Meet your skin microbiome. This unseen shield defends the largest organ of your body from UV rays, pathogens, and toxic substances. It safeguards your internal organs, prevents dehydration, and even helps dictate your immune response. And yes, it impacts your skin’s texture, tone, and appearance, too. 

Here’s your game plan for building a strong, resilient, and balanced skin microbiome—no intensive facials or pricey regimens required.

What Is the Skin Microbiome?

The skin microbiome is the collection of microorganisms that reside on and in the three main layers of human skin (epidermis, dermis, and hypodermis).^1,2 

More than 600 species of microbes have been identified in this ecosystem, including 174 new-to-science species of bacteria as well as a cadre of mostly harmless fungi and viruses.³ 

The skin microbiome forms an invisible shield between you and your environment, preventing harmful substances and chemicals from penetrating your body. 

If you were to map out your entire skin microbiome from head to toe, you’d find a highly varied topography. Regions of dry skin, such as the forearms and palms, tend to have greater microbial diversity than more oily (or “sebaceous”) areas like the face and back.^4,5 Under a microscope, these sites can be “likely as ecologically dissimilar as rainforests are to deserts,” researchers say.⁴

The skin’s thickness, lipid content, and density of hair follicles and glands can all affect the types of microbes that are able to survive on it.

Outside of major changes such as puberty, the composition of the skin microbiome tends to remain generally stable.⁶ However, the degree of stability varies depending on the body part. The skin on your foot, forearm, and behind your knee, for example, tends to be more diverse and likely to change over time.^4,6 

How the Skin Microbiome Impacts Whole-Body Health

You can think of skin microbes as boots-on-the-ground soldiers protecting you from intruders and sounding the alarm whenever potential threats approach. Here are just a few reasons this microbial landscape is so essential:

1. It helps fight infection and manage inflammation: Beneficial microbes can create a slightly acidic skin environment that is not conducive to the growth of many pathogenic bacteria.⁵ They can also produce or trigger the release of antimicrobial peptides that further inhibit harmful species’ growth.^5,7 Furthermore, your skin microbes are lucky enough to have a direct communication line to your immune cells. This means that once they come in contact with a potential threat, they’re able to help modulate how your immune system reacts to it.⁸ Commensal (good) bacteria can signal immune cells to maintain a balanced response, reducing inflammation and preventing overactions that can lead to skin conditions (more on those below).
2. It speeds up wound recovery: When disruptions do occur on the body’s surface, a resilient skin microbiome can help us recover from them. Some species of bacteria, such as Lactobacillus reuteri, may expedite wound healing by modulating the immune response, reducing inflammation, and promoting tissue repair.^9,10
3. It helps prevent UV damage: Other beneficial bacteria promote skin resilience and produce antioxidants that fend off damage from UV radiation.¹¹ 
4. It can improve skin hydration and appearance: The skin microbiome also interacts with your sebaceous glands to regulate oil (aka sebum) production and skin pH. Hello, hydrated complexion.^5,12,13 
5. It may play a role in skin cancer prevention: Certain strains of Staphylococcus epidermidis bacteria may even be protective against skin cancer.¹⁴ Based on mice studies, this microbe seems to produce a molecule that can inhibit melanoma and other cancer cells while sparing benign cells. Though more research needs to be done, it is thought that about 20% of people carry this cancer-protective strain of S. epidermidis.

Signs of a Disrupted Skin Microbiome

When the balance of beneficial and harmful microbes on your skin is disrupted, your skin microbiome enters a state of dysbiosis. This impacts the skin’s ability to maintain a strong and resilient barrier.¹⁵ 

The changes associated with dysbiosis can potentially trigger or worsen skin issues like the following:

