Optimal Oral Health Reduces Degenerative DiseasesJuly 2009
By Julius Goepp, MD
Aphthous Stomatitis (Canker Sores)
Compelling evidence suggests that probiotics may offer relief from the most common disease affecting the oral mucosa in the US—aphthous stomatitis, also known as canker sores. These painful ulcerations, which can affect the inside lining of the lips and cheek, underside of the tongue, and the floor of the mouth, represent a significant source of suffering and distress.49 Although the precise causes of canker sores are not yet fully understood, scientists believe that immune system dysregulation may be a critical causative factor, noting elevated levels of TNF-alpha and reduced cellular expression of shock protein 27 and interleukin-10 in association with the ulcers.50-52 The occurrence of canker sores has also been linked with increased anxiety and elevated levels of salivary cortisol, a manifestation of stress that can set the stage for a host of illnesses.53
Conventional medical and dental management focuses on relieving pain and inflammation until the ulcers heal, which typically occurs in 7-10 days. Impressive reports suggest that the probiotic Bacillus coagulans (previously known as Lactobacillus sporogenes) helps dramatically speed healing of aphthous ulcers. In fact, reports suggest that supplementing with the probiotic Bacillus coagulans may help canker sores heal in as little as two to three days, providing much needed relief for those plagued with these troublesome outbreaks.54,55
Halitosis (Bad Breath)
While bad breath is not dangerous physically, it can be a sign of deteriorating oral health. Intriguingly, the S. salivarius probiotic (known as BLIS K12™) is showing beneficial effects against this challenging and embarrassing problem. That makes sense to dentists, who know that the best treatment for oral malodor is the reduction of bacterial populations, especially those on the tongue—but the problem is that the germs quickly grow back after standard treatment.56 A research group led by Dr. Tagg’s colleague Jeremy P. Burton at BLIS Technologies Center for Innovation in New Zealand achieved impressive results using BLIS K12™ lozenges.57 The researchers studied 23 subjects with halitosis, giving them all a three-day regimen of antibacterial mouth rinses followed by either BLIS K12™ or placebo. They measured the odor-producing sulfur compounds in subjects’ breath a week later, finding that 85% of the BLIS group, but only 30% of the placebo group, experienced substantial reductions in the noxious chemical. The BLIS group also had lower counts of bacteria implicated in halitosis compared with the placebo recipients. Burton’s researchers concluded that BLIS K12™ “may provide an effective strategy to reduce the severity of halitosis.”
Upper Respiratory Tract Infections
Poor oral health does not just produce cavities. It can contribute to a range of other diseases such as strep throats which, if left untreated, can lead to consequences at sites far remote from the throat, including a devastating form of kidney disease and the once-deadly rheumatic fever. These former scourges of childhood and young adulthood have been largely eradicated in the modern industrialized world, but that eradication has come at the expense of growing levels of antibiotic resistance. A superior approach is to prevent the offending organism—Streptococcus pyogenes (S. pyogenes)—from setting up housekeeping in the throat to begin with. Studies from Dr. Tagg’s research group have demonstrated that beneficial probiotics hold the potential to do just that.
Tagg and others studied children in New Zealand, culturing the germs that lived in their mouths, and identifying the inhibitory BLIS agents they produced.21 They were able to identify one particular strain of the beneficial organism, S. salivarius, that when present prevented the children from acquiring the dangerous S. pyogenes bacteria. This strain produced two highly potent BLIS molecules that inhibit the detrimental strep organisms efficiently. Now known as BLIS K12™, this strain of S. salivarius is the active probiotic organism in a new line of oral probiotic products.
Ear infections are another cause of substantial misery, particularly in young children. The middle ear is actually a branch of the upper respiratory tract, connected to the throat by the Eustachian tube, a mucus-lined channel that normally allows equalization of air pressure between the delicate chambers of the ear and the outside world. When swollen closed, however, as so often happens following a viral illness like a cold, the tube fails to ventilate the ear, and fluid builds up. That moist, dark, and warm environment can provide a haven for disease-producing organisms—if they take hold and grow, the result is a middle ear infection. Since it is impossible to culture the germs from that space without invasive procedures, doctors tend to treat with antibiotics—often indiscriminately and with the attendant risk of antibiotic resistance. As with strep throat, a preventive approach would be superior, and BLIS K12™ is showing promise in this arena.
Another of Dr. Tagg’s protégés, D.A. Power of the University of Otago in New Zealand, has just published an intriguing study of BLIS K12™ in 19 young children prone to ear infections.58 Power and colleagues gave the children the probiotic following a three-day course of an antibiotic in advance of ear surgery. The scientists found that the BLIS K12™ organisms readily colonized not only the mouth, but also the back portion of the nose, where the Eustachian tube is located. This study suggests that BLIS K12™ might be effective in preventing the growth of the organisms that can cause bacterial ear infections.
