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Comment by coryrc | Hacker News Reader

Some people rarely brush their teeth and never get cavities. Some people brush thrice daily and floss and still get cavities and need root canals.

The working theory is we could all be in the first group with the right bacteria in our mouth.

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That's it exactly. Some beneficial species play an active role in suppressing the pathogenic species (those that release acid or cause gum disease) and have other benefits including helping us break down dietary nitrate into nitric oxide, which is critical for heart/brain health.

My company tests/researches the oral microbiome and we're starting to discover the signatures of what puts people in one group vs. the other, with hopes of helping develop more personalized approaches down the road, but for now helping people understand what will work best for them.

Here's my company for anyone who is interested in learning more: https://www.bristlehealth.com/

This is very cool.

What’s your take on xytiol gums? Think they’re effective in changing our oral microdiome for the better?

The initial data on xylitol looks promising for reducing cavities! Particularly for stimulating saliva production (dry mouth is a large contributor to cavities risk) and as a sugar substitute that cavity-causing species can't digest into acid. I'm excited to see more research come out and compare it with our data.

I'm also curious about this, but unfortunately I think that's where it will end for me in practice. Even if xylitol is effective, it seems the xylitol you'll get in any products (at least in the US) is going to be industrial byproduct from sketchy unregulated sources, just with greenwashed packaging. If there is a gum or rinse out there that is transparent and credible about their source of xylitol, and it's a source you can trust with your health, I'd love to try it out.

(I admit that you can probably say the same thing about any toothpaste you can buy in the US. But those have at least some additional benefits from regulation.)

What's preventing you from shipping to Canada, and any plans to expand outside the US in the future?

Could it also be about the level of salivation in general, since saliva also helps kill some bacteria and keep the mouth cleaner (relatively)?

Definitely! Saliva is our best natural defense against cavities (and harmful bacteria), so we always recommend people who have struggled with cavities or dry mouth to consider options for increasing their saliva production, like chewing sugar-free or xylitol gum.

Those two groups are likely differentiated on diet. For starters, diet can overload your mouth with complex and simple sugars, but diet can also determine the bacterial makeup of your mouth.

No idea where it eventually led, but I read about work done back in the 80s to vaccinate against the bacteria that cause tooth decay. That suggests that some people might have natural immunity to them.

It's also pretty likely that there is variation in enamel formation and hardness (driven by genetic differences).

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