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The oral microbiome has been recently classified as a “gateway” microbiome, giving it immense importance in total body health. The placental microbiome is another gateway microbiome- it sets the immune system of the developing child- and is extremely important since it's closely related in microbial content to the oral microbiome! But what creates a dysbiotic oral microbiome?
My guest today is Mark L. Cannon. He is a Professor of Otolaryngology- Division of Dentistry at Northwestern University, Feinberg School of Medicine, an Attending Physician at Ann and Robert Lurie Children’s Hospital, and a member of the International Association of Pediatric Dentistry. In addition to being the founder of Associated Dental Specialists of Long Grove (1981); he is the Research Coordinator of the Pediatric Dental residency program at Ann and Robert Lurie Children’s Hospital, Chicago, Illinois. Dr. Cannon has 40 years of experience in pediatric dentistry and has presented lectures both nationally and internationally. He lectures on many oral health topics including evolutionary oral medicine, the gateway microbiomes, biologic and bioactive dental materials (patents owner), probiotics, and all aspects of everyday Pediatric oral health. Dr. Cannon has humbly accepted two invitations by the Karolinska Institutet, first to the Nobel Forum (2016) and secondly to the Nobel Assembly (2017). Most of all, Dr. Cannon is the proud father of five, all of whom are very accomplished. He is also a very proud grandfather!
Do you have issues with both the skin and your dental health? Have you considered tackling the mouth issues first? Let me know in the comments!
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In this episode:
- What is a “gateway microbiome”?
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Why missing THESE bacteria from your mouth microbiome is problematic
- List of diseases + health issues associated with a messed up oral microbiome
- What bacteria like P. gingivalis can INSIDE of your cells
- Is xylitol helpful for oral microbiome health?
- Strep salivarius VS. Strep mutans
Quotes
“Half the population has their gut controlled by the mouth. If you have leaky gut, you have leaky gums, leaky blood-brain barrier… And before you know it, problems with the skin, which is what we've seen in so many studies. You'll find a lot of studies showing that with every skin disorder, there's an associated gut microbiome problem” [06:07]
“It was a very, very powerful multi-center study… And they significantly reduced preterm birth by having the moms chewing xylitol gum. I mean, the savings and healthcare dollars are huge, but again, you're working on a gateway microbiome and you're inhibiting a keystone pathogen.” [16:04]
Links
Find Dr. Cannon's bio here
The American Academy for Oral Systemic Health
Want to try some amazing toothpaste + mints with xylitol? Try RiseWell!
Healthy Skin Show ep. 260: Oral Microbiome-Skin Rash Connection w/ Dr. Mark Burhenne
Healthy Skin Show ep. 020: How Your Mouth Microbiome Can Mess Up Your Skin w/ Trina Felber
293: Watch Out For This Inflammatory Mouth Bacteria To Your Skin + Health w/ Dr. Mark Cannon, DDS FULL TRANSCRIPT
Jennifer: Dr. Cannon, thank you so much for being here.
Dr. Cannon: Well, thank you for having me. This is truly an honor and a pleasure.
Jennifer: Well, the way that we met was at the Integrative Dermatology Symposium 2022, and you had given a fantastic talk to all of these physicians and other practitioners in attendance about the connection of the microbiome in the mouth and what can happen in other areas of the body, including the skin. And I just thought it was such a fascinating conversation because I was, I am somewhat familiar with the oral microbiome causing problems systemically and we've had a couple conversations about this on the Healthy Skin Show, but you came at this from a completely different angle that I had never heard of before and I thought it was so worthwhile to have this conversation because I think that my listeners would love to know this. So, you talked about this whole concept of sort of gateway microbiomes and that the mouth is a gateway microbiome. So can you explain to listeners like what, what is this gateway microbiome that you speak of?
