Micro Plastics and Dentistry

Hi everybody, I'm Dr. Sanda Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most in a natural way. Welcome to another episode on The Holistic Dentistry Show. Today we're going to be uncovering the truth about microplastics in your mouth and the hidden dental exposure that no one is talking about. Imagine brushing your teeth tonight. You grab your toothbrush, squeeze toothpaste onto the bristle, you floss, maybe even rinse with a mouthwash. Now imagine that every one of those steps could be releasing tiny plastic particles directly into your mouth. Are those getting absorbed through the mucosa? Those particles are called microplastics and nanoplastics, and new research suggests dentistry itself, from toothbrushes to fillings to orthodontics aligners, may be an overlooked source of microplastic exposure. Today we're diving into where these microplastics come from, how dental materials release them, what science says about possible health effects and what holistic dentistry can do about it, and what each and every one of us can do about it. Because the mouth isn't just teeth, it's one of the main gateways into the body. I found this article that I want to share with you called Micro and Nanoplastics and the Oral Cavity: Implications for Oral and Systemic Health, Dental Practice, and the Environment. And this article was published last year, September 2025. Micro and nanoplastics. Okay, we need to define those. Microplastics are plastic particles smaller than 5 millimeters. So you can imagine 5 millimeters is pretty small. However, you could still see a 5-millimeter plastic particle. A lot of them are thousands of times smaller than that though. Some are so tiny they're classified as nanoplastics, meaning they're smaller than a micron. These particles come from two main sources: plastics breaking down over time, products intentionally made with tiny plastic particles. And we now know they're everywhere. I'm sure a lot of you have been seeing this in the news. Don't drink out of plastic bottles because of the microplastics. Just really watch the kind of containers that your food comes into in order to avoid having microplastics in your body. By now, all of us have microplastics. It's impossible not to. Scientists have found microplastics in drinking water, seafood, table salt, human blood, the placenta, and even the brain. In fact, plastic production has exploded since the 1970s, with billions of tons produced globally, and most of it persisting in the environment for centuries. Luxuries. But here's the twist: your dental routine might be exposing you to them every single day. This is the review and a few others that I actually looked at microplastic in dentistry and nanoplastic exposure. We know we have some dental materials, of course, that have micro and nanoplastics, but we also have oral care products. Let's break those down. Especially today, I want to talk more about dental materials. Modern dentistry relies heavily on polymer-based materials. What is a polymer reaction? Is something basically that is cured with a light or, uh, something that hardens, basically goes from a liquid to a solid via polymer reaction. These include composite fillings or resin fillings, or those white fillings that you may be going to the dentist for. Dental adhesives. These are anything that might be gluing down a crown or perhaps even denture teeth, also dentures, orthodontic aligners such as Invisalign, ClearCorrect, any kind of clear aligners or even retainers that are made out of a clear plastic. And of course, we also have impression materials. Many of these materials are essentially engineered plastics. Over time, they can release particles through mechanical wear. So for example, let's say you're wearing your Invisalign. Top and bottom in the course of the 2 weeks that you're wearing a set of aligners, you're actually going to see wear on the surface of that enamel. That's what we refer to as mechanical wear. Chewing, chewing with your aligners can also cause microplastic particles to come off. Temperature changes. Let's say you're a denture wearer and you're going to drink hot soup when you're going to eat hot soup or drink hot coffee. That kind of temperature change will cause the release of microplastics. And for some, just simply saliva exposure. Studies show that resin-based composites, prosthetic material, and clear liners can release microplastics as, as they degrade or are mechanically stressed. Even normal dental procedures like polishing, grinding, trimming, restoration. So trimming, for example, fillings that are high can generate microplastic debris. Now, if we look at this article, it goes in depth of all the different plastics in the dental materials. Plastics contain over 13,000 chemicals, of which at least 3,200 unknown or suspected to be hazardous to human health or the environment, including carcinogens, neurotoxicants, endocrine disrupting chemicals, meaning something that'll cause hormonal disruption, and persistent organic pollutants. Microplastics, which are less than 