The Oral Microbiome, Pregnancy, & Childhood Cavities (+ kids herbal toothpaste recipe)

During pregnancy, poor dental health and gum disease has been associated with preterm labor and low birth weight babies. Early childhood cavities are a chronic infectious disease that can be passed from parent to child.

[UPDATED May 2020] With all the excitement about the gut microbiome, less attention has been paid to the oral microbiome and its connection to a variety of health issues. We know that gut dysbiosis (or an imbalance of the resident microbial communities in our gastrointestinal tract) can lead to a myriad of issues including immune dysregulation, skin problems, allergies, metabolic imbalances & weight gain, mood changes, and more. But what about oral dysbiosis?

Dental and gum health (or lack thereof) is tightly connected with the health of our other body systems including our cardiovascular, metabolic, reproductive, and respiratory systems. During pregnancy, poor dental health and gum disease has been associated with preterm labor and premature rupture of membranes, low birth weight babies, and preeclampsia. Preterm labor and premature rupture of membranes is often caused by vaginal dysbiosis and/or urogenital infections – often associated with oral dysbiosis and gum disease. And when a pregnant person has oral dysbiosis they risk passing this on to their baby — early childhood cavities are a chronic infectious disease that can be passed from parent to child (via microbial transfer during pregnancy, birth, and early parenting).

So what can be done? One of the first steps in prevention of childhood cavities is balancing your own microbiota and supporting the microbiota in your baby or child. The bacterial balance (or imbalance) in your baby’s mouth will affect their likelihood of developing early childhood cavities (and influence a variety of other health-related issues). Certain strains of Streptococcus bacteria, especially S. mutans are a primary cause of tooth decay. Balancing parents and babies’ oral microflora can prevent proliferation of these pathogenic bacteria and the resulting decay. While there are many aspects to preventing early childhood cavities, I’ll focus on a few tips for preventing oral dysbiosis in babies.

Flossing, Brushing, and Rinsing. For parents who have dental issues and want to avoid passing them to children, it is essential to floss once per day after brushing (my herbal toothpaste recipe for adults and kids is at the end of this post). After flossing finish with an herbal mouth rinse to inhibit the growth of cariogenic (cavity-causing) bacteria. You can make a simple mouth rinse with a base of rose water plus tinctures (alcohol or glycerine extracts) of echinacea, myrrh, licorice, calendula, yarrow, and rosemary. Try ½ - 1 teaspoon of each extract per ½ – 1 cup of rose water and swish a small amount in your mouth after brushing for at least 30-60 seconds before spitting (save the remainder in a small jar for the rest of the week). These herbal extract can also be added to a water-flosser for a deeper clean. A great mouth rinse for children old enough to swish and spit is cranberry powder mixed with some plain water or rose water (phytochemicals in cranberries help prevent cariogenic bacteria from adhering to teeth and rosewater is an excellent gentle astringent for the gums – both are edible and safe for children). Liquid xylitol made from the birch tree is also an excellent inhibitor of cariogenic bacteria and can be added to any mouth rinse for adults and kids old enough to swish and spit.

Protect your microbiome during pregnancy and birth. Proactive strategies during pregnancy and breastfeeding as well as during the child’s first two years of life are important to establish a health microbiome. A child’s microflora is established within the first two years of life and exposure to antibiotics can disrupt this process. If possible, avoid antibiotic use during pregnancy, labor and in young babies unless medically necessary. If antibiotics must be used or if you have signs of oral dysbiosis (cavities, bleeding gums, chronically enlarged tonsils, bad breath, GBS positive during pregnancy) this is a sign that you should work on rebalancing your microbiome. Babies who are born by cesarean are also prone to dysbiosis due to not passing through the vagina at birth as well as the use of antibiotics during surgery. There is emerging evidence on the benefits of “seeding” the microbiome of a baby following cesarean using gauze inserted into the vagina before the surgery. Pregnant and postpartum parents can also take up to 100 billion CFUs of probiotics (focusing on both lactobacillus and bifidus strains) for a minimum of 3 months following a microflora disruption such as antibiotic use or cesarean surgery.

