Breastfeeding, the boob biome, and selling out at Dentown
And we're back with more this month.
Welcome back to the newcomers, the regulars, and everyone still meaning to unsubscribe.
How can we improve our patients' microbiomes? Start with breastfeeding.
We spend a lot of time in this newsletter talking about probiotics, prebiotics, and the latest microbiome-modulating supplement. But sometimes the most powerful intervention isn't a new product. It's one that's been around forever.
Butler et al. (2022) found a distinct difference between the oral microbiomes of breastfed and non-breastfed babies. Nearly a decade earlier, Holgerson et al. (2013) had already shown that formula-fed infants carried greater numbers of anaerobic bacteria, the kind generally associated with inflammation.
Why the difference?
Breast milk appears to act as a prebiotic, giving beneficial bacteria the chance to colonise the infant oral microbiome early, before less helpful species get a foothold. And that's before you even factor in the nutritional and immunological benefits breastfeeding is already well known for.
To be clear, this isn't a "just breastfeed" lecture. We know it isn't possible or right for every parent, and that's not a conversation we're here to have. But where it is an option, it may be one of the earliest and most meaningful things we can do for a child's oral, and quite possibly systemic, health, long before their first dental visit.
So breast milk has its own microbiome…?
While we're on the subject of breastfeeding, here's one for your dinner party trivia arsenal: breast milk isn't sterile.
It has its own microbiome.
Researchers have identified upwards of 200 bacterial species in human milk and have taken to unofficially (but delightfully) calling it the "boob biome."
Nobody's entirely sure how all those bacteria get there. One proposed mechanism, the entero-mammary pathway, suggests bacteria or bacterial components may travel from a mother's gut to mammary tissue via immune cells during pregnancy and lactation, meaning what's going on in mum's microbiome may influence what ends up in baby's mouth.
The composition isn't static either. It shifts across the stages of lactation and is influenced by numerous maternal and environmental factors.
One more reminder that the microbiome was never a single organ system we could point to. It's a network that apparently that network includes breast milk too.
Once you know breast milk has its own microbiome, the obvious next question is whether that can be harnessed as a product. And it already has been…
Companies like Evivo have built infant probiotics around Bifidobacterium infantis EVC001, a subspecies specifically adapted to feed on human milk oligosaccharides (HMOs), the complex sugars in breast milk that babies themselves can't digest.
The idea is cool: rather than feeding a baby a generic probiotic and hoping it survives, you give them a strain that's evolved to eat exactly what's already in their milk.
In their own studies, Evivo report substantial increases in B. infantis colonisation and changes in the infant gut microbiome. As with any commercial probiotic, though, it's worth separating the interesting biology from broader health claims that still require further independent evidence.
What's interesting for us is less the specific product and more the principle. It's one of the clearest examples yet of the "microbiome as network, not single organ" idea translating into something you can actually put in a baby's mouth.
And if microbial colonisation this early can influence immune and metabolic development, it raises an obvious question: what could an equivalent, evidence-backed approach look like for the infant oral microbiome specifically?
ORALIS 1 takes over Dentown
We were amazed by the feedback we received from Dentown, an innovative conference held in London by the Global Dental Collective.
THS Labs was lucky enough to curate one of the rooms at Dentown, along with all the speakers who spoke there that day.
We had a phenomenal lecture from specialist periodontist Dr Devan Raindi on the importance of nutrition for periodontal health.
One of the studies underpinning his thinking looked at periodontal health, neutrophil activity and cardiovascular health in captive chimpanzees, and the results were genuinely counterintuitive.
Despite substantial plaque build-up, the animals showed low bleeding scores and healthy immune responses, and over three years of follow-up there was no correlation found between periodontal status and cardiac markers, even in animals that went on to develop heart disease.
In other words: plaque alone didn't predict disease.
It's a compelling data point for the argument that host response and nutrition, not simply bacterial presence, may be doing more of the work than we sometimes give them credit for.
We also had Forbes 30 Under 30 specialist periodontist Dr Crystal Marruganti explaining the bidirectional relationship between psoriasis and periodontal disease, drawing on her own pre-clinical murine work exploring how the two conditions may influence one another through shared inflammatory pathways.
Next, Dr Hugo Madeira flew in from Lisbon to show us not only how he uses ORALIS 1 in his daily workflow at his clinics in Portugal, but how dentists can take a more holistic approach to patient care more broadly.
He walked us through his blueprint for pulling together huge amounts of data, photographs, CBCTs, microbiome tests and blood tests, and actually turning them into actionable treatment plans.
We also had Dr Michelle Jorgensen fly in from Utah to show us that there's no such thing as one-size-fits-all dentistry, tracing her own journey from a more traditional approach to a more biological one, fuelled in part by her own health experiences after decades of working as a dentist.
She debunked plenty of myths along the way and left attendees with a lot to think about.
Last but not least, your girl talked about ORALIS 1, the research we're building (and publishing, watch this space!), and all the updates we've made to the test.
We also offered 50% off a first oral microbiome test to anyone who took the plunge at the event.
Because if you truly want to know a product well enough to recommend it confidently to your patients, you should try it yourself.
And the reception was incredible.
We sold out of tests.
This time last year, I would never have dreamed we'd be up on stage, let alone selling out our tests at a dental conference.
So thank you to everyone who came, listened, tested, asked questions, challenged us and continues to support what we're building.
Your belief in what we're doing means the world.
Viva saliva.
Until next month,