• Acne: While the exact causes and development of acne are not fully understood, there is evidence that microbes play a role in the condition. Microbial communities on your skin interact with sebaceous glands to regulate oil production and support hydration. When this balance is disrupted, acne can happen. One key player is Cutibacterium acnes, a bacterium that primarily lives within hair follicles and relies on sebum as a primary nutrient source.^5,12 More sebum equals more food, potentially leading to an overgrowth of C. acnes—certain strains of which can contribute to acne and trigger inflammation.¹⁶ That said, acne is often caused by a mix of genetic, immune, and environmental factors, in addition to microbial ones.¹⁷ (For example, as many of us are painfully aware, during puberty, sex hormones trigger the development of the sebaceous glands which can lead to breakouts.¹⁶)
• Atopic Dermatitis (AD): Atopic dermatitis (aka eczema) is linked with overall declines in microbial diversity on the skin and a notable increase in Staphylococcus aureus. This overgrowth of S. aureus overwhelms commensal microbiota and can, in turn, exacerbate inflammation and skin damage. (In general, the less microbial diversity, the more severe the AD symptoms.)¹⁸
• Psoriasis: Psoriasis vulgaris typically affects drier spots of skin, such as the elbows and knees. Although research is mixed, some studies suggest that dysbiosis of the skin microbiome may play a role in the chronic condition.¹⁸ Specifically, areas with psoriatic lesions may have a different balance of certain bacteria compared to skin that is not inflamed.¹⁹ 
• Rosacea: Microscopic mites like Demodex folliculorum are usually found at the base of the eyelashes. Despite their sinister-sounding name, they’re usually harmless. However, in folks with rosacea, these tiny bugs seem to collect on facial skin.²⁰ In high numbers, D. folliculorum mites can harbor bacteria that can trigger inflammation and redness.²¹ The presence of certain microorganisms, including Staphylococcus epidermidis and Cutibacterium acnes, has also been linked to rosacea, potentially due to their activation of the innate immune system.²²

One important caveat: While research has shown that changes in the microbiome are associated with certain skin conditions, we don’t yet know the precise role of each microorganism in skin health, or how to treat these conditions via the skin microbiome.²³

How Can I Tell If Mine Is in Good Shape?

Skin microbiome testing is one way to learn more about your microbial makeup. Though convenient, at-home testing kits may not provide a complete, accurate representation of the entire skin microbiome.

Your skin microbiome is a diverse ecological landscape, so if you take samples only from the surface of one or two areas, your results won’t reflect a complete view of the microbiome. (That’s like saying an animal as unique as a manatee can be found in waters across the U.S. just because you saw one in Florida.) 

The collection process is also flawed: The skin has a relatively low microbial load compared to other parts of your body, so it’s tough to get enough DNA for analysis.²⁴ Results can vary depending on the type of tool used (say, a swab vs. a sticky tape or a scraping tool), and there’s a risk of contamination when you gather and send in your sample. 

Testing services also lack a universally accepted standard for skin microbiome analysis. This means your results could vary from service to service.²⁵

Even if your results do accurately reflect your skin microbiome, there’s not enough scientific research yet to credibly link certain microbes with certain skincare tips or treatment plans. 

With this in mind, how can you tell if your skin microbiome is functioning as it should? For starters, you can get to know your baseline: What does your skin usually feel and look like? When you become acquainted with your personal “normal” (which is different for everybody), you’ll be able to pick up on when something’s off. 

That said, having smooth, hydrated, and less sensitive skin tends to be a sign your skin microbiome is in good shape. When yours veers out of balance (due to harsh skincare products, diet, stress, or other factors outlined below), you might notice issues like dryness, redness, irritation, or conditions like eczema. 

How to Support the Skin Microbiome

Supporting your skin microbiome is all about prioritizing practices that nurture its diversity and resilience. This doesn’t have to be complicated or expensive; just do your best to stick with the routines below.