Support your baby’s microbiome & dental health. Breastfeeding has been shown to help normalize the microflora of babies born by cesarean. Breast milk contains a special type of short chain sugar (known as human milk oligosaccharides) that selectively feeds the good bacteria in their gut. Babies born by cesarean as well as babies exposed early to antibiotics can also be supplemented with bifidus strains of probiotics (up to 5 billion CFUs per day) formulated for infants – probiotic powder can be mixed with breastmilk. Toddlers over age 2 can take chewable kids probiotics (10-25 billion CFU per day) with lactobacillus and bifidus strains and can also be encouraged to eat lactofermented foods such as sauerkraut and various types of pickled veggies. All toothless infants should have their gums “brushed” twice per day with a clean damp washcloth wrapped over the parent’s finger or an infant gum brush and gently massaged around all surfaces of the gums. The washcloth or gum brush can be dampened with warm chamomile or fennel tea – especially good for teething infants. As soon as any teeth pop through start using a real baby toothbrush with baby toothpaste twice per day.

General Recommendations for Parents/Adults

Here are a few other general recommendations for any adults experiencing signs of oral dysbiosis, gum inflammation or poor dental health:

• Avoid/minimize sugars in the diet (especially highly refined sugars, sweet/starchy foods that stick in your teeth, sipping on sweetened drinks all day long and snacking frequently on sweet/starchy foods)

  • Stevia (the herb Stevia rebaudiana as a green powder or dried green leaves - not the synthetic sweetener versions) as a sugar replacement not only tastes sweet but is anti-cariogenic (anti-cavity)

• Floss well once per day after brushing – this one is so important and too easily ignored!

• Eat lacto-fermented foods daily (and consider taking probiotics and/or gently swishing an opened up probiotic capsule mixed with a little water in the mouth)

• Eat a whole foods diet rich in minerals & vitamins (especially vitamin D3, vitamin K2, calcium, phosphorus, and trace minerals)

• Receive regular dental cleanings (ideally with a holistic-oriented dentist)

• Consider trying oil pulling with sesame or coconut oil

• Consider tongue scraping in the morning

• Reduce any nasal congestion in order to avoid mouth breathing which dries out the mouth and allows cariogenic and periodontogenic bacteria to flourish (consider neti-pot, decongestant herbs, and sleeping with warm-mist humidifier if mouth breathing is an issue).

Lena’s Herbal Toothpaste Recipes (for Kids & Adults)

Kids cranberry-rose toothpaste

These recipes are good basic adult and kid recipes for preventing cavities and normalizing oral bacteria (and a nice way to save money and avoid chemical detergents found in most commercial toothpaste – even the “natural” ones).

I eyeball the amounts, so here is an estimate of the general proportions:

Basic Powders:
~2/3 cup Calcium Carbonate (chalk)

~2/3 cup xylitol powder (made from the birch tree)

~1/4 cup Sodium Bicarbonate (baking soda)

~3-5 tsp Glycyrrhiza glabra root powder (Licorice)

For adults add:
~2 tsp Commiphora myrrha resin powder (myrrh)
~2 tsp Camellia sinensis leaf powder (matcha/green tea)
~1 tsp Azadirachta indica leaf powder (neem)

For kids add:
~2 tsp Vaccinium macrocarpon powder (cranberry)

~2 tsp Rosa canina powder (rose petals)
-(optional) extra licorice powder or natural green Stevia rebaudiana powder (stevia) for extra sweetness (and dental benefits)

Liquids:
-start with ~1/4 cup vegetable glycerine
-optional (if you like your toothpaste to get foamy) add ~1-2 tsp pure castile soap (Dr. Bronner’s unscented works well)
-optional essential oil blends (~70-100 drops total for adults; ~15-20 drops total for kids over 2; no essential oils for babies)

Adults essential oil blend can include:

-peppermint or spearmint
-cardamom
-cinnamon
-myrrh
-fennel
-clove
-anise
-rosemary
-black pepper

Kids essential oil blend can include:
-spearmint
-lemon
-sweet orange
-ginger
-fennel

Instructions:

Start by whisking all your powders together. Then in a separate container (a glass measuring cup works well) mix your liquids gently with a whisk (make your own essential oil blend based on your tastes and preferences with the suggestions from above). Then add the liquid to the powders and mix well — you can add additional vegetable glycerine if needed until it’s the pasty thickness that you want (or if it gets too thin just add a little extra chalk powder). Store it in a small jar and use a mini bamboo spatula to scoop it onto your toothbrush (just rinse the mini spatula and keep it in the cup along with your toothbrush). Or purchase refillable squeeze tubes for the toothpaste.

*Note: the matcha powder in the adult formula makes it a pretty green color, but the part that touches air does tend to oxidize to a greenish-brown – it’s not bad. If that bothers you then it is a perfectly good formula without the matcha.

Article originally published on ArborVitae School of Traditional Herbalism Blog