Oral Probiotics: Reinforcing the First Line of Defense Against Pathogens

Filed Under: Gut Bacteria & Probiotics, Probiotics, Digestive Health

mouth on a woman

I’ve been a strong proponent of probiotics for as long as I can remember. I’ve probably tested, ingested, cultured, formulated, and incubated as many pre- and probiotic liquids, tablets, and suppositories as anyone on the planet. I’ve always believed the beneficial bacteria we harbor in our bodies provide one of the most potent tools we have to fend off pathogens of all forms. Research is beginning to finally support this idea, and we’re seeing more and more probiotic supplements and foods on the market each year.

Having a predominance of friendly, beneficial bacteria throughout the gastrointestinal tract in large part determines just how efficiently our immune system can respond to invading pathogens and prevent infections from taking hold.

When we think of friendly bacteria, we generally think of those in the middle and lower gut, but our entire gastrointestinal tract is lined with colonies of bacteria. In fact, most common pathogens enter the body through the nose or mouth.

See a list of all articles about Gut Bacteria in the Gut Bacteria and Probiotics Index

The influenza virus is a good example. It can be airborne and enter through the nose and upper respiratory tract or enter through direct contact with our mouth, nose, or eyes through touching, kissing, drinking after someone, et cetera. Our first line of defense is very often the beneficial bacteria that reside in our nose, mouth, and throat. While there’s been a stronger push to boost these beneficial microorganisms in the mid- and lower bowel, those residing on the front line have largely been ignored.

Over the Lips and Past the Gums

More than 600 species of bacteria have been identified within the oral cavity. Most of those species probably play a less important role in our health. Researchers, however, have found that higher numbers of the more prominent beneficial species directly correlate to a reduced incidence of everything from halitosis (bad breath) and dental caries (cavities) to ear infections, strep throat, and tonsillitis. (J Appl Microbiol 06;100:754–764) (J Med Microbiol 03;52:829–833) (Revista de Microbiol 99;30:332–334) (Scand J Infect Dis 93;25:31–35) (Ann Otol Rhinol Laryngol 97;106:571–574)

One of the primary investigators in this field of research has been Professor John Tagg with Otago University in New Zealand. Over a 25-year period he has collected and studied hundreds, if not thousands, of species and strains of oral bacteria. He has learned that the body’s oral immune response can be enhanced dramatically through the use of oral probiotic lozenges, particularly those which contain the species Streptococcus salivarius.

Much of the work I cited above involving tonsillitis, strep throat, and otitis media (inner ear infection) was either performed by Professor Tagg or based on his research efforts. His research is a continuing effort that I’m sure will have a dramatic impact on how we can approach a long list of problems in the future.

For example, the species of bacteria we’re talking about, S. salivarius, has numerous strains. S. salivarius K12 is the one that replaces the malodorous bacteria on the back of the tongue that causes bad breath. Dr. Tagg’s work shows that K12 is also effective at preventing and helping treat periodontal disease, recurrent tonsillitis, and viral infections. Along with strain K12, strain 18 provides ear infection protection. Prevention of dental caries seems to be enhanced by strains MIA and T32.

Professor Tagg and his team continue to isolate and study probiotic strains of bacteria that can be used for specific bacteria/pathogen-related problems such as body odor, skin infections, and urogenital infections.

Professor Tagg has helped develop a commercial throat lozenge, BLIS K12 Throat Guard. This product, sold in New Zealand, incorporates primarily the K12 strain of S. salivarius. Tests have shown that using this lozenge can help restore the natural bacterial flora of the mouth and throat. And these bacteria, in turn, produce compounds referred to as “bacteriocin-like inhibitory substances” or BLIS, which act as natural antibacterials and help control the growth of undesirable invasive microorganisms that cause infections.

Research has shown that the greater numbers of beneficial bacteria also simply take up the physical space that harmful pathogens need to colonize, and use up their necessary food supply.

For years, I’ve discussed two research areas where I felt there was tremendous potential to dramatically change the way we prevent and treat disease. Those are stem cells and probiotics research. Professor Tagg’s work is just the tip of the iceberg in probiotics research.

What Oral Probiotics Can Do

Based on what I’ve seen, I believe that Dr. Tagg’s product will prove to be a godsend for a variety of problems. Fortunately, it’s now available in this country in tablet form. I’ll provide sources for K12 in a moment.

For small children, it can offer a wide range of benefits. Along with the Xlear nasal wash, I would highly recommend using it in children with recurrent ear infections and recurrent tonsillitis. The beauty of the tablets is that they can be easily pulverized and given to very young children without any difficulty or objection.

Studies have shown that, in infants who have inner ear infections, treating with this product following antibiotics resulted in a 50 percent reduction of recurring infections. Similar results were found when the product was used for recurrent tonsillitis.