Dr. Cannon: Well, we have barrier microbiomes, like the skin is a barrier, but the oral cavity of the mouth, that's where everything goes in fluid, food. People breathe through their mouth, which they shouldn't, but they have all these things that go in. And so the microbiome, the bacteria of the mouth have to be extra developed as a defensive microbiome. And also to process nutrients. One of the things we didn't talk about is that there's a genus, a big group of bacteria called Rothia. They break down gluten as you chew. Anything that has gluten, it breaks it down. And people who are gluten sensitive are missing their Rothia. And if you have, that's why they've done these great studies showing, you know, the first degree relatives, they'll show a young lady who is any studies who cannot eat any bread or they're gluten sensitive, but the brother drinks pizza, you know, drinks beer and eats pizza.
No problem at all, because they have gluten metabolizers. That research was done first at Harvard and Foresight and about 2013, and they actually went ahead and they copyrighted the use of those bacteria to treat celiac disease. But for some odd reason, it hasn't gone anywhere, mainly because you cannot really patent those bacteria. Mm-Hmm. They found 150 strains. And then the very next year, my research group, we found 16 more strains, including one that was a super gluten metabolizer that would break down over half of all your gluten in your mouth and lavi broken down as you swallow it. And then the bolus, the chunk of food and saliva. By the time it gets to your stomach, the gluten's gone. It's been digested by the bacteria, and that's been going on for thousands and thousands of years ever since we started the neolithic period 12,000 years ago and we started to eat grains. Those grains were covered with bacteria that actually break down those grains. And when we stopped utilizing stone, like stone mills or brass rollers, we created so many illnesses. But let's go back to the gateways. Okay. Cuz I digress easily as you notice, <laugh>.
Jennifer: Well, I'm sure you have a lot of great knowledge of things that you have been exposed to that I'm sure we can dive into in another episode, but Yeah. This gateway microbiome concept that you shared was just fascinating and especially about that one bacteria you can say, yeah, I'm gonna, I'm gonna butcher it.
Dr. Cannon: Yeah, yeah. It's okay. I'm, I'm really bad at remembering people's names, but remember bacteria very well, <laugh>there's a little humor in that, but yeah, so we have gateways with the nasal gateway microbiome and we have the oral gateway microbiome, and then there's a third important one, which is the placental microbiome, which is also a gateway microbiome. The placenta's supposed to have a lot of bacteria. It's called maternal imprinting. And that goes back to, I think it was 2004. Well, 2007 was another major one article in the Journal of Pediatrics about how in a mother, the white blood cells called monocytes pick up bacteria, keeps those bacteria alive throughout the blood, takes it over to the breasts so it can, those bacteria can be excreted in the breasts milk. And we now know that there are thousands of strains of bacteria and breast milk is very loaded.
Because that, again, is a form of a gateway going into the mouth. You got implant the right bacteria in the mouth. So nasal microbiome, we just finished not even a year ago, probably six months ago now, doing the deep sequencing whole genome. We went deep, found over 2,500 interesting species and strains. A lot of 'em are involved with health. Let's don't talk about that. Let's go on to the oral microbiome because that gateway microbiome we use all the time. Every time you swallow, you know, you swallow a thousand times a day, you swallow a hundred billion bacteria a day. And people talk about taking that probiotic of their, which has 2 billion CFUs, but you swallow a hundred billion CFUs a day colony farming units. If you have the wrong guys here, your gut gets messed up.
Now the human microbiome project proved that, and we talked about that, that lecture, that over half the, well half the population has their gut controlled by the mouth. And so if you have leaky gut, which makes our new access of disease, you have, you know, leaky gums, leaky gut, leaky blood-brain barrier. And before you know, problems with the skin, which is what we've shown in so many studies and published, you'll find a lot of studies showing that with every skin disorder, there's an associated gut microbiome problem. You know, atopic dermatitis, there was just one last month published in journal immunology where they looked at mother-child pairs, dyads, or look at the mom and the, and the kid, and it was a long-term study longitudinal, they weren't going back retrospectively. They went, started off looking at the microbiomes and checked for which microbiomes were related with what disease.