A German research group has now established that BLIS K12™ goes to work immediately in the mouth after ingestion, ramping up its production of the bacteria-inhibiting compound salivaricin A.59 The researchers found high levels of this compound in saliva and on all mucous membranes, peaking between days 4 and 8 after ingestion, and remaining detectable for as long as three weeks. These researchers stressed the importance, then, of repeated uptake of the probiotic to maintain good levels in the mouth needed to confer protection against bacterial infection.
We know by now that most of the debilitating and deadly conditions associated with aging are established by chronic inflammation. Intense research both in basic science and drug therapy focuses on the development of new products that limit inflammation without shutting down the beneficial parts of the immune system. This is another completely unexpected area in which the probiotics BLIS K12™ and Bacillus coagulans (GanedenBC30) may offer some relief.
Their capacity to precisely modulate our inflammatory responses makes them astonishingly appropriate candidates for preventing a host of acute and chronic inflammatory conditions, reducing cytokine levels that contribute to conditions as diverse as atherosclerosis and pre-term labor.2,60
Canadian immunologists have explored the ability of the BLIS K12™ organisms to regulate immunity in a remarkable new study.61 They cultured the pro-biotic germs together with cells from the lining of the human respiratory tract, and measured the production of inflammatory cytokines in the human cells. Astonishingly, the BLIS K12™ organisms specifically altered the activities of 565 human genes, particularly those involved in immune system pathways. BLIS K12™ inhibited production of inflammatory cytokines, largely by inhibiting the activity of the powerful intracellular immune regulator called NF-kappaB, which is also a key link between infection, inflammation, and cancer. The researchers observe that BLIS K12™ organisms therefore assure their own survival in human tissue while protecting the host from inflammation and cell destruction caused by dangerous germs.
Promising research likewise suggests a role for Bacillus coagulans in modulating inflammation. In laboratory studies, scientists studied the effects of Bacillus coagulans preparations on white blood cells known as polymorphonuclear cells. They found that a preparation derived from Bacillus coagulans cell walls inhibited the migration of polymorphonuclear cells toward the inflammatory chemoattractant known as leukotriene B4, indicating a powerful anti-inflammatory effect.48 Leukotriene B4 is believed to play a central role in numerous pathological conditions related to aberrant inflammation, such as rheumatoid arthritis and inflammatory bowel disease.62 The ability to dampen cellular responses to leukotriene B4 suggests a powerful disease-modulating effect for Bacillus coagulans.
Preliminary findings suggest a range of applications for Bacillus coagulans in supporting optimal immune function. In the laboratory, scientists examined the effects of two preparations derived from Bacillus coagulans on immune system cells. They found that the Bacillus coagulans preparations enhanced white blood cells’ surveillance for bacterial invaders and increased the immune cells’ ability to respond to a simulated bacterial attack. Additionally, the two Bacillus coagulans preparations increased a process called phagocytosis, or the ingestion of invaders like bacteria, by polymorphonuclear cells of the immune system.48
In addition to supporting the body’s defense against bacterial infections, scientists found evidence that Bacillus coagulans may help protect the body against cancer and viral infections by activating immune cells known as natural killer cells. Two Bacillus coagulans preparations enhanced the expression of cancer-fighting factors from natural killer cells when they were brought in contact with tumor cells. The investigators noted that the Bacillus coagulans preparations would likewise be expected to enhance natural killer cells’ ability to destroy non-malignant, virally infected cells.48
We live in a new era of living in harmony with our environment. The use of probiotics—living bacteria that have beneficial, not harmful, characteristics—is the perfect metaphor for this new, integrative approach. Rather than aggressively seeking to eradicate all germs in the mouth, incorporation of a probiotic regimen allows us to capitalize on nature’s bounty, creating a healthier oral environment and promoting overall health and longevity. Oral probiotics, combined with vigorous and attentive oral hygiene (and of course, regular checkups), show promise for reducing not only dental cavities, halitosis, and upper respiratory infections, but also for modulating the burden of chronic inflammation that can lead to atherosclerosis, the metabolic syndrome, and cancer. Through the groundbreaking work of Dr. John Tagg and the growing numbers of oral health experts who are joining in his campaign, there is renewed hope that we may further triumph over many of the chronic threats to our health that have plagued us since time immemorial.
If you have any questions on the scientific content of this article, please call a Life Extension Health Advisor at 1-800-226-2370.