This oral probiotic can also be used in conjunction with antibiotic therapy. Most antibiotics are non-selective in the bacteria they destroy—they tend to wipe out all species, including the beneficial ones. If you use this product immediately after the course of antibiotic therapy, there should be even more open physical sites in the oral cavity for the probiotics to colonize and flourish.

I’d like to see future studies that focus on determining if the product can reduce influenza or common cold infections. I would be very surprised if it didn’t.

I’d imagine this product would also be helpful in adults with chronic halitosis or periodontal disease, either without or following antibiotic use.

Prescription mouthwashes are routinely used in periodontal disease, but thought is seldom given to recolonizing the oral cavity with beneficial bacteria afterward. While a few doctors realize the importance of replacing the beneficial bacteria in the colon after antibiotic therapy, doing the same in the oral cavity is practically unheard of. I expect that to change in the future but, as in so many other cases, it may take a decade or longer.

It’s important to keep in mind also that most mouthwashes work much like antibiotics, at least in the oral cavity—they’re non-selective when to comes to killing bacteria. They provide short-term relief from bad breath, but the odor-forming bacteria quickly re-establish colonies and the problem returns. No mouthwash is able to actually sterilize the oral cavity. If mouthwash is used and then later followed with the oral probiotic (sucking on the lozenge or tablet until it totally dissolves), there will be more sites for the beneficial bacteria to colonize.

At this point, the bacterial flora in the oral cavity is being totally ignored. It amazes me that the connection between oral hygiene, gum health, and cardiovascular disease has been firmly established, yet we have research people like Professor Tagg and a commercially available product that we’re not taking advantage of. There’s no telling how many deaths occur each year from heart disease that originated from chronic oral infections.

Focusing on oral health should be the focus of every cardiovascular specialist, right alongside diet changes and exercise. If you have cardiovascular problems, stopping the chronic inflammation “leaking” from the oral cavity should be on your list of priorities. This oral probiotic now gives you the opportunity to do so.

These same oral infections present a constant drain on the immune system, making the host far more susceptible to all kinds of diseases and autoimmune problems.

How to Use Oral Probiotics

There are a couple of ways to use the lozenges. Either method will eventually help achieve the same results. The first method is more for those who have a severe, chronic condition that hasn’t responded to typical measures.

On the first day of use, the teeth and tongue are brushed thoroughly and then a mouthwash is used to clear the oral cavity of both the good and bad bacteria. (In the studies, the prescription mouthwash chlorhexidine was used. An over-the-counter mouthwash can be used, but the recolonization time will be slightly longer.) Then at 2-hour intervals for the next 8 hours suck on a lozenge (it should take about 5 minutes to completely dissolve; don’t chew it). This is repeated again on days 2 and 3. Then for the next two weeks simply follow your normal morning and evening tooth brushing/flossing and take one lozenge in the morning and one at night but refrain from using any mouthwash. After that, only one lozenge daily will generally be all that’s needed for maintenance. In most cases, beneficial bacteria will begin to recolonize within the first three days.

The other method simply involves taking one lozenge per day after your normal brushing/flossing. Recolonization occurs generally within two to three weeks. One tablet daily is also the maintenance dose with this program.

Overall Immune Support From Bacteria

Professor Tagg was initially looking into the benefits of S. salivarius K12 as a method to prevent rheumatic fever in infants. In a small percentage of cases, strep throat infections progress to rheumatic fever, which is an extremely serious, life-threatening condition and very difficult to treat. He discovered that individuals with higher oral levels of S. salivarius seemed to never be bothered with colds or other respiratory infections. He also found that, as we age, levels of this beneficial bacteria decline. His hope of finding a way to prevent the rheumatic fever led to the above discoveries. Starting a child on an S. salivarius K12 product could be a lifesaving move if they’ve been diagnosed with strep throat.

Although it hasn’t been formally studied, this product is being used by many New Zealanders to treat a cold and/or flu as soon as the first signs and symptoms appear. Many report resolving the problem within 24 hours, if they take 4 lozenges when the first signs appear. Research has demonstrated the product does trigger an elevated immune response, as illustrated by a significant increase in interferon gamma levels.

Unfortunately, at this point no studies have been undertaken to monitor the effects it might have on specific strains of the flu virus. As I mentioned earlier, however, with a surplus of H1N1 vaccines the pharmaceutical companies need to get rid of, publicizing a safe, natural alternative can draw the wrath of the FDA.

S. salivarius K12 is available in a number of products in this country. Look for it online or in health food stores.

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DISCLAIMER: The content of DrDavidWilliams.com is offered on an informational basis only, and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified health provider before making any adjustment to a medication or treatment you are currently using, and/or starting any new medication or treatment. All recommendations are "generally informational" and not specifically applicable to any individual's medical problems, concerns and/or needs.

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