And they found that specific microbiome from the mother, which is given to the child, was associated with allergies, asthma, atopic dermatitis, eczema. So we have all those skin issues, which are, because something went wrong in the gateway and a gateway microbiome. In the oral microbiome we have, which I have often lecture about, there are these bacteria that are very, very important and they break down the nitrates. Those are things you find in all your green leafy vegetables. If you're missing the bacterium of the mouth, if you're missing those bacteria in the mouth, this is what happens to you. Cavities, gum disease, higher blood pressure, more likely to have a cardiovascular event, more likely to have higher BMI,, more likely to get diabetes and more likely to get cancer. So always there's the good guys. You're missing, whether it's the Rothia I mentioned before for breaking down your gluten, but if you don't have the nitrate-reducing bacteria, you know what they've actually shown in studies, which surprises a lot of people. If you don't have those bacteria, you don't get much of a benefit from working out.
Jennifer: Really?
Dr. Cannon: Yeah. They do mouth rinses that kill the bacteria. Then you have the workout and they check the benefit. It has and effect on your blood pressure from working out and you lose those benefits because you can't form new capillaries without having the nitrites in your system. Nitric oxide was the reason why three people got the Nobel Prize in 1998. It's on the American Heart Association recommendations that you keep your oral nitrate-reducing bacteria. But right now, you can go to any drug store, buy a mouthwash, it'll kill your good guys. So that is tragic. And we often say, don't use those mouthwashes. They'll kill the good guys. You wanna get rid of the bad guys. Well, sadly, most of the bad bacteria, the pathogens like you were mentioning Porphyromonas gingivalis, which is a keystone pathogen related, there's another one called Fusobacterium nucleatum. These guys, they're related to cardiovascular disease very strongly. In fact, you can take a bunch of mice and give them little, you know, rinses, they inoculate the mouth with pone gingivalis and you'll see them start to get a gum disease and cardiovascular disease. Whereas you've used the sterile saline in other groups, they don't get that. They end up getting atherosclerosis because Porphyromonas gingivalis creates atherosclerosis.
Jennifer: So the mouth bacteria, that's, that's what we're talking about here. The mouth bacteria is a cause. What is it? Would you say it's a causative factor in developing?
Dr. Cannon: Yeah. In Alzheimer's too. Inflammatory Alzheimer's. Again, they have great studies showing Inhumans famous ones by Steven Domini and others where they look at brain samples, his sessions of the brain, they'll find the Porphyromonas gingivalis in there because as people call it PG, so we'll call it PG and make it easier for everybody. It is a strange bug that started to evolve with us about 40,000 years ago, as the best we can guess. It came to us from dogs. We return to favor. Sadly, that's why dogs have terrible gum disease. And cats now we return the favor to our pets. It is one that is capable of being a guerilla. It subverts your immune system. It goes inside your cell. So like epithelial cells, like on the skin, you're gonna have your keratinocytes and all that. Right? What it does is it goes inside the cell.
Now, once it gets inside the cell, it forms these little pockets called vesicles phytolysosomes is a correct term. And they will propagate in that. And they become quiescent. They, they lose what is called quorum sensing. They don't become aggressive, they become parasites. And the term is a pathobiont. They live in your cell, they turn off your normal cell system of death called apoptosis. They make the cell go into a sleep state called senescence. And they just propagate and grow your cells of your body become a breeding plant for this pathogen. Now something comes along and disturbs it and causes a bacteremia- those bacteria in their blood. They do the same thing inside your endothelial cells, but they break down all your barriers. They can make these junctions between your cells like your epithelial cells break apart. So other things again in, so you get a lot more inflammation in general. Yeah, it's a controlling keystone pathogen recognized now by the NIH- National Institutes of Health. And there is now a big race to try to develop a vaccine against it, which is stupid!
Jennifer: <Laugh>. Okay. Because I'm not gonna fight. Yes. Why, why is it stupid?
Dr. Cannon: Because it's a… It's evolving and we have six strains. But I think if we go back far enough, we'll find there is only three strains. And the more recently evolved ones are even more clever at evading our immune system. We can get rid of it by using a lot of good supplements. There's a lot of good probiotics that inhibit it. There's a lot available right now. You can walk into anywhere and buy some good probiotics that greatly inhibit PG and the other one, FN. There's prebiotics readily available, all of xylitol-based products. Xylitol greatly prevents it from adhering and penetrating into the cell. So I can't get into the cell. It prevents it.
