For years, doctors and dentists have recognized that gum disease and heart disease often go hand-in-hand. Statistically speaking, gum disease is linked to a 25% to 90% higher risk for heart disease.

Latest development: Emerging research is now linking oral health with a host of other systemic conditions, including diabetes, pneumonia, erectile dysfunction, Alzheimer’s disease and more. On top of that, a study published in The Lancet Oncology found that men with gum disease, also known as periodontitis,have a 50% higher risk of developing kidney cancer and are about 30% more likely to be diagnosed with lung or blood cancers. 

Inflammation is the likely culprit. Scientists theorize that the body interprets inflammation as a sign that something is injuring its cells. In the case of a flu virus or a scraped knee, that’s helpful—it mobilizes the immune system to fight the virus or heal the wound. But chronic low-grade inflammation, like that caused by gum disease, puts the body into a constant state of high alert for perceived threats, wearing down organ systems in the process.

Something else is at play, too. When bacteria in the mouth express themselves in a harmful way, they also can “hijack” our immune system, hampering our ability to fight diseases and predisposing people to chronic systemic illness or complicating existing chronic conditions.  

There’s plenty we can do to prevent these health-sabotaging bacteria from running wild. The key lies in nourishing and protecting your oral microbiome. 

What is the Oral Microbiome?

Most people associate the term “microbiome” with the gut. But the mouth ranks second behind the gut as the most diverse community of microbes in the body. More than 800 bacterial species reside in the average mouth…and that’s a good thing!  

Ideally, when this grand community of bacteria is in balance, the good bacteria outnumber the bad, optimizing an environment that not only fosters oral health but also limits the likelihood of inflammation and bad-for-you bacteria spreading from the mouth to other parts of the body.

That balance is elusive, though. The most popular conventional oral hygiene products have adopted a scorched-earth policy of killing all bacteria. In the process of eradicating the bugs that cause bad breath and cavities, they disturb the entire terrain, including the beneficial microbes needed to rein them in. 

For example, in a healthy mouth, fusobacterium nucleatum is a common oral bacteria, but more or less well behaved. But when the community is disturbed, this microbe can cause ­trouble—it’s the main bacteria identified in colorectal tumors and a host of other serious diseases. Fusobacterium nucleatum can act like a “key that opens a door” in human blood vessels and can cause other bacteria to enter the blood and travel to almost any destination in the human body, like a bus loaded with passengers. 

We also need good bacteria to “re­mineralize” (or strengthen) teeth (bacteria transport minerals from the saliva to the surfaces of teeth) and oxygenate gums—both important for fighting tooth decay and gum disease.  

Because the importance of the oral microbiome is still under-recognized, many people make mistakes that are putting their overall health at risk. Among the most common missteps—and the healthy habits to follow instead… 

MISTAKE #1: Using a detergent-based toothpaste and harsh mouthwash. Detergent-based toothpastes contain many ingredients, including the foaming agent sodium lauryl sulfate (SLS), that have a laundry list of harmful effects on the body. Mouthwashes containing alcohol or antimicrobial agents essentially sterilize your mouth. Listerine, for example, was originally invented as a surgical disinfectant…and to clean floors! But while you might temporarily enjoy minty fresh breath, you’ve also killed off helpful microbes, clearing the way for opportunistic pathogens to multiply.

A note about fluoride: This mineral is supposed to bind to tooth enamel so that the tooth becomes resistant to damaging acids from bacteria. However, there is conflicting evidence on the ability of fluoride to prevent tooth decay…and fluoride is considered a poisonous ingredient, which explains why labels for widely used over-the-counter (OTC) toothpastes warn against swallowing toothpaste after brushing. 

Meanwhile, fluoridated water combined with other sources of fluoride have led to an increase in fluorosis, a discoloring of the teeth, and in some cases, rough, pitted enamel. My belief is that a far superior approach to preventing tooth decay focuses on a healthy balance of the oral microbiome—along with good nutrition.  