5 millimeters, and nanoplastics are referred to as micro-nano-plastics. And this article mentions that, um, experimental models on animals have shown that micro-nano-plastic exposure leads to oxidative stress, inflammation, cytotoxicity, and immune dysregulation, as well as disruption in gut microbiota, impaired fertility, developmental neurotoxicity, and translocation across the blood-brain barrier and placental barrier. That's why we have to care about this topic. We can't ignore it. We might say, oh, you know what, they're everywhere anyway, so why should I ignore it? Because we have to lessen the amount of these micro and nanoplastics that are entering our body. We can do something about this. Systemic health risks associated with chronic exposure to carcinogenic chemicals derived from plastics include elevated risks of cancer, respiratory disease, and premature mortality. Now, because of the dental materials, which is the topic of today's episode, we have to be careful not just as a patient, but we You must be careful also as somebody that works in the dental office. Why? Because we have studies, especially if you actually look at this particular, um, review of many studies that were found, uh, in PubMed, is that the dental personnel, such as dental assistants, whenever they're grinding something made out of plastic, they can actually inhale microplastic particles. Those are harder to be eliminated. The cilia in the lung actually can move these microplastic particles out and then they get into the pharynx and then they can be swallowed. And it turns out that not all nanoplastic or not all microplastic particles get absorbed. However, the smaller the particles, especially when we're getting to nanoplastics, those can cross the intestinal barrier and end up in the circulation. So we must be careful. Careful, dental assistants or dentists or anybody grinding plastic, wear a mask because you cannot see these nano and microplastics that are floating in the air. The gastrointestinal tract has emerged as a principal site for micro and nanoparticle accumulation. And of course this makes total sense, especially since, you know, we are drinking out of plastic bottles and there's, you know, plastic containers and also, you know, dentrowares, the resin fillings that we can swallow plastic from. Clinical studies have identified plastic particles in the colonic tissues and feces, with higher levels observed in individuals with inflammatory bowel disease compared to healthy controls. So this actually shows that there might be a relationship between chronic inflammation and microplastic retention. Uh, now microplastics have been detected also in placenta. Confirming prenatal exposure and the capacity of transplacental transfer. So again, these particles are found in all organs. Um, and we don't know exactly what's the best way to detoxify from these nano and microplastics. Inhaled microparticles can penetrate deep in the respiratory tract and persist potentially, uh, causing fibrosis and neoplastic transformation in the lungs. Now, microplastics have been identified in human saliva samples, particularly after the use of plastic containers and food storage. These particles may interact locally with mucosal surfaces and contribute to downstream GI and systemic exposure. In vitro experiments, according to this article, with, with gingival fibroblasts exposed to polystyrene nanoparticles showed cytoskeletal disruption, mitochondrial dysfunction, and increased ROS generation and DNA damage. So in the mouth, fibroblasts are actually part of the gingival health. If you're going to have nanoplastics stuck there. And how would you get nanoplastics? You could get it definitely from a filling. You're going in to replace your mercury fillings with white fillings, and you're not really asking the dentist, hey, are these plastic-based fillings? A lot of the white fillings are plastic-based. Then when they shave this plastic in order to polish it, there's micro and nanoparticles that are being released off the filling into the oral environment. Some of these might actually stay in that gum tissue, especially if your filling is deeper under the gum. And why would your filling be deeper under the gum? Because the cavity was deeper under the gum. So the gingival fibroblast gets affected and the DNA gets damaged inside, leading to chronic inflammation. And according to this article, even genotoxic potential. What does that mean? The ability to cause DNA damage and potentially oral cancer. Super important. What can you do about this as a consumer? Even as a dentist, just be more conscious about the fillings that you're putting inside a tooth. Is there resin-based or is there ceramic-based? We have some great fillings today that are ceramic-based fillings, meaning they're 80 and 90% filled with ceramic particles, which do not contain BPA. We don't have fillings that are completely devoid of polymers. The healthiest option if you want to completely avoid white fillings are ceramics. Ceramics in the form of inlays, onlays, and crowns. And you