some minimally invasive conventional dental therapies.
Ozone (O3) is a triatomic molecule, consisting of three oxygen atoms. One way of understanding ozone is to think of it as an activated, excited form of oxygen. The highly unstable ozone molecule (O3) wants desperately to kick off one oxygen so it can return to the more stable O2 molecule. Some think this powerful reaction is what gets the oxygen beneath the surface of a tooth to kill bacteria causing decay or into the dentinal tubules. [8]
There are 3 easy ways ozone can be applied to the oral cavity: (1) ozonated water, (2) ozonated olive oil, and (3) oxygen/ozone gas. Ozonated water and olive oil have the capacity to entrap and then release oxygen/ozone, an ideal delivery system. This makes ozonated water an ideal use in perio therapy and maintenance, with its application delivered through the ultrasonic during a prophy. These applications can be used singly or in combination, like ozonated water during treatment in the dental office and ozonated oils at home. All three of these modalities can be utilized for a wide variety of dental conditions, including periodontal therapy, decay therapy with remineralization of early lesions, root canal treatment, tooth sensitivity, canker sores, cold sores, and bone infections, and also stimulate blood circulation and the immune response. [9]
Controlled ozone application has been found to be extremely safe and free from side effects — far freer than most medications, including antibiotics. The ozone molecule is the most powerful agent that we can use on microorganisms. It is deadly to bacteria, viruses, and fungi, yet the more highly evolved human cells are not damaged by ozone in lower concentrations.
In conclusion, the natural approaches of oil pulling, probiotics, and ozone therapy are safe, cost effective, and gaining popularity. With its simplicity of use, accessibility, and promising results on the oral cavity as well as systemically, I feel these natural approaches for treatment of dental conditions should be considered as possible alternatives to traditional dental treatments.
References
- https://pubmed.ncbi.nlm.nih.gov/19336860/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131773/#ref18
- https://pubmed.ncbi.nlm.nih.gov/22632388/
- https://pubmed.ncbi.nlm.nih.gov/28390121/
- https://www.rdhmag.com/patient-care/xerostomia/article/16408156/dental-probiotics-has-a-better-way-to-fight-bad-breath-finally-been-found
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412664/
- https://opencommons.uconn.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1484&context=srhonors_theses
- https://www.dentaleconomics.com/science-tech/oral-medicine-anesthetics-and-the-oral-systemic-connection/article/16389313/dental-ozone-the-revolution-is-happening-here#:~:text=Mixed%20into%20water%20or%20plant,tissue%2C%20and%20accelerates%20surgical%20healing
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3276005/
Images: Hygienist by Barbaricino, via Wikimedia Commons;
oil pulling by thedabblist, via Flickr