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prevention International magazine for oral health No. 1, 2018

| biofilm Gingival health benefits of enzymes and proteins in toothpaste By DTI How healthy the gingivae are largely depends on the balance of the oral microbiome. According to a review by Kilian et al. in the British Dental Journal, our oral micro- biome encompasses no less than 700 distinct bacterial species that cover the teeth and oral mucosa and are at- tached to these surfaces as part of the oral biofilm.1 Ideally, this microbiome is naturally in a state of balance—sym- biosis—protecting our mouths from the over-prolifera- tion of disease-promoting bacteria. However, the inges- tion of fermentable sugars, smoking, stress, physiological changes like pregnancy, or the frequent use of antibiotics and antimicrobials can create an imbalance in the oral mi- crobiome—dysbiosis—that in turn can lead to diseases such as caries, gingivitis and periodontitis. Toothpaste—The helpful assistant Maintaining a healthy oral microbiome is clearly es- sential to good gingival health, but what measures can we take to achieve this? According to Mogens Kilian, Professor of Medical Microbiology at Aarhus University, as well as Affiliate Professor of Bacterial population ge- netics at the University of Copenhagen, “The balance that has been lost as a result of modern lifestyles can, in most cases, be restored by improved oral hygiene, including the use of toothpastes containing not only fluoride but also other beneficial compounds, such as enzymes and proteins occurring naturally in saliva.” Fluoride in toothpaste Fluoride, firstly, has been proven to provide effective protection against the development of caries by harden- ing and remineralising tooth enamel. It also exerts an an- tibacterial effect. “The most dramatic success of dental research is the discovery of the protective effects of fluo- ride,” said Kilian. “Virtually every commercial toothpaste includes fluoride, which increases the resistance of tooth enamel against caries. In this way an imbalanced oral mi- crobiome can be restored in spite of the negative effects of modern life.” Enzymes and proteins— Natural salivary components Enzymes and proteins are naturally present in saliva and are key to a healthy mouth. Each person produces over one litre of saliva per day on average. Made up of 99.4 per cent water, saliva keeps the mouth lubricated and comfortable, allowing one to speak, chew, taste and swallow. The remain- ing 0.6 per cent of saliva is made up of minerals, proteins and enzymes, which all perform an integral role in protecting and repairing the oral cav- ity. These salivary components are es- sential for maintaining good oral health, since they protect the enamel of the teeth, thereby helping to prevent dental caries and ensure gingival health. Saliva is also important in the formation of the pellicle, the thin acellular organic film that forms on oral surfaces after exposure to saliva. The pellicle is a mostly bacteria-free protective film consisting of protein, glycoprotein, lipids and salivary enzymes that forms on 36 prevention 1 2018

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