Do: 

• Use gentle, low-pH products. Your skincare and cosmetics products shouldn’t disrupt the natural pH of the skin (roughly 4.5 to 5.5).²⁶ Many popular cleansers, soaps, and texturizers tend to have an alkaline pH ranging from 7 to 8, which can throw off the skin’s microbial balance. Instead, look for unscented, low-pH products (less than 5) that don’t contain antimicrobial preservatives. They’ll be less likely to disrupt microbial diversity—and they may actually positively impact the microbiome by reducing certain potentially pathogenic microbial populations.²⁷  
• Eat a balanced, plant-rich diet. Your gut-skin axis is a two-way telephone line between the gut microbiome and the integumentary system (the scientific term for your body’s outer layer, consisting of your skin, hair, nails, and some glands). Thanks to this axis, consuming plenty of fruits, veggies, and probiotics can help promote skin health and potentially ease acne and certain skin diseases (e.g., eczema and atopic dermatitis).^28,29
• Get outside. The ecosystem surrounding you influences the ecosystem within you. Researchers speculate that the microbiomes throughout your body (including on your skin) “pick up” some of the beneficial microbes you encounter in the outdoors—even through simple acts like touching or breathing in nature.³⁰ While the long-term microbiome benefits of this exposure are still being explored, getting outdoors has plenty of validated whole-body benefits too.

Don’t:

• Over-cleanse. Excessively washing your skin, especially with harsh cleansers, can strip it of its natural oils and beneficial microbes, disrupting the skin barrier and affecting pH. If you’re experiencing irritation, dryness, or tightness, that could be a sign of over-washing or using the wrong products for your skin.³¹ Chat with your healthcare provider or dermatologist for specific recommendations. 
• Sit in the sun without sunscreen. Excessive UV exposure can cause acute and chronic skin damage, including inflammation, premature aging, and increased cancer risk. UV radiation also disrupts the skin microbiome, potentially leading to dysbiosis and compromised skin barrier function.³² 
• Accept chronic stress as “normal”: Stress activates the hypothalamic-pituitary-adrenal axis, increasing the production of cortisol and other stress hormones. This hormonal response can cause inflammation and immune dysregulation, which may exacerbate skin conditions like psoriasis, eczema, and acne. Stress might also lead you to pick up not-so-healthy habits, like neglecting your skincare routines or eating a poor diet, that further disrupt the skin microbiome.^33,34

Frequently Asked Questions (FAQs)

• Why is the skin microbiome important? Though invisible to the naked eye, the skin microbiome plays a crucial role in many major bodily functions, including wound healing, maintaining skin hydration and integrity, and supporting immunity.
• How can I improve my skin microbiome? Don’t overthink it. Using gentle, lower pH skincare products, prioritizing time outdoors, and fueling yourself with fruits, veggies, and probiotic-rich foods can help you achieve a balanced, diverse skin microbiome without overhauling your routine.
• What disrupts the skin microbiome? Stress, excessive UV exposure, harsh antimicrobial skincare products, and over-cleansing can all cause disruptions to the skin microbiome. Due to the gut-skin axis, dysbiosis in the gut can cause negative changes to the skin microbiome.
• What foods help the skin microbiome? Fruits, vegetables, fiber-rich foods, and probiotic ingredients can enrich and regulate the gut microbiome, potentially supporting the skin microbiome too.

The Key Insight

Beauty isn’t just skin deep. The skin microbiome—with its vast impacts on your gut, mind, and immune system—proves it. Protect yours by using gentle, low-pH skincare products, prioritizing time outdoors, and fueling up on plants and probiotics to help your skin function (and look) its best.

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Microbiologists have been studying bacteria and their interactions with the human body for more than 350 years, but their attention has historically been focused on pathogens: the “bad” microbes that can cause disease. The past decade, however, has seen an explosion of scientific interest in the human microbiome—the community of microbes that live symbiotically with and within us—which is necessary for whole-body health. In 2010, the word “microbiome” showed up in a little over 6,700 scientific publications from that year, according to Google Scholar. In 2022, there were over 65,000 publications, connecting the microbiome to everything from obesity to cancer to schizophrenia. As the science has advanced, people and businesses have taken notice.

So what, exactly, do all those “biotic” terms mean? Here, we demystify the most common of them and (hopefully) help you become more informed about the products and foods you can buy, as well as the fascinating advances in science.

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1. Probiotics: Planting Med-Locks of Good Health

Much like a gardener plants med-locks with the expectation that they’ll turn into flourishing plants, we introduce these beneficial microorganisms into our bodies with the hope they’ll prosper and benefit our health.