My advice: Opt for a gentler ­detergent-free toothpaste and ­alcohol-free mouthwash. If you’re concerned about bad breath, harsh antiseptic mouthwashes aren’t the right option. Bad breath and cavities are caused by an imbalance in the oral microbiome—not from an individual bacterium, as was once thought. It’s all about promoting balance—or what is known as microbial homeostasis.

Toothpastes I recommend: ­Auromere Ayurvedic Licorice Toothpaste…Weleda Calendula Toothpaste…and Revitin Prebiotic Toothpaste.* You can make your own mouthwash (look online for recipes)…or look for a gentle OTC product. For example, Hello Mouthwash and Aesop Mouthwash do not have harsh ingredients or alcohol. All of these products are available online.

MISTAKE #2: Eating the wrong foods. The Standard American Diet, aptly known as “SAD,” is filled with foods (such as sweets and refined carbs, fried foods and alcohol) that shift the pH balance of the mouth to a more acidic level. An ­acid-leaning oral pH level helps promote the overgrowth of harmful bacteria. 

My advice: Increase your intake of alkalizing foods. Whole, natural foods such as fresh produce, lean protein and beans and seeds are considered alkalizing, and they keep the oral pH balance in check. One surprising microbiome-friendly pick is celery. Besides its alkalizing effect, celery is a rising “superfood” with a host of medical benefits, such as improving cholesterol levels. It’s highly anti-inflammatory, contains more than a dozen antioxidants and is known to help the gut microbiome by restoring levels of hydrochloric acid in the stomach, which are often depleted by acid-suppressing medications.

Helpful: To distinguish acidic foods from alkalizing, remember this hint—alkalizing items can spoil, as opposed to acidic, packaged products, which have unnaturally long shelf lives. ­Exception: Fermented foods, such as kefir, kimchi and sauerkraut, are alkalizing while also having long shelf lives.

MISTAKE  #3: Taking medication that dries out your mouth. Saliva is the “life blood” of the mouth and essential for oral health. Yet more than 400 drugs, including antidepressants, antihistamines, narcotic painkillers and blood pressure drugs, can cause dry mouth, depriving teeth and gums of nourishing saliva and promoting periodontitis. 

My advice: If you have dry mouth and take one of the medications that causes this, ask your doctor if another drug can be used. For a list of medications and their side effects, including dry mouth, go to MedlinePlus.gov/druginformation.html.

Also, sip water throughout the day and promote saliva production with sugar-free candy or gum. Avoid caffeine and alcohol (both contribute to dry mouth)…and consider sleeping with a humidifier. 

MISTAKE  #4: Not moving enough. Regular exercise is irrefutably good for us. But what does it have to do with the microbes in our bodies? Emerging evidence suggests that exercise can have a positive effect on the microbiome. High-intensity resistance training is especially helpful.  Besides enhancing circulation, contracting muscles cause the body to release myokines, anti-inflammatory proteins that help dampen chronic inflammation throughout the body. 

My advice: Get 15 minutes of high-intensity resistance training, twice a week. When combined with proper nutrition and rest, this regimen will help turn off the inflammatory cascade that can lead to periodontitis. 

You need super-slow, high-intensity movement to fatigue each muscle group in order to get the biggest anti-inflammatory payoff. 

In general, you’ll want moves that work all muscle groups—such exercises as squats, seated rows and chest presses—while using a high-quality resistance band. 

Each rep (usually 15 to 20 reps per exercise are done each session) should take 20 seconds…10 seconds up and 10 seconds down, continuing until your muscles burn and shake. You can work with a trainer to develop a routine. 

 Also, build movement into your daily routine. What helps: Get up every other hour to grab a glass of water. Hide your TV’s remote control. Stand or pace when talking on the phone. Stand for part of the time when commuting via bus or train. 

And don’t forget: Regular dental visits are the backbone of oral health. Adults should get cleanings at least twice a year.

*Dr. Curatola is the creator of Revitin Prebiotic Toothpaste.