The Role of the Oral Microbiome in Children: How Bacteria in the Mouth Shape Dental Health Beyond Cavities

🦠 What Is the Oral Microbiome?

The oral microbiome refers to the complex community of microorganisms — primarily bacteria — that live in the mouth. In fact, over 700 species have been identified in the oral cavity. Some bacteria are beneficial and help maintain a healthy balance, while others contribute to decay and disease.

Think of your child’s mouth like a miniature ecosystem. A healthy mouth has a good balance of “helpful” and “neutral” bacteria that work together to protect the teeth and gums. Problems occur when this balance is disrupted — a state known as dysbiosis.

🧠 Note: While the BSPD doesn’t yet have a formal statement on the oral microbiome, this concept is supported by general microbiological and paediatric dental research.

Why It Matters in Children

In children, the oral microbiome begins forming at birth and evolves rapidly in the first few years of life. Influencing factors include:

• Mode of delivery (C-section vs vaginal birth)
• Feeding habits (breastfeeding, bottle feeding)
• Introduction of solid foods
• Eruption of baby teeth

According to the BSPD’s Infant Feeding Position Statement, early feeding choices play an important role in the development of oral and general health — which includes microbial exposure and colonisation.

A balanced oral microbiome in childhood has been linked not just to fewer cavities, but also to healthier gums, lower inflammation, and possibly even better overall immune health.

Diet, Sugar and Bacterial Balance

The BSPD strongly recommend reducing free sugars in children’s diets to lower the risk of dental caries.

When a child frequently consumes sugary foods or drinks, harmful bacteria — such as Streptococcus mutans — thrive. These bacteria produce acids that demineralise enamel and contribute to tooth decay.

Oral Hygiene and Fluoride: More Than Just Cleaning

Regular brushing with a fluoride toothpaste is one of the most effective ways to support a healthy oral microbiome. By removing plaque and balancing pH levels in the mouth, brushing reduces the environment that harmful bacteria need to survive.

This advice endorsed by the BSPD, recommends:

• Twice-daily brushing with at least 1000 ppm fluoride toothpaste
• Supervised brushing up to age 7
• Professional fluoride varnish applications every 6 months for most children

These practices don’t just remove bacteria — they promote the growth of protective bacterial species by maintaining neutral pH and remineralising enamel.

How We Support Children’s Oral Health at Our Fulham Clinic

At Children’s Dentist London, we take a holistic, prevention-focused approach to children’s dental care — one that aligns with BSPD guidance but also reflects the latest science.

Here’s what we do to support a healthy oral environment:

• Supervised brushing education for children and parents
• Dietary advice tailored to reduce sugar exposure
• Fluoride varnish applications (as recommended by SDCEP)
• Monitoring of enamel development and early caries risk
• Friendly, low-stress environment to encourage regular visits

We also stay up to date on emerging research into the microbiome and minimally invasive dentistry — so we can evolve with the science.

Key Takeaways for Parents

• The oral microbiome plays a major role in your child’s dental and general health
• You can support a balanced mouth environment through diet, brushing, and hydration
• BSPD-backed prevention (fluoride, brushing, sugar reduction) already supports microbial health
• More microbiome-targeted tools may be available in the future — but prevention remains key
• Regular dental visits help detect imbalances before they become problems