Taking Care of Your Oral Microbiome
While we don’t entirely understand how the microbiome works, changing the microbes in the mouth and gut is a possible way to improve health for people with lupus. Because you are, to a degree, what you eat, taking care of the mouth takes care of nearly the whole body: Improving your oral health can improve your heart health, safeguard against many pregnancy complications, and protect against pneumonia. Bacteria from the mouth can end up in the stomach, lungs, and bloodstream, so if the microbiome is disrupted infections can occur there too.
Fortunately, it’s very easy to manage the oral microbiome – anything that you put into your mouth effects the microbiome there, and you have almost complete control over that. One the easiest method is by changing diet. By changing what bacteria and nutrients enter the mouth and gut, one can change what lives in these areas.
Sugar-rich diets and poor dental hygiene allow non-beneficial bacteria to proliferate. These bacteria produce acid, which lowers the PH of the mouth and dissolves the teeth, making it easier for cavities and dental caries to form. Tooth decay is no joke. The answer, then, is lower sugar diets and regular tooth brushing, flossing, and dental checkups. Caffeine intake should be done in moderation. Many caffeine containing beverages are acidic and caffeine has a dehydrating effect. But some, such as plant-derived tea and coffee, also have antioxidants and other anti-inflammatory nutrients that can have health benefits for people with lupus.
Probiotics can help with both gut and mouth health. Probiotics are microorganisms that potentially offer health benefits when eaten or taken with a supplement. Although most microorganisms die off when eaten due to various defenses in the body, some of these “good bacteria” can find a home in the mouth and gut. Having healthy levels of these “good” bacteria are associated with health benefits, including anti-inflammatory benefits for people with lupus. Good bacteria can be encouraged by eating a balanced diet rich in sources of this bacteria and the nutrition that they need to thrive.
A great way to get probiotics in both places is to eat fermented foods such as yogurt, pickles, or kimchi, as the bacteria can colonize both the mouth. These foods are also often vitamin-rich, though many pickles use an acidic brine which can potentially make tooth decay worse or use a sugar brine that feeds destructive bacteria. Frequent brushing should make this less of an issue, however.
Fiber-rich foods like Leafy greens, bananas, asparagus and apples also encourage the growth of the bacteria that you want and should be part of a balanced anti-inflammatory diet anyway. You can read more about the benefits of fiber for people with lupus here. Although people with lupus should not eat garlic due to its immune system-stimulating substances that increase inflammation in the body, and thus damage from lupus, it is also considered a good probiotic food.
Oral hygiene is also a key factor. Toothbrushing regularly (twice a day is recommended,) flossing, and using mouthwashes can help keep oral health – including the oral microbiome- in top shape. However, be careful of harsh mouthwashes containing alcohol. Although mouthwashes help oral ulcers heal, they can also dry o ut the mouth and irritate the inside of the mouth, which can make symptoms worse. Saltwater rinses are gentle and do not cause drying, but fluoride-containing mouthwashes are also recommended by the American Dental Association.