But the World Health Organization (WHO) has a pretty specific definition of probiotics, and describes probiotics as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”¹ While this could theoretically include many foods and products, from capsules to yogurts to fermented drinks, it’s worth unpacking what this definition requires—namely, that the product includes specific strains of bacteria which have been demonstrated to exert a health benefit in humans, and that your body receives enough of these beneficial microbes in a specific dose to actually make a difference in your health. In other words, it doesn’t really matter if a fermented drink contains bacteria, if they’re not the right type or there aren’t enough of them to provide any actual health benefits. That’s why a scientifically validated probiotic is your best bet if you want to reap the benefits of microbes. 

While an important part of the definition is that the microbes be alive, it’s not necessarily about these microbes colonizing or setting up permanent residence in the gut. Instead, like an annual plant rather than a perennial, they’re typically just passing through—doing good deeds along the way. They travel through your intestines—interacting with local cells, nutrients, and your resident microbes—to deliver health benefits, before they exit your system.

It’s also worth mentioning that the U.S. Food and Drug Administration considers probiotics and dietary supplements to be food, not drugs. While this limits the claims that can be made around what they’ll do for your health, it also means there’s much less oversight—part of why it’s important to dig into the science around any probiotic’s claim of health benefits in order to assess whether it’s likely to work for you.

2. Prebiotics: Fertilizing Our Internal Garden

ISAPP defines prebiotics as “substrates that are selectively utilized by host microorganisms conferring a health benefit.”² In simpler words, they’re food for our beneficial microbes—if probiotics are the med-locks of our internal garden, prebiotics are their fertilizer. They nourish the “good” bacteria, helping them flourish, and sometimes these prebiotics even turn into health-promoting compounds with the help of those same microbes.

Here again, though, the definition is quite specific: ISAPP scientists have pointed out that not everything that feeds bacteria (even good ones) is a prebiotic. The defining characteristic is selectivity. Pure sugar can encourage the growth of “good” bacteria, but it can encourage the growth of harmful ones like E. coli equally well—so it can’t really be called a prebiotic. 

Many of the food ingredients that are marketed for their prebiotic potential are various kinds of fiber: the components of foods that your body can’t digest or absorb on its own, including prebiotics like inulin and fructo-oligosacharides (FOS), which are often added to foods in an effort to make them more microbiome-friendly. But the term “prebiotic” isn’t just a marketing tool—it also applies to whole foods and their components. For example, a fresh apple is most certainly a prebiotic. There are also plenty of food components that aren’t fiber, but which still meet the definition of a prebiotic—many of the antioxidants found in fruits and vegetables appear to exert at least part of their beneficial health effects with the help of certain gut bacteria. A prime example of this is punicalagin, a compound from pomegranate, which you’ll find in our DS-01® Daily Synbiotic.

EXPLORE FURTHER: Prebiotics 101

3. Postbiotics: Harvest, Mulching, + Compost

Part of the magic of the microbiome is that it enables some remarkable chemistry to happen right inside our bodies: Everyday foods can be used by our bacteria to produce vitamins, essential amino acids, short-chain fatty acids (SCFAs), and other health-promoting compounds.^7,8 But sometimes, it’s best to let that chemistry happen outside the body—and that’s where postbiotics come in. A postbiotic, according to ISAPP, is “a preparation of inanimate microorganisms and/or their components that confers a health benefit on the host.”⁹  

“Inanimate” is the key word there—postbiotics are derived from bacteria that have been deliberately killed, often by a process like cooking. It’s a little like mulching your garden: Sprinkling a layer of dead plant matter can help keep weeds down, and offer unique nutrients to the soil. One advantage of this approach is that a postbiotic can confer some of the same health benefits as a probiotic, but is often a lot easier to produce, since keeping bacteria alive for long periods of time under various conditions is tough. (And you don’t have to worry about making sure the bacteria in a postbiotic stay dead.)

