Keeping bad bacteria at bay

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  Posted by: Dental Design      21st February 2024

Maintaining a balance of oral bacteria can reduce the risk of gingival disease 

At-home health tests, such as those for detecting pregnancy, have been around since the 1970s. But the Covid-19 pandemic introduced an even wider audience to the concept and took it to a whole new level. Now researchers at the University of Cincinatti have created a device that can diagnose gingivitis.[i] Its lateral flow assay picks up on the presence of the specific bacteria in saliva that causes the disease. 

As you know, the mouth is colonised by 200 to 300 bacterial species, but only a limited number of them lead to dental decay or periodontal disease.[ii] Some of the most common include:

  • Streptococcus mutans: This bacterium is primarily responsible for tooth decay and cavities by producing acid that erodes tooth enamel.ii
  • Porphyromonas gingivalis: This bacterium is associated with the development of periodontal disease, causing gum inflammation and potential tooth loss.ii
  • Prevotella intermedia: Another bacterium involved in periodontal disease, known to produce toxins that can damage gum tissue.[iii]
  • Fusobacterium nucleatum: This bacterium is frequently found in dental plaque and is associated with gingival disease.[iv]
  • Actinomyces naeslundii: These bacteria typically colonise tooth surfaces and contribute to the formation of dental plaque.[v]
  • Veillonella parvula: A common inhabitant of the mouth, this metabolises lactic acid produced by other bacteria, potentially contributing to dental decay.[vi]

Bacteria such as Porphyromonas gingivalis and Treponema denticola[vii] are anaerobic and produce toxins that cause inflammation of the gums when they multiply. They can infiltrate the areas around the gum line, eventually leading to a breaking down of the connective tissue and bone surrounding the teeth.

Given that bacteria collects throughout the mouth, especially on the teeth and gums, every time food or drink is consumed (other than water), diet can play a significant role in helping to prevent and manage gingival disease. Indeed, a diet rich in vitamins and minerals is essential for healthy gingiva.

Vitamin C, for example, is known to strengthen gums and prevent periodontal diseases by boosting collagen production.[viii] Foods such as citrus fruits, strawberries, and leafy greens are great sources of Vitamin C. Another crucial nutrient is Vitamin D,[ix] which helps the body absorb calcium and promote bone density. Foods like fatty fish, fortified dairy products, and egg yolks are excellent sources of Vitamin D.

Indeed, one particular study has shown that a diet low in carbohydrates, and rich in Omega-3 fatty acids, vitamins C and D, and fibre can significantly reduce periodontal inflammation.[x]

Sweet spot

In addition, maintaining a low sugar intake is crucial for preventing gingival disease.[xi] Sugary foods and beverages can contribute to the growth of harmful bacteria in the mouth, leading to plaque build-up and gum inflammation. Instead, patients should be encouraged to opt for a diet rich in whole grains, lean proteins, and plenty of fruits and vegetables.

Staying hydrated is key for maintaining healthy gums, too. Drinking plenty of water throughout the day helps wash away food particles and bacteria that can contribute to gingival disease.[xii]

Fluoride is a powerful tool in the fight against gum disease.[xiii] When fluoride is applied to the teeth, it binds with the enamel, making it more resistant to the acid produced by bacteria. Fluoride’s anti-plaque properties help to reduce gingival bleeding.

Regular use of fluoride toothpaste, mouth rinses, and professional fluoride treatments therefore can significantly reduce the chances of gingivitis. Good oral hygiene can stop the mouth from collecting too much bacteria, which can live in crevices on the tongue, as well as in the back of the throat and parts of the inner cheek. Daily brushing, interdental cleaning and rinsing are key to controlling harmful bacteria.

Interdental cleaning helps remove plaque and food particles that can get stuck between the teeth and along the gumline, areas that brushing alone may not reach. And when plaque is not effectively removed, it can harden into calculus, which can further irritate the gums and provide a breeding ground for bacteria.

By incorporating daily interdental cleaning into their oral care routine, patients can significantly reduce their risk of developing gingival disease. And they need to be regularly reminded of the fact. In a recent survey, one in three (33%) adults have never flossed or cleaned interdentally.[xiv] You can also recommend the award-winning range[xv] of interdental brushes from Curaprox which boast super-fine, extra-long, ultra-resilient filaments for gentle and effective cleaning with a single-brush action. They are suitable for use with natural teeth, dental implants, crowns, bridges and for post-surgery cleaning.