Jennifer: Would you look for xylitol in a toothpaste or a chewing gum? That's usually where I've seen it.
Dr. Cannon: Yeah. And in the chewing gum studies, I mean the chewing gum studies are famous. There is one by Soling and another one by iso kaus, but they I always quote the people because they deserve the credit for the work they did. I mean, otherwise it's not genuine. But they did one again with mother-child pairs, where the mom chewed the xylitol, chewing gum from six months of age of the child to two years of age of the child. And it prevented the transmission of the bad bacteria to the child from the mom in 80%. And then five years later, those kids ended up having 71 to 73% fewer cavities five years later. So I always tell the moms when, you know, I'm, I'm retired clinically, but in my practice I would always tell the moms who were like, expecting and planning another child, they say, get yourself started on xylitol gum. But here's another big benefit because Porphyromonas gingivalis is associated strongly with preeclampsia. And you know, you can actually transmit preeclampsia from a woman with high blood pressure who is preeclamptic to a mouse that is has in pregnant mouse, that mouse will get preeclampsia.
Jennifer: Wow.
Dr. Cannon: Yeah, because it's, it's controlled by the bacteria of the gut. And if you have those Porphyromonas gingivalis have gotten into the small intestine and all that gets into bloodstream, it causes, in fact you find it in the umbilical cord whenever there is pre-eclampsia. But Fusobacterium nucleatum actually causes miscarriages and has been documented cause stillbirth and preterm birth. So there's a great study done by Dr. Kirsty Agaral Baylor with about, I think 9,000, 10,000 women altogether over a long period of time. And it was a multi-center study, a very, very powerful multi-center study. And they significantly reduced preterm birth by having the moms chewing xylitol gum. I mean, the savings and healthcare dollars are huge, but see it again, you're working on a gateway microbiome and you're inhibiting a keystone pathogen. Actually two of them, you're inhibiting two keystone pathogens. We could do that right now. And in fact, it's common in some countries like Japan, A lot of times they do that in South Korea also.
Jennifer: And can I ask, because I think people are gonna wonder like how, I know you said that this is at least the PG so the Porphyromonas gingivalis, I think I got it somewhat correct this time. I know that it's something that you said came from dogs originally, but like may…
Dr. Cannon: Have. Yeah.
Jennifer: May have. So how do we end up with it now? Is it from, I know you said the mouthwash, the use of mouthwash, which I will be honest, my dentist still makes me use mouthwash every time I go to the dentist. Oh yeah. Which I find annoying. But is it also partly due to the environment or drug use? Like Oh, prescription drugs or
Dr. Cannon: With the dogs, it was a sharing of DNA. You know how they have these little DNA plasmids bacteria, you can share a back and forth like for antibiotic resistance. So it appears, and this is theory, no proof at all. And it could be a nutty, nutty theory too. That they have a form of bacteria called Porphyromonas galE that has these three little genetic modifications. We now have Porphyromonas gingivalis with these six modifications. I think that a couple of those came from dogs because when we started doing hunting with dogs, proto dogs, they were called, and it's a type of wolf that is extinct. It's no longer around. We shared food and we shared microbiomes. And whenever you do that, you always have zoonotic diseases. I mean, look at the classicist tuberculosis. It went from cattle to human then from human back to cattle again. And so, I mean, we're gonna have zoonotic diseases forever. Yeah. Whether it's swine flu, bird flu.
Jennifer: And do you think that the antibiotic use potentially, I mean, I know when I was a kid and I'm in my forties now, I mean my dad was a doctor, I got a lot of antibiotics. Oh, thank you. But I did get a lot of antibiotics, which has unfortunately had a pretty big impact on my gut microbiome. Do you think that that can also, the use of antibiotics can impact this p gingivalis and its ability to thrive?
Dr. Cannon: This guy was going nuts on us way, way back, thousands of years ago. In fact, there's mummies who have extreme periodontal disease. In fact, one of the most classic things you ever see is a mummy that had a special bridge made from here. I mean this is an ancient Egyptian, like from 4,000 years ago, had a fake teeth placed using gold wire and they made a little fake bridge on the bottom and, and it was donor teeth. So the teeth came from someone else.