A postbiotic approach is also useful when the organism involved has beneficial properties, but might be unsafe if introduced alive. One great example is nutritional yeast. While it’s not bacterial, it is a microbe—and it’s probably the most widely used postbiotic on Earth. This flaky substance is a deactivated form of the same species of yeast that produces beer and wine. It’s rich in B vitamins and offers a vegan-friendly cheesy flavor to certain snacks. So why is it better to get this form of yeast as a postbiotic? No amount of vitamin B is worth the risk of a yeast colony setting up shop in your intestines and converting the carbohydrates you eat into alcohol—a known microbiome-disrupter.¹⁰ 

Another common postbiotic, which might surprise you: many vaccines. Oftentimes, vaccines contain an inactive version of a virus or bacterium, which helps the immune system get a handle on it without posing any real threat—and ultimately giving you immunity against it if you ever encounter it again (dead or alive).

4. Antibiotics: Pruning + Weeding

When the word “antibiotic” (literally meaning: “against living things”) was coined near the end of the 19th century, it was used to describe any substance which has a destructive effect on microbes, such as highly concentrated alcohol. (These days, the word “antimicrobial” is a better fit for the original meaning.) Antibiotics as we know them today—that is, “antibiotic” as a noun, rather than an adjective—weren’t discovered until decades later, when penicillin was first isolated from a fungal culture. 

There are now dozens of different kinds of antibiotics in clinical use, and they can be lifesaving tools: Just as it’s sometimes necessary to weed a garden to prevent an invasive species from taking over, these drugs can prevent microbial catastrophe. They’re typically highly potent, and—compared to antimicrobials like alcohol—selective in their activity, only killing certain kinds of bacteria. This selectivity is far from perfect, though, and even “narrow-spectrum” antibiotics still have the potential to cause problems in the gut microbiome.¹¹ Research has long shown that digestive diseases like Crohn’s are linked to antibiotic use, but more and more research also links the use of certain antibiotics to diseases beyond the gut, like Parkinson’s.^12,13

Knowledge is Agency 

It’s important to remember that these categories aren’t cut and dry, or mutually exclusive: A fermented food like kefir can count as all of the above, depending on how picky you want to be. But understanding the broad strokes can help you decide where you want to double-click, whether that’s because you’re trying to find a product that will work for you, or you’re just interested to learn more about the science that’s quickly shifting the way we view whole-body health. 

While it can be hard to keep up with the multitude of terms cropping up in this field, this proliferation is a manifestation of the need to name and understand things as we explore the potential of the human microbiome. It’s a powerful testament to people’s growing curiosity about—and respect for—the worlds within us.

The post Your Definitive Guide to All the ‘-Biotics’ appeared first on Med-Lock.

“Certain habits and lifestyle choices can throw off the delicate balance of good and bad bacteria in your mouth,” says Nini Tran, DDS, Ph.D., assistant professor at the UCLA School of Dentistry and a member of Med-Lock’s Scientific Board. “It’s like a constant tug of war.” 

Fortunately, a few routine habits can nurture and support this delicate ecosystem. Ahead, learn about the microbial world inside your mouth and some of the simple but powerful ways you can nurture it.

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Oral Microbiome 101

More than 700 species of bacteria colonize the oral cavity, making it the second-largest microbial community in humans after the gut.² (Your mouth, interestingly, is one of the most studied microbiota, since saliva and surfaces like the teeth and tongue can be easily sampled —unlike the gut microbiota, which are much harder to access.³)

The mouth is home to a collection of microbial communities in different sites, including your saliva, dental plaque, tongue, cheeks, throat, and tonsils.^4,5 Think of each area like its own, unique ecosystem composed of different microbes. 

Your oral microbiome is shaped throughout life, starting the moment you’re born (though your biological mother’s microbiome may influence your development even before birth). At birth, some of the first microbes you are exposed to are from your mother’s birth canal. Delivery mode appears to influence the diversity of the oral microbiome later on in an infant’s life, with vaginally born children showing a higher number of species three months after birth compared with children born by cesarean section.⁶ (Diversity is one marker of microbiome health.) 