The oral microbiome is highly complex and maintaining the balance of these bacteria plays a crucial role in oral health. By adopting a good oral hygiene regimen, eating more of the right things, staying hydrated and using fluoride toothpaste, patients can keep the bad bacteria at bay and minimise their risk of gum disease.

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[i] Han D,  Xie S and Steckl AJ,  Salivary endotoxin detection using combined mono/polyclonal antibody-based sandwich-type lateral flow immunoassay device, Nanoelectronics Laboratory, Department of Electrical and Computer Engineering, University of Cincinnati, [Accessed October 2023]

[ii] Loesche WJ. Microbiology of Dental Decay and Periodontal Disease. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 99. Available from: [Accessed October 2023]

[iii] Lopes MP, Cruz ÁA, Xavier MT, Stöcker A, Carvalho-Filho P, Miranda PM, Meyer RJ, Soledade KR, Gomes-Filho IS, Trindade SC. Prevotella intermedia and periodontitis are associated with severe asthma. J Periodontol. 2020 Jan;91(1):46-54. doi: 10.1002/JPER.19-0065. Epub 2019 Aug 16. PMID: 31342509. [Accessed October 2023]

[iv] Han YW. Fusobacterium nucleatum: a commensal-turned pathogen. Curr Opin Microbiol. 2015 Feb;23:141-7. doi: 10.1016/j.mib.2014.11.013. Epub 2015 Jan 8. PMID: 25576662; PMCID: PMC4323942. [Accessed October 2023]

[v] de Oliveira RVD, Bonafé FSS, Spolidorio DMP, Koga-Ito CY, de Farias AL, Kirker KR, James GA, Brighenti FL. Streptococcus mutans and Actinomyces naeslundii Interaction in Dual-Species Biofilm. Microorganisms. 2020; 8(2):194.

[vi] Zhou P, Manoil D, Belibasakis GN, Kotsakis GA. Veillonellae: Beyond Bridging Species in Oral Biofilm Ecology. Front Oral Health. 2021 Oct 29;2:774115. doi: 10.3389/froh.2021.774115. PMID: 35048073; PMCID: PMC8757872. [Accessed October 2023]

[vii] Sela MN. Role of Treponema Denticola in Periodontal Diseases. Critical Reviews in Oral Biology & Medicine. 2001;12(5):399-413. doi:10.1177/10454411010120050301 [Accessed October 2023]

[viii] Murererehe J, Uwitonze AM, Nikuze P, Patel J, Razzaque MS. Beneficial Effects of Vitamin C in Maintaining Optimal Oral Health. Front Nutr. 2022 Jan 10;8:805809. doi: 10.3389/fnut.2021.805809. PMID: 35083263; PMCID: PMC8784414.[Accessed October 2023]

[ix] Healthline

[x] Woelber JP, Bremer K, Vach K, König D, Hellwig E, Ratka-Krüger P, Al-Ahmad A, Tennert C. An oral health optimized diet can reduce gingival and periodontal inflammation in humans – a randomized controlled pilot study. BMC Oral Health. 2016 Jul 26;17(1):28. doi: 10.1186/s12903-016-0257-1. Erratum in: BMC Oral Health. 2016 Oct 6;16(1):109. PMID: 27460471; PMCID: PMC4962497.[Accessed October 2023]

[xi] Kusama T, Nakazawa N, Takeuchi K, Kiuchi S, Osaka K. Free Sugar Intake and Periodontal Diseases: A Systematic Review. Nutrients. 2022 Oct 22;14(21):4444. doi: 10.3390/nu14214444. PMID: 36364708; PMCID: PMC9656760. [Accessed October 2023]

[xii] Kim Y-R. Analysis of the Effect of Daily Water Intake on Oral Health: Result from Seven Waves of a Population-Based Panel Study. Water. 2021; 13(19):2716. [Accessed October 2023]

[xiii] Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim). 2017 Apr-Jun;11(2):72-80. PMID: 28539867; PMCID: PMC5426403. [Accessed October 2023]

[xiv] Oral Health Foundation,

[xv] Red Dot Winner 2021 and iF Design Award 2021

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