Cleaning your teeth could help you live longer: meet your oral microbiome

• Gut health is a buzzy topic, but the oral microbiome might be the next big trend.
• The evidence that a clean mouth could lower the risk of chronic diseases is piling up.
• Big voices in the longevity space like Andrew Huberman are starting to spread the word.

You may know that caring for the bugs in your gut, or the gut microbiome, could help you live longer. But a different collection of micro-organisms is getting attention for its health credentials.

Researchers have known for decades that people with problems like gum disease, cavities, and missing teeth, are more likely to experience stroke and develop chronic conditions, including cardiovascular disease, cancer, diabetes, obesity, rheumatoid arthritis, and Alzheimer's.

"I've been in this business for over 50 years," Judith Jones, a professor who researches oral disease at the University of Detroit Mercy School of Dentistry, told Business Insider, "centenarians have more teeth than the people who don't live that long."

The potential reasons for this are "messy," she said: "It's not simple science."

Losing teeth, for instance, can affect our self-esteem and quality of life. We are less likely to socialize if we feel self-conscious and will struggle to eat nutritious but difficult-to-chew foods such as nuts, vegetables, and lean protein.

But growing research suggests the microbes that live in the mouth (the oral microbiome) could play a larger role in our health than previously thought.

Bryan Johnson and Andrew Huberman are talking to their followers about oral health

Some of the loudest voices in the longevity space are mainstreaming the idea that a clean mouth could help us live longer.

Last month, tech CEO-turned-biohacker Bryan Johnson shared his nine-step oral health "protocol" in his newsletter, which involves tongue scraping and tea tree oil to prevent chronic disease.

Days later, Andrew Huberman dedicated an entire episode of his chart-topping "Huberman Lab" podcast to the potential link between the oral microbiome and physical and mental health.

And the industry newsletter Fitt Insider reported on microbiome-focused products entering the $55 billion oral care market, including a prebiotic toothpaste featuring ingredients personalized according to the bugs that live in a customer's mouth.

From 2023 to 2024, the sale of oral care products in the US increased by 6.3%, from $10.8 billion to $12.2 billion, according to market research firm Mintel. Those investing are likely hoping to repeat the success of the global digestive health market, which is projected to be worth $71.95 billion in 2027, up from $37.93 billion in 2019, according to market research by Fortune Business Reports.

Both the mouth and the gut have a microbiome

Just like the gut, the mouth microbiome houses a collection of "good" and "bad" microorganisms, but it functions differently.

A healthy gut microbiome is one with a diverse range of inhabitants. These microbes have been linked to a variety of physical and mental health benefits — from a stronger immune system and better mood to a lower risk of diseases, including type two diabetes and colon cancer. In contrast, a healthy oral microbiome is relatively sparse.

Brushing and flossing hits the reset button and prevents harmful microbes from colonizing and maturing, Johnathon Baker, an assistant professor at Oregon Health and Science University who studies the oral microbiome, told BI.

He likened the ecosystem of the oral microbiome to a landscape following a volcanic eruption. It's barren (after a thorough clean), but plants eventually grow and change the environment, allowing secondary plants such as moss to grow. After a few years (or a few days of not brushing well enough), moss breaks down the rock, and more plant species emerge, until, eventually, you have a whole rainforest of microbes.

The more mature species of microbes are what can cause infections that break down the barrier between the gums and blood, enabling them to enter the bloodstream. That's why bleeding gums are a hallmark of periodontal disease, Baker said.

Once in the bloodstream, bacteria can travel to different parts of the body and cause damage and inflammation, he said. Gum disease-causing bacteria have been found in the brains of people with Alzheimer's, the tumors of colon cancer patients, and in heart tissue of people with cardiovascular disease.

Whether these microbes are causing chronic illness, contributing to its development, or just making the body more vulnerable to disease by causing inflammation is uncertain, Baker said, because research into the oral microbiome is in its infancy.

But evidence suggests there is a strong link between good oral hygiene and a lower risk of cardiovascular disease, with one study suggesting flossing weekly appeared to lower the risk of an ischemic stroke by over a fifth. Similarly, a review of studies into oral health and chronic disease published in 2019 found the most frequently reported correlation was between periodontal disease and cardiovascular disease.

Baker believes that as our understanding develops we may one day see "advances that will help our overall health significantly."

Brush and floss thoroughly daily

Jones, who started her career as a dental hygienist, said that good oral hygiene involves brushing your teeth thoroughly at least once a day. "Most dentists recommend twice a day. I think part of that is so people get it done really well at least once a day. And part of it is making people's breaths smell better," she said.

It's also important to floss daily because a toothbrush can't reach the spot in between the teeth and the gums, which is known as the periodontal pocket, where disease occurs, she said.

"Flossing helps you keep your teeth," Jones added.

When it comes to what kind of floss you should use, she thinks simple is best. "They say now even the water jets are effective, although I can't imagine that they are, quite honestly," she said.

Baker reiterated the importance of flossing. "Before I entered this field, I was definitely one of those people who didn't really floss very much," he said. But as a grad student, he saw "very graphic images" of advanced periodontal disease.

"I was like, I'm flossing every day from now on, and I have," he said.