might say, yeah, you know, I actually have a white filling, but it's pretty small. I don't want to put a crown. No problem. I recommend inlays, which is basically the same filling, but in ceramic form that is actually manufactured in the lab. And then cemented inside the tooth like a puzzle piece. So far from the research that I've done on nanoplastics, that is by far the healthiest way to go. Not using liquid fillings, but actually using ceramic inlays. Onlays is basically just a bigger filling. And then of course, if your filling is large, you're looking at crowns. But you must ask your dentist because not all dentists are trained on making inlays and onlays. So just make sure you ask this question if you're planning on replacing, especially mercury fillings. Don't put in something that's also toxic, that causes microplastics. Go for the healthiest version, which is ceramic made in the lab. Now, animal models of oral exposure had demonstrated deposition of these microplastics in the oral mucosa. So they will stay in the mouth. Some of them are going to go farther down in the intestinal tract. And also in the lymph nodes. Well, 70% of the lymphatic system is lining the GI tract, so it makes sense that, you know, your, um, immune cells will look at these microplastic particles and actually want to gobble them up. Observational studies have further shown that individuals frequently using plastic containers exhibit reduced microbial diversity in the gut. And enrichment of potential pathobionts in their oral and intestinal microbiota, reinforcing the fact that microplastics will contribute to chronic inflammation. So it's also destroying the gut microbiome. As far as the oral microbiome, we don't have concrete studies that will actually disturb because not a lot can stay in the mouth. Sometimes we do see though, from denture wearers that have been wearing dentures for a long time, that their mouth and their tissues start to become bright red, causing this chronic inflammation. We really thought that it was just due to, you know, Candida overgrowth. But now I do think there is a correlation between the microplastics from a denture as well as, you know, this Candida that we see and this inflammation that we see underneath those dentures. Now, human exposure to micro-nanoplastics occurs through ingestion, inhalation, and of course through dermal contact. But when you have skin contact, it's really not as bad. Really, most of it comes from swallowing these micro-nanoplastics and drinking water, bottled water, seafood, commercial salts. You wouldn't think that, but actually commercial salts can be full of nano and microplastics. Tea bags are, is a big one. Why tea bags? Because Tea bags, if you look at it, just make sure it's made out of paper. Some tea bags, especially some of the higher-end tea bags, are now made of this polymer, like this micromesh of plastic. Coffee is another one, um, that this article found, uh, in one of the studies to be contaminated with microplastics. Dairy products, especially in, uh, the plastic gallons of milk, uh, in even the paper, uh, gallon of milk is are actually lined with some form of plastic. Fruits, vegetables, even honey has microplastics. So lots of microplastics have been found everywhere. So it's really a problem. In dentistry, now going back to dentistry, what can we do in order to minimize the absorption of microplastics. Because you have to remember the mouth has direct access to the digestive system and potentially the bloodstream, especially, I always talk about it, anytime gums bleed and you're brushing, there's a potential for microbes to go inside the bloodstream. Now we're talking about nanoplastics, tho— those can easily cross into the bloodstream. Let's talk about these genotoxic effects. When you see this mucosal irritation, That means you've already gotten some cellular toxicity. The cellular toxicity can actually travel all the way to the DNA, and we can see some correlation between possible carcinogenic mechanisms in oral tissues and the presence of microplastics. Now there's another angle to the story. Dentistry is also a major contributor to plastic. Waste. Modern dental clinics rely on large amount of single-use plastic products, suction tips, gloves, impression trays, sterilization packaging, personal protective equipment such as masks, shields that are made out of plastic. The use of disposable plastics increased dramatically during COVID-19 because of infection control protocols. Once discarded, these materials eventually break down into microplastics that contaminate ecosystems. So dentistry isn't an exposure source for patients. It's also part of a larger environmental plastic cycle. What holistic dentistry can do. What is it that we can do? The goal isn't to panic. The goal is awareness and smarter choices. Possible strategies include material selection, use biocompatible materials like I was talking about, use inlays, onlays, crowns instead of plastic fillings. Or plastic crowns. What's interesting when it comes to CAD/CAM design and digital dentistry