Feeding also impacts an infant’s oral microbiome. Three-month-old breastfed infants have shown a higher colonization of health-associated oral flora—primarily Lactobacilli—than formula-fed infants, suggesting breastfed infants may have more beneficial flora.⁷ This makes sense because breastfeeding infants get bacteria from the breastmilk and the mouth-to-skin contact. As children grow, the bacterial composition of their mouth changes, too. Oral microbiome diversity can be affected by factors like diet, living conditions, and environment—think: exposure to family members, pets, and nature.^4,8

The oral microbiome continues to mature and evolve throughout childhood. Baby teeth provide new surfaces for microbial colonization, and with the emergence of adult teeth, the oral microbial habitat changes again.⁹ Teeth are a particularly interesting home for bacteria. Unlike most surfaces on and within the human body, teeth don’t routinely shed. So the bacteria that colonize your teeth aren’t subjected to the same turnaround as those that colonize other human cell surfaces (like those in your gut). Once bacteria colonize your teeth, they’re able to multiply and stick around relatively easily. 

As a child grows, it’s typical for their bacterial diversity to decrease.⁹ But while diversity is often considered preferable when we talk about the microbiome (specifically, the gut microbiome), many adults can have a healthy oral microbiome despite it being less diverse than that of a child. It’s not necessarily a one-to-one relationship—it’s just one of many clues when assessing the state of an oral microbiome. 

After childhood, scientific analysis has shown most people’s oral microbiomes are relatively stable over time.^8,10 But external factors (like that antimicrobial mouthwash we mentioned earlier) and major lifestyle or physiological changes (like hormonal shifts in puberty and pregnancy) can significantly influence it.¹¹ An interesting study highlights the way external factors can throw off the oral microbiome. Researchers found a significant decrease in sailors’ oral microbial diversity and in microbial metabolism after they went on sea voyages that lasted more than three months in which they were subject to highly intense work, a different diet, shifted circadian biorhythms, and a humid, salty environment.¹² 

The bottom line? You may not be heading to sea anytime soon, but as with many health outcomes, your lifestyle can play a crucial role in the health of your oral bacteria. While the various species in your mouth have adapted to be resilient to threats like constant oxygen exposure, moisture, brushing, and chewing, they’re also vulnerable to imbalance. Understanding the role they play, and what happens when things get out of whack, can help these essential microorganisms do their job in your mouth and beyond.

How Oral Bacteria Affect Your Health

The entire bacterial community in a healthy mouth works together to support the human host (that’s you). Some bacteria (such as Streptococcus salivarius) have the ability to inhibit inflammation.¹³ Specific bacteria also regulate acid activity to protect against tooth decay, enamel erosion, cavity formation, and chronic bad breath. People without cavities have species (for example, certain Streptococcus species) that are able to convert amino acids or compounds in the diet to pH-balancing compounds, which lessens their risk of developing cavities.¹⁴ 

In the long term, an imbalance of “good” and “bad” oral bacteria poses harm to the mouth and body. It is now generally accepted that oral disease occurs due to a state called dysbiosis, which happens when the balance of the oral ecosystem is disrupted and disease-promoting bacteria take over.¹⁵ A balanced microbiome, therefore, is important to maintain or restore oral health. For periodontal disease, the problem begins when pathogens travel from the surfaces in your mouth and colonize beneath the gum line. Periodontal disease progression happens when periodontal pathogens start to thrive in oxygen-depleted areas in the mouth below the gum line and cause inflammation.

Perhaps most importantly, it’s crucial to know that your oral microbiome doesn’t exist in a vacuum—its functions can have ripple effects throughout your body. That means that it’s not just your mouth that reaps the benefits of a thriving oral microbiome (or the consequences of dysbiosis). Bacteria tend to travel to other parts of the body, so oral health and overall health often go hand in hand. The oral cavity and gut are linked physically (through the GI tract), as well as chemically (through the enzymes in your saliva that helps you digest food). Experts know that oral bacteria commonly relocate to the gut, where they can change the composition of gut microbiota and potentially affect the immune system.¹⁶ 

While more research is needed to understand the impact of oral bacteria on systemic health, studies have found associations between the oral microbiome and a number of systemic diseases and conditions:^15,17 

• Diabetes: Severe gum disease can impact your body’s ability to regulate blood sugar, increasing the risk of Type 2 diabetes.¹⁸
  