1. Oral Microbiol Immunol. 2009 Feb;24(1):11-7.
2. Ann NY Acad Sci. 2006 Nov;1088:251-64.
3. Arterioscler Thromb Vasc Biol. 2007 Jun;27(6):1433-9.
4. J Pak Med Assoc. 2005 Oct;55(10):448-52.
5. J Am Dent Assoc. 2008 Oct;139(Suppl):19S-24S.
6. J Clin Periodontol. 2008 Sep;35(8 Suppl):398-409.
7. Diabetes Metab. 2008 Nov;34(5):497-506.
8. Eur Heart J. 2003 Dec;24(23):2108-15.
9. Am J Kidney Dis. 2005 Apr;45(4):650-7.
10. Zhonghua Xin Xue Guan Bing Za Zhi. 2008 Mar;36(3):215-8.
11. Clin Exp Immunol. 2007 Sep;149(3):445-52.
12. Oral Microbiol Immunol. 2009 Feb;24(1):64-8.
13. Platelets. 2008 Aug;19(5):352-8.
14. J Am Dent Assoc. 2006 Nov;137(Suppl 2):7S-32S.
15. J Clin Periodontol. 2006 Sep;33(9):612-9.
16. Lik Sprava. 2008 Apr;(3-4):10-21.
17. Trends Biotechnol. 2003 May;21(5):217-23.
18. Can J Microbiol. 1981 Sep;27(9):918-23.
19. Arch Oral Biol. 1983;28(10):911-5.
20. J Appl Bacteriol. 1991 Oct;71(4):339-42.
21. Indian J Med Res. 2004 May;119(Suppl):13-6.
22. Dig Liver Dis. 2002 Sep;34(Suppl 2):S2-7.
23. Se Pu. 1999 Sep;17(5):483-5.
24. Proc Finn Dent Soc. 1991;87(4):515-25.
25. Adv Dent Res. 1994 Jul;8(2):263-71.
26. Int Dent J. 2006 Aug;56(4 Suppl 1):233-9.
27. BMC Oral Health. 2006;6(Suppl 1):S14.
28. J Periodontol. 2008 Aug;79(8 Suppl):1560-8.
29. Oral Microbiol Immunol. 2009;24:7-10.
30. Compend Contin Educ Dent. 2008 Sep;29(7):402-3.
31. Int J Immunopathol Pharmacol. 2008 Oct;21(4):993-7.
32. Caries Res. 2001 Nov;35(6):412-20.
33. Swed Dent J. 2006;30(2):55-60.
34. J Clin Periodontol. 2008 Oct;35(10):897-905.
35. Acta Odontol Scand. 2009 Feb;67(1):19-24.
36. Eur J Oral Sci. 2002 Jun;110(3):218-24.
37. Eur J Oral Sci. 2007 Aug;115(4):308-14.
38. Oral Microbiol Immunol. 2008 Apr;23(2):139-47.
39. J Appl Bacteriol. 1981 Apr;50(2):305-13.
40. Appl Microbiol Biotechnol. 2008 Dec;81(4):591-606.
41. Oral Microbiol Immunol. 2009 Apr;24(2):152-61.
42. Infect Immun. 1985 Apr;48(1):44-50.
43. J Dent Res. 1987 Aug;66(8):1321-5.
44. J Clin Microbiol. 2000 Feb;38(2):643-50.
45. Appl Environ Microbiol. 1993 Jul;59(7):2014-21.
46. Dev Biol Stand. 1995;85:639-43.
47. J Bacteriol. 2001 Jul;183(13):3931-8.
48. Ganeden. Data on file. 2009.
50. J Oral Pathol Med. Jan 1992;21(1):21-5.
51. Clin Exp Immunol. Mar 1995;99(3):392-7.
52. J Oral Pathol Med. Sep 2008;37(8):462-7.
53. Tohoku J Exp Med. Apr 2008;214(4):291-6.
54. Uttar Pradesh State Dent J. 1970;11:7-12.
55. Uttar Pradesh State Dent J. 1980 Jan;11(1):7-12.
56. Oral Dis. 2005;11(Suppl 1):29-31.
57. J Appl Microbiol. 2006 Apr;100(4):754-64.
58. Eur J Clin Microbiol Infect Dis. 2008 Dec;27(12):1261-3.
59. Oral Microbiol Immunol. 2007 Apr;22(2):126-30.
60. Am J Obstet Gynecol. 2003 Oct;189(4):1202-8.
61. Infect Immun. 2008 Sep;76(9):4163-75.
62. Proc Natl Acad Sci USA. 1995 Jan 17;92(2):517-21.
63. Cochrane Database Syst Rev. 2007;(2):CD005097.