Effective Biofilm Management Using Prebiotics is a New Approach to Oral Care Therapy

Effective biofilm management is a new approach to oral care therapy, especially for the home care treatment of folks with oral degenerative tissue such as cavities, gum disease, oral ulcers, and more. The biofilm management is dependent upon "prebiotics."

Emerging science views the oral biofilm as an ecosystem with hundreds of species of microbiota, that together functions as a collective with sophisticated methods of communication, nutrient uptake, waste removal, and defense.

“Prebiotic is a non-digestible food ingredient that promotes the growth of beneficial microorganisms in the mouth and intestines.”

Historically, the most common approach to oral care has been to “nuke” the biofilm and all the bacteria in the mouth. Through the use of various surfactants, found in most conventional toothpaste, the goal is to emulsify the biofilm (in combination with toothbrushing) and kill the bacteria.

More recently, with the addition of triclosan to conventional toothpaste, "nuking" the mouth as in "scorched earth," has become a popular approach to oral health - just nuke and kill all the bacteria in the mouth, both bad and good bacteria alike. Triclosan is a potent antimicrobial which is used in most conventional toothpaste brands to kill everything. Triclosan is most popular as the active ingredient in hand soaps that are desigend to kill bacteria.

Unfortunately, both of these approaches, emulsifying and antimicrobial, have had unintended negative consequences to oral health. There is a better approach, and the better approach includes feeding good bacteria and balancing the natural healthy ecosystem of the mouth.

“Prebiotics is a specialized plant fiber that nourishes the good bacteria of the large bowel or colon. While probiotics introduce good bacteria into the gut, prebiotics act as a fertilizer for the good bacteria that’s already there.”

A Challenge to the Conventional Approach to Cleaning Our Mouth, Teeth, and Gums

A new understanding of the oral environment is rapidly emerging, and it challenges the fundamental assumptions of emulsifying or killing all bacteria with Triclosan.

This new understanding constitutes a new science of oral health that has as its basis an ecological-based understanding of the oral plaque biofilm. The new approach uses prebiotics to help balance the oral ecosystem instead of “nuking” it dead.

Simply put, the oral plaque biofilm refers to the organized, adherent layer that coats the oral hard and soft tissues, separate and distinct from free flowing saliva. The oral plaque biofilm exists on a continuum from an acquired pellicle on one end of the spectrum to a young or mature low film thickness biofilm (LFB), to an overgrown high film thickness biofilm commonly termed as “plaque.”

Each of these stages constitutes an oral plaque biofilm, which is a structure that is natural and, in certain manifestations, is healthy and protective of oral soft and hard tissues.

“Prebiotics help your good bacteria grow, improving the good-to-bad bacteria ratio. This ratio has been shown to have a direct correlation to your health and overall wellbeing, from your stomach to your brain.”

The new science points to an approach which recognizes the need to keep the oral biofilm in a state of balance, specifically, balanced toward the portion of its spectrum that is characterized by a mature LFB, lacking odor and inflammatory cofactors, and containing nutrients and other factors that favor and stabilize its presence in this stage.

A novel approach to oral care based on this new science involves a topically applied complex engineered to balance and stabilize the oral biofilm with the range of its spectrum that clinically results in a healthy oral environment. Key to this approach is avoidance of detergents and antimicrobials, which are elements that destabilize the biofilm and, according to the new science, thereby disrupts this key natural stabilizer of the oral environment.

For more on this topic please see, "NuPath® Bioactives: A More Enlightened Approach to Oral Biofilm Management" by David J. Shuch.