Biofilm and Our Health

Biofilms are present everywhere including our bodies. Biofilms are layers of bacteria, fungi and other organisms held together by glue-like gel; polysaccharide, which sticks to surfaces. (See “It All Starts with Biofilms”) We have biofilms on our teeth, tongue, cheeks, in our intestines, nasal passages, sinuses, and on our skin. We have10 times as many bacteria as there are cells in the body. There are 500 distinct species of organisms in the intestine, 400 in the plaque on your teeth and 182 on the skin. Little is known about the exact function and the interaction of these organisms. Scientists think most of the organisms in our body are harmless. However, we know that some are helpful and some are harmful. The medical establishment believed single species of bacteria caused disease. Biofilm influence didn’t start to be recognized until 1978. Biofilm organization and intercommunication wasn’t recognized until 1990. Many alternative medicine proponents believe that many diseases especially so-called autoimmune disorders like arthritis, chronic fatigue syndrome, fibromyalgia, Crohn’s disease, and ulcerative colitis, are caused by biofilms.Organisms in different parts of the body have some similarities, but by and large they are different. The skin organisms are different than the intestinal organisms. In addition the type of bacteria can vary on the same surface at different times. For example, when you have a sore throat there is a change in your throat biofilm population. Also people taking antibiotics can get yeast infections, vaginally or orally. The antibiotics kill the normal bacteria in the biofilm allowing the fungus (candida albicans) to overgrow. Different people can have different organisms in similar areas of the body. Everyone has staphylococcus aureus bacteria on their skin but some individuals carry a different variation of the species, mrsa (methicillin resistant staphylococcus aureus). These individuals are usually unaware and may not have infections but they can transfer this mrsa to others. Also everyone has streptococcus mutans in their mouth. It is the primary cause of tooth decay. Babies are not born with it. It is transferred to them by their mothers. Some individuals who have the same diet and oral hygiene get cavities and others don’t. Why? Cavity free individuals have other bacteria in their biofilms which are a different species that inhibits the growth of streptococcus mutans.When healthy normal biofilms grow and/or concentrations change, infection and disease occur. This can occur when one or several of the resident organisms overgrow, or when a new infectious (virulent) organism begins to grow. Remember, the new organism can enlist the resident organisms to make products that it can use to grow by “quorum sensing” (See “It All Starts with Biofilms”). The unhealthy biofilm affect on our body usually occurs due to the toxins produced by the organisms, not necessarily the organisms themselves. Prevention of illness from biofilm involves three approaches:

The first approach of minimizing the effect of the toxins on the body can be seen with the use of fluoride prevention of tooth decay. Biofilm bacteria or plaque use sugar to make acid. A particular species of bacteria (streptococcus mutans) is primarily responsible for making acid but it also encourages (“quorum sensing”) other bacteria to make acid. Acid dissolves teeth by removing the calcium and phosphate from the tooth. Fluoride (fluorine) in water, toothpastes, rinses and gels becomes incorporated into the tooth enamel structure making it more resistant to the toxic acid. Another example of this is measuring the acidity (pH) of patients with high cavity rates. It is thought that people who get a lot of cavities have a lower pH or a lot of acid than people who don’t get cavities. When acidity is high (low pH) having the patient rinse with basic (sodium bicarbonate) (high pH) mouth rinses dilutes the acid having less effect on the tooth. The second approach is changing the organisms or type of organism in the biofilm. This can be done by selectively removing organisms or introducing new friendly organisms which compete with existing ones. The use of antibiotics will eliminate the targeted infectious organism or group of organisms that are susceptible to the drug. Another example is the millions of people who eat yogurt with active cultures or take probiotics. This introduces helpful bacteria to the existing biofilm pushing out the harmful bacteria in their intestines improving digestion. It can also be seen in dentistry with the new oral probiotic (Evora plus) which introduces nonacid forming bacteria to compete with tooth destroying acid-forming bacteria. The third approach is shrinking, thinning or eliminating the biofilm. With all the technology available today, it is just like grandma used to say, the best way to clean is to use a scrub brush. And the best method for thinning the biofilm is to scrub it away. Examples of this are tooth brushing, flossing, hand washing, washing and scrubbing surfaces. Nonspecific organism killing agents are also used. Chemicals like alcohol and bleach are used in many household cleaning products. Heat and gas sterilizers are used on medical and dental instruments. We use heat to kill organisms in food preparation. Oxygen in the form of ozone is used to purify water in bottled water manufacturing and sewage treatment plants. Lasers are an excellent method for destroying biofilm. While there are many ways to prevent the ill effect of biofilms on our lives, there are several crucial factors we need to know:

Biofilms have been present since life began. Their effect on our lives is immeasurable. Biofilms are present in nature, industry and our bodies. A biofilm is a layer or coating of living organisms present on moist surfaces. They can be found on a glacier, the desert, on a rock in a stream, the side of a boat, the slime on the inside of the dog bowl, the internal surface of any pipe, the cooling towers in a nuclear power plant, the surfaces of your teeth, gums, skin, your sinuses and your intestines.

Bacteria, fungi and other organisms make sticky substances called polysaccharides which allow them to stick to surfaces. As a biofilm grows in thickness, different layers and different species of organisms develop. Clumps of bacteria break off and attach elsewhere.

One type of organism near the surface of the biofilm layer may thrive on oxygen (aerobe) where another organism deeper may be avoiding oxygen (anaerobe). There are channels throughout the biofilm which allow nutrients & waste products to move throughout the layers. One particular type of bacteria can send messages directing some of its’ related bacteria to make one product and another group of related bacteria another product. This is like a beehive where bees have specific jobs or even the human body where different organs have specific functions. In addition, the different non-related species of bacteria can communicate with one another to make products they usually don’t make. One organism may need iron so it tells another organism to make it. This communication is known as “quorum sensing.” Usually, the thicker the biofilm the more infectious and the harder to eliminate.

Cavity Prevention with Probiotics

Oral probiotics are the latest in the prevention of cavities, gum disease and bad breath. Probiotics were defined by FAO/WHO (The Food Agricultural Organization/World Health Organization) as live microorganisms which, when administered in adequate amounts (in food or as a dietary supplement), provide health benefits on the host. Most of us are familiar with probiotics for digestion where a pill can be taken or yogurt eaten with active bacterial cultures. Oral probiotics provide good bacteria for our mouth. Streptococcus mutans is a bacteria normally found in the mouth. We are not born with it but we get it from our mother’s oral bacteria. S. mutans sticks to your teeth with other organisms forming a biofilm. (See “It All Starts with Biofilms” and “Biofilms and Our Health”. S. mutans uses the sugars from your diet, making acid that dissolves tooth structure and causes cavities. Oral probiotics use helpful bacteria that are present in high numbers in cavity free individuals. These bacteria inhibit S. mutans. There are several probiotics on the market today for oral health. The company that has good studies to back up their claims is Oragenics. The company was founded by Dr Jeffrey Hillman in 2004, a microbiologist who has been studying cavity-causing bacteria since 1976. Oragenics has four oral care consumer products that feature different ratios of three natural strains of beneficial bacteria patented as ProBiora3®. The three stains of bacteria are Streptococcus oralis, Streptococcus uberis, and Streptococcus rattus which naturally support gum and tooth health. These bacteria colonize the mouth and adhere to the tooth surfaces deep below the gum line. They freshen breath by inhibiting odor-causing bacteria. The bacteria S. oralis KJ3™ and S. uberis KJ2™ naturally whiten teeth by producing low doses of hydrogen peroxide. The following four products are available: EvoraPro: A probiotic lozenge with equal portions of all three strains that is designed for those over the age of 10. Taken before bedtime (ideally after brushing) this probiotic lozenge supports gum and tooth health, naturally freshens breath and gently whitens Here at Delmarva Dental Services, we have seen amazing results in cavity reduction, gum health and plaque levels. It has been especially beneficial with patients who have poor oral hygiene like nursing home patients. We have it available for purchase at the front desk. EvoraKids: A Wild Very Berry Cherry chew that has higher levels of S. rattus JH145™, which supports dental health, and reduced levels of S. oralis KJ3™ and S. uberis KJ2™, since periodontal health is not typically a concern for children. We have it available for purchase at the front desk.

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