Children’s Oral Health: How Gut Health Matters

Children’s Oral Health: How Gut Health Matters

A healthy mouth is an important part of a child’s wellness but oral health can be a problem from infancy. Whether it is the Baby Bottle Syndrome – a special form of tooth decay caused by prolonged exposure to milk or sugary liquids as the baby takes the bottle to bed, or tooth decay and cavities among toddlers and school-going children, or then gum disease, this isn’t just about irritated mouths and crying. And, more significantly, these oral health issues are caused not only by what happens in the little mouth but also in their gut.

Most mums are surprised that the health of the child’s gut has an impact on their oral health. If a child has too few good bacteria or too many harmful ones, there is an imbalance. This sends an inflammatory signal to their immune system, causing various symptoms to occur throughout their body – including the mouth

Gut health and oral health both impact each other significantly. According to a 2019 study published in the Journal of Oral Microbiology, oral bacteria can transfer to the gut pretty easily. The report says, “Oral bacteria spreading through the body have been associated with a number of systemic diseases. The gut is no exception. Studies in animals and humans have indicated that oral bacteria can translocate to the gut and change its microbiota and possibly immune defense.” The study goes on to say that good oral health is important not only to prevent oral disease but also to maintain good general health.

Just like the gut microbiome, there are important bacteria in your mouth that serve as the first line of defense for your body. To stay healthy, you must have more of the good bacteria than the bad bacteria. But when you have oral disease, a bacterial imbalance begins.

Research shows that tooth decay or gum disease leads to the increased presence of harmful oral bacteria in the mouth. When harmful bacteria build up, it can then be ingested and, through saliva, travel to the stomach. Once there, the bacteria can cause inflammation to develop in the stomach. While the stomach usually resists the buildup of foreign bacteria, and some harmful bacteria are destroyed by stomach acid, others that are acid-resistant, cause an imbalance in the gut microbiome, thereby weakening the ability to resist disease-causing bacteria originating in the mouth.

Diseases associated with gum disease and gut dysbiosis

The oral microbiota can affect the integrity of your gut lining. The process is called intestinal permeability. In unhealthy states, the lining allows unwanted toxins to pass through easily. One study shows that bacterium P. gingivalis significantly changes the composition of the gut microbiome, and affects the function and integrity of the gut barrier. P. gingivalis is found in the oral cavity, a cause of periodontal disease, as well as in the upper gastrointestinal tract, the respiratory tract and the colon. Here are some issues that a child can suffer from:

Tooth decay – It is caused by bacteria. It can happen when foods containing carbohydrates (sugars and starches) are left on the teeth. Such foods include milk, soda, raisins, candy, cake, fruit juices, cereals, and bread. Bacteria that normally live in the mouth change these foods, making acids. The combination of bacteria, food, acid, and saliva form a substance called plaque that sticks to the teeth. Over time, the acids made by the bacteria eat away at the tooth enamel, causing cavities. When children have tooth decay, they will feel pain and cry, have difficulty even drinking water. They will often lose weight and be malnourished. Tooth decay also affects digestive organs such as the stomach.

Gingivitis or bleeding gums – They are one of the first signs of inflammation in your mouth. Bleeding gums are a sign that there is a problem in the digestive system. The gut controls your immune system. When the immune system is hyperactive or inflamed, it overreacts to its surroundings. Bleeding gums is one of the first signs of potential digestive disease processes. When your child’s diet is high in fruit juice, candy, dried fruit snack bars etc, also high-carbohydrate or starchy foods like bread, chips, crackers, pretzels etc, they turn into sugars. The mouth-bacteria feed on sugars to form plaque on your child’s gums and teeth. The plaque hardens into tartar, leading to tooth decay and gingivitis. Gingivitis inflames gum tissue and will bleed when brushed.

Gum infection is a contributing factor to gut problems. Worsening and recurring dental issues in your child might be a sign that they need to eat more fibre, which feeds good bacteria. Reduce their intake of sugar. Sugary food items encourage the risk of harmful bacteria in their mouth.

Autoimmune diseases – Some of the more common pediatric autoimmune diseases include type-1 diabetes, juvenile arthritis, lupus and celiac disease. The autoimmune response begins in the digestive system. However, specific auto-immune conditions can be found in the mouth. These oral signs may, in fact, help in the diagnosis of the condition. Autoimmune diseases can be caused by changes in the gut microbiome, the population of bacteria that reside within the gastrointestinal tract. According to a 2021 study in the journal ‘Systematic Reviews in Pharmacy’, autoimmune diseases in children can directly and indirectly affect the oral cavity and have various clinical presentations.
There is clearly a two-way relationship.

Obesity: According to a 2019 study published in the journal ‘Obesity Reviews’, gut bacteria and its interactions with immune cells and metabolic organs, including fat tissue, play a key role in childhood obesity.

Research shows that Crohn’s disease, inflammatory bowel diseases, and ulcerative colitis also exhibit oral signs and symptoms.

