Can we taste our way to oral health?
Love your Mouth Bugs! with Dr. Purnima Kumar SHOW NOTES
Background: The impetus for ‘Let’s get Oral’ is the realization that the people seem to underestimate the power of the mouth in all it’s function; from the aesthetics of the lips/teeth, systemic connections, allergy and immunology- the oversight reaches across academic research functions, therapeutic approaches, to the general acceptance of a person who has missing teeth.
Intro: Why have we demonized the Oral Microbiome?
From dental cleaning, root scaling, microbiome guided therapy, chlorhexidine, Listerine, Stannous Fluoride. We are all trained to remove, deplete, and kill our mouth bacteria. How can we harness the oral microbiome for good? What should we be doing differently?
As dental professionals the oral microbiome is problematic and can create obvious problems from cavities to periodontal disease and tooth loss. As we uncover the mysteries of the oral microbiome, we have found that depleting some species with oral care products intended for therapy can cause a depletion in essential nitric oxide, which is essential for heart health; obviously our unique microbiome is nuanced and tricky and I cannot think of a single person more qualified to speak on this subject than Dr. Purnima Kumar, recently named Chair of Periodontics and Oral Medicine at University of Michigan.
Q: Can you share with us how you came into oral microbiome research?
C to P: You and I had been circling the oral health research community together but it wasn’t until several years ago that we were able to spend some time together after one of your lectures. My coworker and I were deeply moved by your research findings which primarily centered around healthy and never smokers which concluded with the increased diversity of the microbiome of smokers that predisposed them to periodontal pathology. Your work felt urgent for several reasons but if I were to name just one, it was that your work showed the increased diversity of the microbiome as a detriment rather than a benefit which was a departure from the notion that higher diversity meant healthier microbiome. *for those listening, richer/higher diversity in gut microbiome research has typically correlated with a healthier body, and this notion pervades research in other microbiomes niches like the oral cavity* I wanted to bring this up to get your perspective on two things:
Q: The oral microbiome has been likened to a fingerprint, do you think we might better understand the microbial community by evaluating the microbial metabolome as an ecological parameter of health as opposed to the species level assessment? - how to simplify this question??
Q: There seems to be a growing awareness around the oral microbiome with microbiome guided therapy, microbiome testing, and probiotics. When looking broadly at the dental profession, where do you think we are headed with the oral microbiome in terms of chairside therapy?
Q: How do you see diagnostics and therapeutic approaches changing as we learn more?
Q: There have been some recent publications that suggest periodontal disease might predispose a patient to worse COVID outcomes. I would love your thoughts on those studies as well as your opinions around the potential capacity of the oral microbiome to shape immunity to other pathogens?
Q: I think we can all agree there is a systemic connection between the oral microbiome and the body, does this inform your research approach?
Q: One of my personal pet peeves in oral health research is that we know oral health care products can impact the state of oral pathology; either by contributing to inflammation with irritants like SLS or simply by removing bacterial species and shifting the inflammatory profile. In any other clinical investigation, the therapies utilized for daily control would be captured, but in oral health research this issue seems largely ignored. How do you feel about the idea of including this type of information in research studies?
End of Podcast wrap-up Questions:
Before we go- I wanted to ask a final question:
You use poetry to accentuate a particular learning in your study reports and review articles: can you tell the listeners about a poet or book of poetry you consider an essential for any collection?