The Mouth Report, Issue Two: Summer, Sweat and Celebration
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Time to read 9 min
Summer, sweat and celebration
In Issue One we looked at the big picture: large studies linking gum disease with heart disease, brain health and how long we live, and Cochrane evidence that treating the gums improves blood sugar control. This issue brings that research into real life.
November is the start of the season of long lunches, Christmas parties, summer training and early morning ocean swims. Three studies show how those habits reach your mouth, and how your mouth reaches back into the rest of your body.
“The longevity conversation tends to focus on what you add: supplements, cold plunges, wearables. This issue is about the everyday things we already do in summer, the drinks, the training, the rinse after the gym, and how small adjustments to those habits can protect the mouth. None of it is about perfection. It is about not undoing the good work you are already doing.”
Dr Cate Gerber
1. Festive drinking and the bacteria below your gums
Maley SJ, Yue Y, Burns KF, et al. Alcohol consumption and the diversity of the oral microbiome in postmenopausal women. Journal of Nutrition, 2024. Cross sectional analysis within a large cohort study.
The research
Researchers at the University at Buffalo studied 1,179 women taking part in the Osteo Perio Study, part of the long running Women’s Health Initiative. They recorded how often each woman drank beer, wine and spirits, then sequenced plaque collected from below the gum line, the area where gum disease begins.
About two in three women drank alcohol, and 14% had one or more drinks a day. Alcohol intake was associated with measurable differences in both the variety and the make up of bacteria under the gums. The authors point to two plausible reasons: alcohol reduces saliva flow, and it dampens the white blood cells that help keep gum bacteria in check.
This builds on an earlier study of 1,044 American adults (Fan et al., Microbiome, 2018), in which heavier drinkers carried more of certain bacteria linked with gum disease, including Neisseria species that can convert alcohol into acetaldehyde, a known carcinogen.
Dr Cate’s take
“I am not going to tell anyone to skip the Christmas party. What this research says is that alcohol does not just pass through the mouth, it changes the environment the bacteria live in. Dry mouth, more acid and less immune activity at the gum line is a combination that adds up over a long silly season. The balanced approach is simple: alternate every drink with a glass of water, keep sugary mixers and cocktails to mealtimes, and on a big night at least rinse with water and brush before bed. Remember too that this was a study of older American women, and it shows an association, not proof that alcohol causes gum disease.”
Why this matters for you
- Saliva is your mouth’s natural defence. Anything that dries the mouth, alcohol, air conditioning, a hot summer’s day, lowers that defence. Water between drinks helps more than you might think.
- Australian guidelines (NHMRC, 2020) recommend healthy adults drink no more than 10 standard drinks a week and no more than 4 on any one day. Staying within these supports your mouth as well as the rest of your body.
- Wine and many mixers are acidic. Wait about 30 to 60 minutes after an acidic drink before brushing, so softened enamel has time to recover.
- If your gums bleed when you brush during or after the festive season, that is worth a check, not something to brush through.
2. Your mouth helps your workout lower your blood pressure
Cutler C, Kiernan M, Willis JR, et al. Post exercise hypotension and skeletal muscle oxygenation is regulated by nitrate reducing activity of oral bacteria. Free Radical Biology and Medicine, 2019. Randomised, double blind, placebo controlled crossover trial.
The research
After a workout, blood pressure normally dips for a few hours, one of the reasons regular exercise is so good for the heart. Researchers at the University of Plymouth asked whether bacteria in the mouth play a part. Healthy adults ran on a treadmill for 30 minutes on two separate occasions, then rinsed with either an antibacterial mouthwash or a placebo.
With the placebo rinse, systolic blood pressure fell by an average of 5.2 mmHg one hour after exercise and nitrite levels in the blood rose. With the antibacterial mouthwash, the blood pressure lowering effect was 61% smaller at one hour and had disappeared completely by two hours.
The explanation is the nitrate pathway. Certain friendly mouth bacteria convert nitrate, found in leafy greens and beetroot and recirculated into saliva, into nitrite, which the body then uses to make nitric oxide, a molecule that relaxes and widens blood vessels. Wipe out those bacteria and the pathway slows.
Dr Cate’s take
“This is one of my favourite studies because it turns the idea of a ‘clean’ mouth on its head. A mouth that has been stripped of bacteria is not a healthy mouth. Some of those bacteria are doing a job for your heart. I am not telling anyone to throw out a mouthwash their dentist has prescribed, because there are times when an antiseptic rinse is exactly the right tool, for example after gum surgery. But I would question the habit of an antiseptic rinse straight after every gym session. It was a small study in healthy young adults, so we need larger trials before drawing firm conclusions about long term blood pressure.”
Why this matters for you
- Think ecosystem, not sterilisation. Brushing and cleaning between your teeth remove plaque without wiping out the helpful bacteria that live elsewhere in your mouth.
- Use antiseptic mouthwash for a reason and for a set period, as your dentist recommends, rather than as a daily habit by default.
- Feed the good bacteria. Nitrate rich vegetables such as rocket, spinach, lettuce and beetroot are the raw material for this pathway, and they are at their best in an Australian summer.
- If you are managing high blood pressure, keep your GP and your dentist in the loop with each other. Your mouth is part of the picture.
3. The fittest people in the room often have the least healthy mouths
Needleman I, Gallagher J, Ashley P. What do we know about elite athlete oral health? British Dental Journal, 2026. Narrative review.
The research
Published in February 2026 as part of a British Dental Journal theme issue on sport, this review from the UCL Eastman Dental Institute pulls together more than a decade of research. Tooth decay, gum disease and acid erosion are common in elite athletes and may be more common than in people who do not train at that level, with decay in particular likely higher than in the general population.