Ways to prevent tooth decay

Tooth decay is preventable. Most children have a full set of 20 baby teeth by the time they are 3-years-old. The American Dental Association has the following tips to clean children’s teeth:

  • Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth. As soon as teeth appear, decay can occur. A baby’s front four teeth usually push through the gums at about 6 months of age, although some children don’t have their first tooth until 12 or 14 months.
  • Until you’re comfortable that your child can brush on his or her own, continue to brush your child’s teeth twice a day with a child-size toothbrush and a pea-sized amount of fluoride toothpaste. When your child has two teeth that touch, you should begin cleaning between their teeth daily.
  • For children younger than 3 years, caregivers should begin brushing children’s teeth as soon as they begin to come into the mouth by using fluoride toothpaste in an amount no more than a smear or the size of a grain of rice. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician.
  • For children 3 to 6 years of age, use a pea-sized amount of fluoride toothpaste. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician.

Nutrition and your child’s dental health

While keeping your children’s teeth clean is critical, diet is your number one defensive tool to safeguard their oral as also gut health. Healthy foods lead to a better digestive system. Children need to eat right to be able to keep their teeth free from decay. Good nutrition involves all the food groups, and Children need food from all the major food groups to grow well and stay healthy. Too many carbohydrates, sugars from cake, cookies, candies, fruit juice, etc. and Savoury foods and starches from pretzels and potato chips can cause tooth decay. Here are some tips from Cleveland Clinic for choosing foods that are more healthful to your child’s teeth:

  • Keep fruits and vegetables in your house to offer as healthy snacks instead of carbohydrates. Choose fruits and vegetables that contain a high volume of water, such as pears, melons, celery and cucumbers. Limit bananas and raisins, as these contain concentrated sugar. You should brush immediately after these fruits are eaten.
  • Serve cheese with lunch or as a snack. Cheese, especially cheddar, Swiss, and other aged cheeses, help to trigger the flow of saliva, which helps wash food particles away from teeth.
  • Avoid sticky, chewy foods. Raisins, dried figs, granola bars, oatmeal or peanut butter cookies, jelly beans, caramel, honey, molasses and syrup stick to teeth, making it difficult for saliva to wash away. Have your child brush their teeth immediately after eating.
  • Serve sugary treats with meals, not as snacks. If you plan to give your child any sweets, give them as desserts immediately following the meal. There’s usually an increased amount of saliva in the mouth around mealtime, making it easier to wash food away from teeth. The mealtime beverage also helps to wash away food particles on teeth.
  • Try to limit snacks as much as possible and to no more than one or two a day. The frequency of snacking is far more important than the quantity consumed. Time between meals allows saliva to wash away food particles that bacteria would otherwise feast on. Frequent snacking, without brushing immediately afterwards, provides constant fuel to feed bacteria, which leads to plaque development and tooth decay.
  • Avoid sugary foods that linger on the teeth. Lollipops, hard candies, cough drops, and mints all contribute to tooth decay because they continuously coat the teeth with sugar.
  • Never put your baby to bed with a bottle filled with milk, formula, juice or soda. If your baby needs a bottle at bedtime, fill it with plain water. Offer your child plain water instead of juice or soda. Juices, sodas and even milk contain sugar. Water does not harm the teeth and aids in washing away any food particles that may be clinging to teeth.
  • Include good sources of calcium in your child’s diet to build strong teeth. Good sources include milk, broccoli and yogurt.

How to improve the oral microbiome.

  • Feed them microbiome-supporting foods that are alkalising, anti-inflammatory, and antioxidant-rich. Organic fruits and vegetables, high-quality meats and and fermented foods and drinks promote ensure that your salivary flow is rich with essential nutrients and microorganisms.
  • Get regular dental checkups done for your children. Regular cleanings, dental exams, and checkups significantly reduce the risk for developing severe gum disease.
  • Use probiotics. One of the best ways to maintain a stable and functioning gut and mouth is to supplement a healthy diet with probiotics. Yogurt is one of the most cost-effective and well-known source of probiotics. According to a report by Harvard T H Chan School of Public Health, probiotics can be most effective at both ends of the age spectrum, because that’s when your microbes aren’t as robust as they normally are. You can influence the huge bacterial colonisation process more effectively with probiotics during these periods. Take probiotic supplementation that will increase the disease-preventing bacteria to support a healthy microbiome.


Your child’s gut microbiome determines how good their health is. But as their mouth is the opening to their intestinal tract, the oral microbiome plays a very significant role and helps to keep your gut healthy. You can support your child’s oral microbiome through the right nutrition and the use of probiotic foods and supplements. Healthy choices make for good dental health.

Sources J Oral Microbiol. 2019; 11(1): 1586422.
Published online 2019 Mar 18. doi: 10.1080/20002297.2019.1586422

Systematic Reviews in Pharmacy Vol 12, Issue 2, Jan-Feb 2021
Sys Rev Pharm 2021;12(2):385-396,of%20consuming%20too%20many%20calories.
Halle J. Kincaid, Ravinder Nagpal, Hariom Yadav. Microbiome‐immune‐metabolic axis in the epidemic of childhood obesity: Evidence and opportunities. Obesity Reviews, 2019; DOI: 10.1111/obr.12963,The%20oral%20cavity%20and%20gut%20are%20the%20two%20largest%20microbial,to%20the%20oral%E2%80%93gut%20barrier.

Park SY, Hwang BO, Lim M, Ok SH, Lee SK, Chun KS, Park KK, Hu Y, Chung WY, Song NY. Oral-Gut Microbiome Axis in Gastrointestinal Disease and Cancer. Cancers (Basel). 2021 Apr 28;13(9):2124. doi: 10.3390/cancers13092124. PMID: 33924899; PMCID: PMC8125773.,stomach%2C%20reports%20the%20research%20team.

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