• Heart disease: Gum disease has also been associated with an increased risk for cardiovascular disease, which increases the risk for heart attack.¹⁹
  
• Cancer: Researchers have found that oral dysbiosis that manifests as periodontitis has been linked with oral, esophageal, gastric, lung, pancreatic, prostate, hematologic, and breast cancers.¹⁷
  
• Inflammatory bowel disease (IBD): Research has shown that certain harmful organisms and cells from the mouth were able to translocate and colonize in the intestines, causing ulcerative colitis and Crohn’s disease in mice with gum disease.²⁰ A 2020 meta-analysis demonstrated that periodontitis was positively associated with IBD, however the mechanisms aren’t totally understood yet.²¹
  
• Respiratory conditions: Certain oral microbiota (like those within the Haemophilus and Moraxella species) have been associated with chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), potentially through aspiration of oral bacteria into the lung, leading to lung microbiota dysbiosis and inflammation.²²

9 Ways To Support a Thriving Oral Microbiome 

Some factors, such as your genetics and early life experiences, are beyond your control. But the choices you make now can also profoundly affect the health of your oral microbiome. While research has yet to determine the exact protocol for maintaining a thriving community of oral microbes, we do know that there are some key best practices for supporting your oral microbiome, as well as certain factors that underlie or contribute to oral diseases. These include: 

• Brush and floss regularly. As periodontal infection likely plays a role in enabling the systemic spread of oral bacteria, good oral hygiene is important to control the total bacteria load and prevent dissemination to other body sites. To support a healthy mouth and body, Dr. Tran recommends following your dentist’s advice to regularly brush and floss.²³
  
• Avoid antiseptic mouthwashes. Over-the-counter antiseptic mouthwashes can wipe out beneficial oral microbes due to an active ingredient called chlorhexidine. A 2020 study showed that healthy people who used chlorhexidine mouthwash experienced a major shift in their salivary microbiomes. Alcohol-based mouthwashes, Dr. Tran says, can also lead to dysbiosis.¹¹
  
• Reduce your sugar intake. Diet can result in shifts of the oral microbiome.²⁴ For example, certain types of bacteria convert sugar and starch into acids that can erode enamel, increasing calcium in the oral cavity and creating a hostile environment to healthy microbes. “People with a sugary diet will have a higher proportion of unhealthy bacteria than healthy ones,” Dr. Tran says. (Added sugars, primarily, are to blame—Dr. Tran says it’s still important to eat lots of fruits and veggies, which unlike many processed foods, have other health benefits.)
  
• Make sure you’re eating enough fiber. Fiber intake has been shown to increase bacteria diversity levels and decrease “bad” bacteria.²⁵
  
• Quit smoking and/or vaping. Not only have cigarettes been shown to be rich in pathogenic bacteria (which can be inhaled and colonize the oral cavity), but smoking them also alters oral microbial ecology, increasing the acidity of saliva, depleting oxygen, causing bacteria to adhere to mucosal surfaces, and impairing host immunity.^26,27,28
  
• Reduce your alcohol intake. Heavy alcohol consumption may alter oral microbial composition and potentially affect how bacteria function.^29,30
  
• Work with your doctor to use antibiotics sparingly. Many studies have shown that antibiotics can affect the number and diversity of oral microbes, and that the functions of the oral microbiome may be drastically changed as a result of antibiotic treatment.³¹
  
• Reduce your stress. This is potentially easier said than done, but there is a scientific basis for this recommendation. The stress hormone, cortisol, can enter the blood and negatively impact the organs. Similar to other steroid hormones, cortisol has been found in saliva, suggesting it may impact the mouth directly.³²
  
• Take a high-quality probiotic. More recent studies also suggest that certain probiotics could help prevent cavities, in addition to other periodontal diseases, by enriching the population and diversity of your oral microbiome. Keep in mind that not all probiotics are created equal. Look for a probiotic with clinically studied strains.^33,34

So, as you seek to support your well-being, and as research on the oral microbiome continues to evolve, keep your mouth in mind—and all the ways the oral microbiome is working to support your health.

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