The oral microbiome plays a crucial role not only in the health of our mouth, but also in the entire body. It consists of a variety of microorganisms, including bacteria, viruses and fungi, that live together in a finely tuned balance. However, antibiotics used to fight bacterial infections can significantly disrupt this balance. In this blog post, we will take a closer look at the effects of antibiotics on the oral microbiome and shed light on the consequences this can have for our health. We will also show what measures should be taken after taking antibiotics to bring the oral microbiome back into balance and thus effectively protect yourself against disease.
The Oral Microbiome: A Delicate Ecosystem
The oral microbiome includes hundreds of different species of bacteria that live on the teeth, gums, tongue and other surfaces in the mouth. In total, over 700 different bacteria have been found in the oral cavity, which is an impressive number. These microorganisms perform important functions such as supporting digestion, stimulating the immune system and protecting against pathogens. A healthy oral microbiome is therefore essential for maintaining oral health and preventing diseases such as tooth decay and periodontitis.
How antibiotics work
Antibiotics are drugs that kill bacteria or inhibit their growth. They are essential for treating serious bacterial infections and have undoubtedly saved many lives. However, antibiotics are not selective and can also damage beneficial bacteria in the mouth and other parts of the body, even leading to a serious disruption of our body's microbiome, also known as dysbiosis. It has been shown that the effects of taking antibiotics on the oral microbiome are just as dramatic as on the gut microbiome.
Effects of antibiotics on the oral microbiome
reduction of bacterial diversity
One of the main consequences of antibiotic therapy is the reduction of bacterial diversity in the mouth. Studies have shown that antibiotics can drastically reduce both the number and diversity of bacterial species in the oral microbiome. This reduction in diversity can disrupt the balance of the microbiome and make it more vulnerable to pathogenic bacteria that can lead to infections and inflammation.
overgrowth of pathogenic bacteria
By reducing the number of beneficial bacteria, pathogenic bacteria can gain the upper hand and spread in the mouth. A common example is the overgrowth of Candida albicans , a fungus that is normally found in small amounts in the mouth. Under normal circumstances, Candida is kept in check by the beneficial bacteria. However, after antibiotic treatment, Candida can multiply uncontrollably and lead to oral candidiasis, also known as oral thrush.
impairment of the immune system
The oral microbiome plays an important role in stimulating and regulating the immune system. By destroying beneficial bacteria, antibiotics can weaken the immune defenses in the mouth. This can not only increase the risk of oral infections, but also have implications for systemic health, as the entire body's immune system can be affected.
development of antibiotic resistance
Another serious problem associated with the use of antibiotics is the development of antibiotic resistance. Bacteria can become resistant to antibiotics when they are used repeatedly or inappropriately. These resistant bacteria can colonize the mouth and cause infections that are difficult to treat. In addition, resistant bacteria can be transmitted from person to person, posing a greater health risk.
Long-term health consequences of antibiotics
The long-term effects of disruption of the oral microbiome by antibiotics can be significant. A disrupted microbiome can lead to a variety of oral health problems, including:
caries
The reduction in bacterial diversity and the overgrowth of pathogenic bacteria can increase the risk of tooth decay. Certain bacteria, such as Streptococcus mutans, are known to cause tooth decay by converting sugars into acids that attack tooth enamel.
periodontitis
Periodontitis is an inflammatory disease of the gums caused by the overgrowth of harmful bacteria. Antibiotic therapy can disrupt the balance of bacteria in the mouth and encourage the proliferation of bacteria that cause periodontitis. This can lead to bleeding gums, tooth loss, and other serious health problems.
bad breath
A disrupted oral microbiome can also cause bad breath. The reduction of beneficial bacteria and the increase of pathogenic bacteria can increase the production of sulfur compounds that cause unpleasant odor.
upper respiratory tract infections
Since the entry point for infections of the upper respiratory tract (including throat, tonsillitis and middle ear infections, flu, colds, corona) is the mouth and nasal cavity, a reduction in bacterial diversity in the oral microbiome also significantly increased susceptibility to such diseases.