Jennifer: Oh my.
Dr. Cannon: Probably not a volunteer <laugh>.
Jennifer: Probably not <laugh>. Oh my, oh my goodness.
Dr. Cannon: As gum disease. So, so rampant. Okay. Going back to even before it was when we were hunter-gatherers, we started to get really bad gum disease. So okay. That predates a lot of things now cavities, much worse now than ever before. I mean, a skyrocketed, like the most common reason for a child to have outpatient surgery in the United Kingdom is dental surgery.
Jennifer: Oh, that sounds awful. I don't like having dental surgery now as an adult. I can't, ugh,
Dr. Cannon: These little poor little 3, 4, 5 year olds are coming in with everything going on. Abs us, us shutting down for covid was a dual edge sword. Everyone will tell you that with the fact they had on oncology patients, cardiology patients, kids, kids learning- everything! It had a huge negative effect too. And we saw so much more disease when people started to come back, it was pretty rampant. Part of it was this eating nonstop. You had the refrigerator right there and kids weren't to school.
Jennifer: Mean, it's just, yeah, the lack, the lack of activity definitely did not help. And I, and speaking of kids, strep tends to be a problem in kids. And I have noticed a really interesting correlation between some of my clients who struggle with psoriasis and that it was triggered That's me or would worsen from a strep infection. Do you have, do you have any thoughts about that? I know that you had mentioned strep in your presentation, but is it a strep infection of the mouth that's… I mean obviously we do get strep infections in the mouth. So talk to us a little bit about that.
Dr. Cannon: Well, the bacteria involved strep that bacteria is actually strongly inhibited by a good bacteria strep salivarius. So that work was done decades ago by Dr. Stan Schulman at my children's hospital. I'm a full professor at the Fine Bridge School of Medicine and at Anna Rubber Hary Children's Hospital. And he was a great guy, brilliant person to work with. And he discovered that, again, disease is because you're lacking the good guys. And so there are strep salivarius probiotics you can take. And I routinely did that for my patients who had strep throat or ear infections because it not only inhibited the occurrence of ear infections and sinus infections and strep throat, it also at the same time reduced the cavity rate. And because strep salivarius would kill the strep mutans that causes cavities… They compete. They compete all the time. When you hear people say that your microbiome is ongoing battlefield, it is a ongoing battlefield. What you need to do is give your good guy's allies, which are the probiotics, the good bacteria you need to give them the weapons they need, which are the prebiotics. And please do me a favor, everybody out there don't think as prebiotics, as fibers please anymore. Prebiotics are anything that helps the good bacteria. Think about prebiotics for your skin. Are you gonna put fiber on your skin?
Jennifer: No.
Dr. Cannon: No. But a prebiotic for your skin could be an essential oil that inhibits pseudomonas that would inhibit staph aureus. But there's a good essential oils, as you know, they've done a lot of studies with essential oils in the skin microbiome. So yeah, you use the skin product coconut oil. One of my absolute favorites is coconut oil. And it is so good around so many ways and it's antifungal, which is very important because Candida albicans, all the Candida assemblages were, it forms a superorganism by with certain bacteria. Those are so pathogenic, they're so disease-causing and they're oncogenic, they're cancer-causing. In fact, the assemblages between bacteria and certain fungals have just recently in the last few months, I think it was about six months ago, was shown in the oncology journals to be associated with over 35 different cancer cell line developments. Wow.
Jennifer: Wow.
Dr. Cannon: Now at Northwestern, we're working with prebiotics right now in, in our studies with these are preclinical trials with humanized mice that we're working to inhibit two very deadly cancer cell lines and we're having success. So it's very important people realize that prebiotics is anything that benefits the good microbiome bacteria.
Jennifer: Yeah. Yeah. Can I also ask, and this is just a question that popped into my head as you were talking. I've had some clients against psoriasis clients mm-hmm. <Affirmative> who've really struggled with tonsil stones.
Dr. Cannon: Yeah.
Jennifer: Is there any connection with the microbiome and tonsil stones?
