Terrain Theory And Oral Health – How Probiotics Boost Oral Health

The idea that disease is caused by an imbalance in the body’s internal environment has existed for centuries. This theory, known as “terrain theory” or “environment theory,” suggests that it is not the presence of harmful bacteria that cause disease but an unhealthy environment within the body that allows harmful bacteria to thrive.

This theory is particularly relevant regarding dental health. Research has shown that gum disease and other dental disorders are not caused by excess harmful bacteria but rather a lack of beneficial bacteria in the mouth.

After the colon, the mouth harbors a substantial population of microorganisms. Some of these microorganisms provide beneficial effects, while others are considered pathogenic. Depending on the circumstances, certain microorganisms can benefit or harm the host.

This article will examine whether taking probiotics can be a valuable approach to enhancing oral health. Before we delve into this topic, it’s essential to understand the relationship between the host microbiota and the host tissue.

The Relationship Between Microbiota and Health: Important Considerations

The human mouth is home to a complex ecosystem of microorganisms, including bacteria, viruses, and fungi. While some of these microorganisms are harmful and can cause dental problems, many others are beneficial and play an essential role in maintaining oral health.

For example, certain bacteria in the mouth produce enzymes that help break down food particles and prevent plaque formation. Other bacteria produce acids that help neutralize harmful substances in the mouth and protect the teeth from decay.

Terrain Theory And Oral Health

When the balance of bacteria in the mouth is disrupted, harmful bacteria can quickly multiply and cause problems. This can happen due to poor oral hygiene, a weakened immune system, or other factors that affect the body’s internal environment.

Microorganisms are often thought to be potentially harmful to health. However, this is not always the case and depends on the type of microorganism and its behavior.

There is a significant link between the physiological microbiota and the health of the organism it inhabits. It acts as the first line of defense against the spread of pathogens. Physiological microorganisms populate all body surfaces, including hair, skin, nose, eyes, ears, mouth, esophagus, nails, bronchi, lungs, and colon.

A mutually beneficial relationship exists between the host microorganisms and the host tissue. Certain bacteria and yeasts can nourish our bodies by releasing functional molecules, multiply within certain limits to self-regulate, and prevent the proliferation of more aggressive species and strains.

It is often difficult to differentiate between physiological and pathological microorganisms, and this distinction may even vary based on general conditions. In some situations, what is considered normal and positive can become anomalous and potentially harmful. After all, maintaining balance is not always easy.

If one side does not contribute appropriately or lets its guard down, the balance can be disrupted, ultimately harming both parties.

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The Mouth Function According To The Terrain Theory

The mouth, also called the oral cavity, buccal cavity, or “cavum oris” in Latin, serves a range of essential functions in animal anatomy. It is the opening through which various species take in food, begin digestion, communicate, ventilate, disperse heat, and even fight.

In biology, the oral cavity is a hallmark of a “complete” digestive system, forming the upper end of the alimentary canal or digestive tract, and is made up of two regions: the vestibule and the oral cavity proper.

The oral cavity is bounded externally by the lips and internally by the pharynx. In higher vertebrates, it contains a tongue and teeth. The oral mucosa is the epithelium that lines the inside of the mouth and performs various functions, such as absorption and secretion. It is also home to a vast but natural microbiota.

The mouth, like the colon, hosts a large population of microorganisms, some beneficial, some pathogenic, and some with the potential to be either, depending on circumstances. There is a mutually collaborative relationship between the host microorganisms and the host tissue, and the physiological microbiota represents the first “defensive barrier” against the spread of pathogens.

The oral cavity performs various functions, such as digestion, communication, and ventilation, and comprises two regions: the vestibule and the oral cavity proper. The oral mucosa is populated by a vast but physiological microbiota, whose role is to avoid the proliferation of bacteria and fungi that could attack the mucosa or descend from the pharynx to the larynx and beyond.

The metabolic activity of certain bacteria, particularly lactobacilli, and bifidobacteria, may have proven benefits for the mouth.

The role of the buccal bacterial flora is primarily to prevent the proliferation of bacteria and fungi that could attack the mucosa or spread to other body parts, such as the larynx and beyond. However, excessive food residues can facilitate microbiota attacks on the teeth, especially when the pH is unfavorable, leading to tartar, plaque, and caries.

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Terrain Theory And The Benefits Of Probiotics

While probiotic supplementation has historically been associated with intestinal health, interest in the potential benefits of probiotics for oral health has significantly increased in recent years. Certain bacteria, such as lactobacilli and bifidobacteria, have a metabolic activity that may positively impact the oral cavity.

Probiotics taken orally can act in three ways:

  • Normalization of the microbiota in the gut.
  • Modulation of the immune response.
  • Metabolic effects.

The impact of probiotics on the oral cavity may be similar to their impact on the gut. Probiotics may affect oral health by:

  • Promoting aggregation.
  • Competing for nutrient substrate and growth factors.
  • Producing antimicrobial compounds, such as certain acids.
  • Improving immune response, such as enhancing the production of IgA and defensins.
  • Inhibiting the synthesis of pro-inflammatory cytokines.
  • Reducing MMP production.

Overall, probiotics may benefit oral health by helping maintain a balanced microbiota and modulating immune responses in the mouth.

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Conclusion On The “Terrain Theory”

The conventional approach to treating gum disease and other dental disorders has typically targeted the harmful bacteria directly through antibiotics or other antimicrobial agents. However, this approach is often ineffective, as it fails to address the underlying imbalance in the oral microbiome.

Instead, a growing body of research suggests that the most effective way to prevent and treat gum disease is to promote the growth of beneficial bacteria in the mouth. This can be done through various means, including probiotics, prebiotics, and other natural remedies.

Probiotics are live microorganisms similar to the beneficial bacteria found naturally in the mouth. They can be consumed as dietary supplements or fermented foods like yogurt or kefir. When taken regularly, probiotics can help promote the growth of beneficial bacteria in the mouth and prevent the overgrowth of harmful bacteria.

The mechanisms of action of oral probiotics include normalizing intestinal microbiota, modulation of the immune response, and metabolic effects. Probiotics affect oral health by competing for membership sites, aggregation, competition for nutrient substrate and growth factors, production of antimicrobial compounds such as certain acids, improving the immune response, inhibition of the synthesis of pro-inflammatory cytokines, and reduction of MMP production.

The ecological theory of plaque hypothesizes that the buccal mucosal surface is lined with a biofilm of both commensal and pathogenic bacteria. In balance conditions, no disease is generated; otherwise, it happens if the compromise fails. Different bacterial strains are potentially valuable for preventing or treating oral diseases.

The use of probiotics to improve oral health has significantly increased in the last decade, and the impact of probiotics on the oral cavity could be similar to that described for the intestine.

Prebiotics, however, are non-digestible fibers that promote the growth of beneficial bacteria in the gut and mouth. They are found in various foods, including fruits, vegetables, and whole grains.

In addition to probiotics and prebiotics, many other natural remedies can help promote oral health and prevent gum disease. These include oil pulling, herbal remedies, and proper oral hygiene practices, such as brushing and flossing regularly.

In conclusion, the terrain theory or environment theory suggests that gum disease and other dental disorders are not caused by excess harmful bacteria but rather by an imbalance in the oral microbiome that allows harmful bacteria to thrive.

By promoting the growth of beneficial bacteria in the mouth through probiotics, prebiotics, and other natural remedies, it is possible to prevent and treat these conditions and maintain optimal oral health.

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