Ahh, the holidays. Many of us love them and look forward to them each year. They start as early as October when ghost, goblin, and pumpkin-decorated sweet treats are passed around to celebrate All Hallows’ Eve. Some trick-or-treating plans are even made based on which neighborhoods pass out the best candy – a strategy many kids and parents know well. Perhaps they know exactly which neighborhood passes out the full-size candy bars.
After Halloween, it’s all the fall fun and pumpkin-spiced everything, and Thanksgiving is a smorgasbord of all things yum and delectable. For some, the December holiday season – including Christmas, Hanukkah, and Kwanzaa, among others – begins the day after Thanksgiving with Black Friday folly, fueled by peppermint mocha or vanilla gingerbread lattes. Party schedules are carefully planned so as not to miss a single event, whether for school, the neighborhood, friends, or the office.
At each party, we are surrounded by decadent and delicious delicacies (yay for alliteration). It’s hard to resist, and even with a Herculean effort, we sometimes give in. Take, for example, your sister-in-law who makes a certain cookie only for Christmas ‒ that’s it, literally, no other time during the year. Of course, you’re going to try one or five.
New Year’s Eve is yet another party with all the eats and all the drinks. Before we know it, it’s the first of January, and we have been going rogue for three months – an entire quarter of the year!
The Party’s Over
After all this fun, the waistline is not the only thing that needs to get back in check – the oral microbiome does as well. All that snacking and cocktailing has done a number on the microbial balance. Many patients are unaware that this dietary change may have affected their oral health.
Clinically, every year after the holidays, I would notice a shift toward less healthy biofilms when viewed under the microscope. Most patients reported similar stories, explaining that they had been off their normal oral hygiene routine because of the hustle and bustle. For some, it was traveling and forgetting their electric brush. For others, it was dietary changes, such as increased consumption of processed foods and higher alcohol intake. These changes were often combined with added stress and less sleep than usual.
All of this is the perfect storm for disease. It’s time to whip the oral microbiome back into shape.
Dental Gym
As dental hygienists, it is our job to help patients restore their oral health through not only treatment but also education to prevent further disease. This time of year, think of yourself as a trainer ‒ not the weight-lifting and protein shake kind ‒ but the biofilm boot camp kind.
Assess the patient and guide them in an individualized, clear path back to a healthy oral microbiome. We do this all the time during hygiene appointments, but it can’t be stressed enough during the holidays. Discussing patients’ lifestyles and habits over the holidays is also important when creating a plan to achieve optimal oral health.
Here are three key components to discuss with patients to help restore their oral microbiome to a healthy state.
1) Daily oral hygiene
Daily oral hygiene is our area of expertise, but some patients really don’t know how to adequately clean their mouths. Sometimes it’s helpful to return to the basics and show the patient, step by step, the proper technique for brushing and interdental cleaning. Explain how an electric toothbrush works and how it is the “work smarter, not harder” method.
The effective disruption of biofilm also needs to be emphasized, so late-stage, more pathogenic bacteria are not allowed to hang around long enough to cause disease.
2) Nutrition
Although we are educated on nutrition, some of us tend to shy away from this fundamental pillar of oral health. We don’t need to be certified dietitians to have these high-level conversations. Simply focus on what a healthy, nutritious diet looks like and how it affects the oral microbiome.
Discuss with patients how a healthy diet nourishes teeth and supporting structures in addition to cultivating a healthy microbiome. Explain that they can feed or starve whatever bacteria they want in their mouth through diet. Good (commensal) bacteria want whole, unprocessed foods, and bad (pathogenic) bacteria love and thrive on sugar and processed foods.1
Encourage patients to take note of what they eat in a day and challenge them to go a whole day without eating anything from a paper or plastic container. If they have never done this, it may be harder than they realized. If nothing else, it makes people stop and take notice of what they put in their mouths on an average day.
3) pH
Some patients may not understand the importance of pH or how it affects their oral health. Explain that the mouth needs to be neutral (7.0 pH) to help prevent disease. Discuss how drinks like sodas, juices, and energy drinks are very acidic and often contain huge amounts of sugar, which not only feeds bad bacteria but also makes the mouth even more acidic once metabolized. Once the pH drops to 5.5, enamel begins to demineralize, and decay can form.2
Explain to patients that periodontal pathogens also thrive in a more acidic environment, so keeping the mouth neutral helps prevent both decay and periodontal disease.2 Feel free to give them healthier food and drink suggestions that are less acidic.
In Closing
The good news is that even if the oral microbiome became imbalanced over the holidays, it has the ability to recover and return to a healthy state. Some small, day-to-day adjustments can make a big difference in helping improve patients’ oral health. Before they know it, their oral microbiome will be back in tip-top shape.
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References
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- Rajasekaran, J.J., Krishnamurthy, H.K., Bosco, J., et al. Oral Microbiome: A Review of Its Impact on Oral and Systemic Health. Microorganisms. 2024; 12(9): 1797. https://pmc.ncbi.nlm.nih.gov/articles/PMC11434369/
- Pandit, S., Pradhan, S., Muchhal, M., et al. Impact of Saliva pH on Oral Health: A Comprehensive Analysis. South East Eur J Public Health. 2024; 25: 2732-2736. https://www.seejph.com/index.php/seejph/article/view/3153/2128