is that CAD/CAM design of different inlays, onlays, even though they're made out of composite-based material, it's actually a lot lower in micro and nano plastic release than the liquid fillings we actually cure inside the mouth. Another interesting fact on the composite or resin-based fillings or bondings is that in the first 24 to 48 hours, that's when we get most release of the micro and nanoplastics. And we really think that's because the top layer of the filling, or the air-inhibited layer, doesn't cure in the presence of oxygen. And that layer actually gets washed out with saliva. We can reduce single plastics in the clinic where safe alternative exists. So, um, especially with us, we have completely gotten rid of plastic gowns and we're actually using washable gowns. There is a service out there that you can get in order to use disposable plastic gowns, and there is hundreds of thousands, if not millions, of plastic gowns being used every day. I encourage all the dentists listening to actually switch to a washable gown, reusable gown service in order to stop the plastic release in the environment. I do wanna talk about also a little bit about oral care, so make sure you stay tuned to the next episode when I will be talking about that. Now let's talk about night guards to close up this episode. Um, a lot of patients have asked me, Do you have BPA-free night guards? Yes, absolutely. Our 3D-printed night guards actually are BPA-free, but I was mentioning to you earlier that plastics have 13,000 different chemicals inside of them. Can we stop all of them via 3D printing? Unfortunately, we cannot. And another thing that's interesting with 3D printing is it's super important that we cure the material coming out of the 3D printing very well in order to prevent the release, uh, of those microplastics. Then super important to wash really well the 3D printed night guards before handing them to a patient. Now, do we have any other materials to make night guard out of? Yes, we have silicone, but what's the problem with silicone? Silicone is actually soft, so not everybody can, uh, especially the heavy grinders, can actually use silicone. They'll probably wear through that silicone night guard in the first month, so then they'll have to replace that silicone guard so often. The other problem with silicone is that it's soft, and for some people, it actually will make them grind even harder with the use of silicone. So you don't really have an option there. Um, what we are seeing is that people that are actually grinding their night guards, they're releasing microplastics, and these microplastics actually just pass through, through the GI tract. They don't actually get absorbed in the organism. However, That's not any better because if you're looking at the GI environment, we have the microbes, we have the, or the microbiome that we have to worry about. As, as I mentioned earlier, actually the microbiome does get affected with a plastic. So we don't really have a good solution for those heavy bruxers out there. So the story in microplastics and dentistry is just beginning. What we know today is this. Plastic has revolutionized dentistry, but it also introduced a new question: What happens when materials designed to repair the body slowly break down into microscopic particles? Holistic dentistry has always focused on one idea: the mouth is connected to the whole body. And as we learn more about microplastic, that connection becomes even more important. Because the future of dentistry may not just be about stronger materials. It may be about safer ones. For example, we actually have a plastic that's coming out. Some of you might have seen it. It's some of the bags. They're made— it's made out of plant-based, like corn-based plastic. But is that any better? You know, we really don't know. We really don't know if it's better or not. Um, so I invite you to really look at this article. I'm going to post the link of it. It's quite a lengthy article. Um, but Basically, we know that evidence shows that particles can cross biological barriers, persist in tissues, and induce a variety of cellular responses, including oxidative stress, mitochondrial dysfunction, inflammation, and DNA damage. So in light of these findings, the article says promoting a more conscious approach to material selection and handling in dental settings might be beneficial. We all have to be conscious of nano and microplastic, whether in the air, whether in the saliva. So next episode, we are actually going to be talking about microplastic and oral care products. If you found this episode helpful, share it with someone who cares about whole body health and dentistry. And the next time you brush your teeth, you might look look at that toothbrush just a little differently. Thank you very much for joining us on another episode on the Holistic Dentistry Show. See you next time. Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer, message me on Instagram @drsandamoldovan. This is Dr. Sanda Moldovan, and remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.