Measures to restore the oral microbiome
After antibiotic therapy, it is important to take steps to rebalance the oral microbiome. Here are some strategies that can help:
Healthy eating
A balanced diet rich in fiber, fruits and vegetables can promote the growth of beneficial bacteria. Sugar and processed foods should be avoided as they can promote the growth of harmful bacteria.
Good oral hygiene
Regular brushing, flossing, and antibacterial mouthwashes can help control the growth of harmful bacteria and support the oral microbiome.
Avoiding unnecessary antibiotics
Antibiotics should only be taken when necessary and after consulting a doctor. Avoiding unnecessary antibiotics can help minimize the risk of disrupting the oral microbiome and developing resistance.
The Effect of Probiotics on the Reconstruction of the Oral Microbiome after Antibiotic Administration
Probiotics are beneficial bacteria that can promote the growth and restoration of the microbiome. Eating probiotic-rich foods such as yogurt or taking probiotic supplements can help restore the diversity of bacteria in the mouth.
Restoration of bacterial diversity
Antibiotics not only kill harmful bacteria, but also many of the beneficial microorganisms in the mouth. Probiotics can help restore bacterial diversity by introducing new, beneficial microorganisms that support the balance in the microbiome. Streptococcus salivarius in particular plays a crucial role in the oral microbiome and the bacterium can be found in the mouth of newborns just a few hours after birth. Streptococcus is the dominant species in a healthy microflora and plays a central role in its balance. In order to restore a high level of bacterial diversity in the mouth as quickly as possible after taking antibiotics, it is advisable to look for probiotic products that contain the bacterium Streptococcus salivarius .
suppression of pathogenic bacteria
Probiotics compete with pathogenic bacteria for nutrients and space in the mouth. Through this competition, they can inhibit the growth of harmful bacteria and prevent them from overgrowing. Some probiotics also produce antimicrobial substances that act directly against pathogenic bacteria. It has been shown that Streptococcus salivarius produces so-called bacteriocins, which are antibacterial substances that have a very broad and effective spectrum of action against pathogenic bacteria in the mouth. Taking probiotics that contain the bacterium Streptococcus salivarius can effectively prevent the mouth from becoming repopulated with pathogenic bacteria after taking antibiotics.
support of immune function
Probiotics can stimulate and support the immune system by promoting the production of antibodies and increasing the activity of immune cells. A well-functioning immune system is crucial for fighting infections and maintaining oral health. For example, the probiotic bacterium Streptococcus salivarius has been shown to stimulate the production of interferon gamma in the mouth, which is known to be a powerful antiviral substance.
Probiotics are an effective option for bringing the microbiome back into balance after taking antibiotics and thus building up effective protection against diseases such as tooth decay, gingivitis, bad breath, periodontitis and also diseases of the upper respiratory tract. The bacterium Streptococcus salivarius M18 in particular has been shown by a large number of clinical studies to be the best option at the moment after taking antibiotics. A period of several weeks of use is certainly necessary to achieve the desired effects.
Conclusion
Antibiotics are life-saving drugs, but they can also have unwanted side effects on the oral microbiome. The reduction in bacterial diversity, the overgrowth of pathogenic bacteria, the impairment of the immune system and the development of resistance are serious consequences that can affect oral health. It is important to use antibiotics responsibly and to take measures to restore the oral microbiome to balance after antibiotic therapy. The use of probiotics - in particular the clinically tested bacterium Streptococcus salivarius M18 - is the best alternative to restore the microbiome to balance after taking antibiotics and thus build up effective protection against disease.
Sources:
Laws et al. 2024 Probiotics Antimicrob Proteins 16(1): 93-98.
Dzidic et al. 2018 ISME J Sep;12(9):2292-2306.