The main driver is fuel. Training and recovery demand frequent, prolonged intake of carbohydrates, sports drinks and gels, often combined with a dry mouth from heavy breathing. Strikingly, athletes generally report good knowledge and good brushing habits, which suggests that knowing what to do is not enough on its own. The authors conclude that oral disease can affect performance, health and wellbeing, and that simple, low cost measures work best when built into athletes’ daily routines.
Earlier work by the same group (Gallagher et al., Community Dentistry and Oral Epidemiology, 2018) found that around one in three UK elite athletes reported that their oral health had affected their training or performance, most often through pain.
Dr Cate’s take
“You do not need to be an Olympian for this to apply. Anyone training for a summer fun run, a triathlon or a fitness block is sipping sports drinks, chewing gels and breathing hard through an open mouth for an hour at a time. That is a steady drip of sugar and acid onto teeth that are drying out. Nobody is suggesting you give up sports nutrition when you genuinely need it. The fix is about timing and habits: use sports drinks for long or intense sessions rather than as your everyday drink, sip water as well, and protect your teeth with good daily care and regular checks. If you play contact sport, a custom mouthguard is not optional.”
Why this matters for you
- For most workouts under an hour, water is all you need. Save sports drinks and gels for longer or harder sessions.
- Rinse with water after a sports drink or gel, and avoid brushing immediately afterwards while enamel is softened.
- A dry mouth in the summer heat speeds up both decay and erosion. Hydrate before, during and after training.
- Wear a properly fitted mouthguard for contact and ball sports. A custom guard made by your dentist fits and protects better than a boil and bite one.
- Tell your dentist if you train hard. It changes the advice you need about diet, toothpaste and how often to be seen.
The thread that ties it together
Festive drinks, summer sport and the post workout rinse all point to the same idea from Issue One: the mouth is an ecosystem, and its balance is connected to the rest of the body. Here is how Dr Cate suggests carrying that into the holidays.
Earlier work by the same group (Gallagher et al., Community Dentistry and Oral Epidemiology, 2018) found that around one in three UK elite athletes reported that their oral health had affected their training or performance, most often through pain.
Where Peg Paste fits
Peg Paste is a fluoride free toothpaste built around micro hydroxyapatite, the same mineral your enamel is made of. It also contains xylitol, a sugar free sweetener that mouth bacteria cannot ferment into acid, and a prebiotic fibre from chicory root. It is designed for daily use as one part of a routine that includes interdental cleaning, sensible food and drink habits and regular professional care.
It is not a treatment for gum disease, high blood pressure or any other medical condition, and it does not replace the advice of your own dentist about the right toothpaste for your level of decay risk.
References
- Maley SJ, Yue Y, Burns KF, Hovey KM, Wactawski Wende J, Freudenheim JL, et al. Alcohol consumption and the diversity of the oral microbiome in postmenopausal women. J Nutr. 2024;154(1):202–212.
- Fan X, Peters BA, Jacobs EJ, et al. Drinking alcohol is associated with variation in the human oral microbiome in a large study of American adults. Microbiome. 2018;6(1):59.
- Cutler C, Kiernan M, Willis JR, Gallardo Alfaro L, Casas Agustench P, White D, Hickson M, Gabaldon T, Bescos R. Post exercise hypotension and skeletal muscle oxygenation is regulated by nitrate reducing activity of oral bacteria. Free Radic Biol Med. 2019;143:252–259. doi:10.1016/j.freeradbiomed.2019.07.035
- Needleman I, Gallagher J, Ashley P. What do we know about elite athlete oral health? Br Dent J. 2026;240(4):217–222.
- Gallagher J, Ashley P, Petrie A, Needleman I. Oral health and performance impacts in elite and professional athletes. Community Dent Oral Epidemiol. 2018;46(6):563–568.
- National Health and Medical Research Council. Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC; 2020.
This article is general information and is not medical or dental advice. Speak with your own dentist or GP about your situation.
WHAT IS HYDROXYAPATITE?
Hydroxyapatite is a restorative mineral that occurs naturally in teeth and bones. Hydroxyapatite works to repair, remineralise and strengthen the tooth’s outer layer, acting as a buffer to help prevent mineral loss, tooth erosion, tooth sensitivity and plaque.
HOW DO PREBIOTICS SUPPORT ORAL HEALTH?
Prebiotics support oral health by promoting the growth of beneficial bacteria, which can help maintain a balanced environment in the mouth. It is important to maintain good oral hygiene so harmful bacteria does not take over potentially leading to bad breath, cavities and disease.
WHERE IS PEG PASTE MADE?
Peg Paste is made and manufactured in Australia.
DO YOU USE MICRO-HYDROXYAPATITE OR REGULAR HYDROXYAPATITE?
We use micro-hydroxyapatite in our toothpaste and ensure that it fully complies with current SCCS (Scientific Committee on Consumer Safety) and Australian oral care and cosmetic regulations. We are aware of the European Union’s upcoming ban on nano-materials in cosmetics starting November 2025. The reason for this ban is still unclear, but reports suggest potential risks if nano-hydroxyapatite is used in high concentrations or in sprayable products, where inhalation could be a concern. Since our toothpaste is not a spray and is formulated with concentrations that are within safe guidelines, we remain confident in its safety and effectiveness.
IS PEG PASTE SUITABLE FOR CHILDREN?
Absolutely. Prevention is key when it comes to oral health, so why not instil healthy habits early. Children’s toothpaste normally consists of a lower level or no fluoride because of the greater risk of potential fluoride toxicity. Given Peg Paste is a natural, fluoride-free formulation, it is safe for junior toothypegs. We recommend children use a pea size amount and brush under adult supervision.