Dr. Cannon: You know, I think you asked me that question before. I, I, I found some articles about different strep strains and tonsils, which way I, I think we've known about that for a long time. But again, I'm not sure, you know, the, the connection between psoriasis and strep Biogen is, has been well established now. Yeah. But I think it was probably questioned for years. But there's been enough meta-analysis, large studies done that they have shown the connection. And of course I'm a psoriasis sufferer… Yeah. Cuz you know, you what I do for mine. I know. I, I think I mentioned to you before, I have this little miracle thing that helps me so much with skin. Can I tell you?
Jennifer: Please. You can share <laugh>.
Dr. Cannon: Okay. African black soap
Jennifer: And that's just what you use to wash in the shower. Mm-Hmm.
Dr. Cannon: <Affirmative> African black soap. Are you, are you familiar with African black soap?
Jennifer: I, I actually am.
Dr. Cannon: Okay, good. I figure you probably were very familiar with it. But I'm a rather recent convert and I got converted because I was at a typical Chicago festival several years ago. I walked past a booth. I always look at different soaps because my skin issues. And there was this nice big display of African black soap when I was immediately intrigued. Cuz whenever you make something outside and in my lectures I show how they make the soap outside. You get the good bacteria, you get all those soil organisms you need to get the bacillus subtillus, you get all the good soil organisms. So that's what your skin needs. You're so much healthier outside. Right.
Jennifer: Yeah. That is, that is very true. There's a lot of truth to that. And we've had e experts on the show who have attested to that and even mm-hmm. <Affirmative>, the detrimental impact from the pandemic of people being locked in doors and how that drastically and negatively impacted their disease severity of Oh yeah. Whatever condition they had. Mm-Hmm. <affirmative>, it was just sort of like interesting that we have that data, but in a sense, kind of sad that we have it now because of what happened to people in real life in real time. But it was,
Dr. Cannon: It was predictable.
Jennifer: Yes.
Dr. Cannon: It was predictable because we know what's good for us. We know that being outside we know that having, being exposed to some regular elements actually makes your skin better. Because what makes you better is defense.
Jennifer: Mm.
Dr. Cannon: You know, your body is always trying to repair and to reestablish itself. Yeah. And so when you are little constant challenges keep you, that keeps you sharper mentally, working out every day makes you sharper too. Right. Yeah. All we know that that was predictable putting people in with processed food in a closed environment. I mean, who could not predict safely that we were going to have a problem?
Jennifer: <Laugh>. Exactly. Exactly. And, and so I definitely wanna make sure too that people can get in touch with you because I know that you're retired now from clinical practice, but you are available on LinkedIn, which will link to your profile but also you had shared with me beforehand that you are the president of the American Academy of Oral and Systemic Health. And so people could connect with you there at the aaosh.org. This is predominantly for doctors and other medical practitioners. And it sounds like practitioners even potentially who are more on the functional and alternative side as…
Dr. Cannon: Well. Many, many, many functional alternative integrative. We have many like nurse practitioners coming in. Nutritionists… We're just integrative health and it's the American Academy for Oral and Systemic Health. It's AOSH. I'm the president-elect and, and I have a big job in front of me next year. They've already said we want to have 10 times the members. So everyone out there be sure to sign up tomorrow.
Jennifer: <Laugh>. Awesome. Well, and you have this fireside chat, which is a part of that. So if people are interested in learning more, and it looks like you also get CE credits, which are important for folks who are, you know, obviously licensed in their state and they need those CEs to keep their licensure, that can be really helpful. So I think it's a great opportunity for people to expand their knowledge base is and connect with other like-minded practitioners. And I just, like I said, I loved your talk at I thank yous, I found it to be really informative. And I think it's fascinating when we can connect so many different dots and remember that the body is a whole unit. It's this whole beautiful, it's a whole unit universe or orchestrated universe in one one. It's one thing. And in not these little tiny pieces cut up, you know, as we oftentimes see in conventional medicine. And so thank you so much for sharing this with us and I hope I can have you come back sometime and Oh, I love, dive into some other research that you, you have, are clearly digging into, which is so cool. Okay, well thank you so much.
