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The human microbiome is a complex and diverse ecosystem of microorganisms that inhabit various parts of our body, including the skin, gut, mouth and reproductive tract. In recent years, the oral microbiome has gained significant attention due to its immense role in overall health and disease. Various studies have emphasised the importance of maintaining oral health to prevent diseases and infections.

What is the oral microbiome?

The oral microbiome is the collective microbial community that inhabits the mouth or oral cavity. It comprises various microorganisms such as bacteria, viruses and fungi that form a complex and diverse ecosystem. The oral microbiome contributes significantly to the normal function of the oral cavity, oral hygiene and digestion. The oral microorganisms are involved in various metabolic and physiological processes that contribute to the well-being of the host.

Structure of the oral microbiome

The bacterial community is the most abundant and diverse, comprising over 800 different species. These can be divided into two groups based on their oxygen sensitivity: aerobes and anaerobes. The oral microbiome also consists of viruses and fungi that play crucial roles in shaping the oral microbial community.

The oral microbiome varies between individuals, depending on various factors such as age, diet, genetics and environmental factors.

Function of the oral microbiome

The oral microbiome plays a crucial role in maintaining oral health and function. The microorganisms in the oral cavity contribute to the digestion of food, maintenance of a healthy oral environment and protection against pathogens. The oral microbiome also has an essential role in the immune response and modulation of inflammation. The oral microbiome produces various metabolites such as short-chain fatty acids that promote a healthy ecosystem and contribute to overall health.

Potential health implications of the oral microbiome

The oral microbiome has been implicated in various health conditions and diseases, indicating its potential health implications. Poor oral hygiene and an imbalance in the oral microbiome can lead to various oral conditions such as tooth decay, periodontal disease and oral infections. The oral microbiome has also been associated with systemic health conditions such as diabetes, cardiovascular disease and cancer. An imbalance in the oral microbiome can lead to dysbiosis, which can contribute to the pathogenesis of various diseases.

Healthy oral microbiome

Ahealthy oral microbiome is characterised by a diverse bacterial community that is in balance. Beneficial bacteria, such as Streptococcus salivarius, produce antimicrobial compounds that inhibit the growth of harmful bacteria. Good oral hygiene practices, such as regular brushing and interdental cleaning, can help maintain a healthy oral microbiome by removing plaque and preventing the build-up of harmful bacteria.

Oral microbiome and disease

Dysbiosis, or an imbalance in the oral microbiome, can lead to various diseases such as tooth decay, periodontal disease and oral cancer. For example, tooth decay is caused by bacterial acid production that can dissolve enamel and dentine. The bacteria responsible for tooth decay are primarily from the Streptococcus and Lactobacillus genera. Periodontitis is caused by the accumulation of plaque and tartar, leading to inflammation and ultimately destruction of the periodontal ligament. The bacteria responsible for periodontitis are primarily Porphyromonas Gingivalis (p.ginig) and Treponema denticola.

Future directions

The field of oral microbiome research remains relatively new and there is much left to learn about the interactions between the diverse microbial community and the host. Advancements in technology, such as next-generation sequencing and metagenomics, provide new opportunities to investigate the oral microbiome’s complexities further. Studying the interactions between the oral microbiome and the immune system could lead to the development of new treatments for oral diseases.

In conclusion, the oral microbiome is a crucial component of the human microbiome and plays a crucial role in maintaining oral health and overall health. The diversity and balance of microorganisms in the oral cavity are crucial for optimal function and immune response. The oral microbiome has immense potential in predicting and preventing various diseases and conditions by providing insights into the balance and diversity of microorganisms in the oral cavity. Maintaining good oral hygiene and a healthy oral environment can promote a healthy ecosystem and contribute to overall health and well-being.

References

1. Human Microbiome Project Consortium. Structure, function and diversity of the healthy human microbiome. Nature 2012; 486: 207-14.

2. Baker JL, Bor B, Agnello M, et al. Oral microbiome composition reflects prospective risk for esophageal cancers. Cancer Res 2020; 80: 554-63.

3. Man WH, de Steenhuijsen Piters WA, Bogaert D. The microbiota of the respiratory tract: gatekeeper to respiratory health. Nat Rev Microbiol 2017; 15: 259-70.

4. Belkaid Y, Hand TW. Role of the microbiota in immunity and inflammation. Cell 2014; 157: 121-41.

About the author

Tabitha Acret graduated from Newcastle University with a Bachelor of Oral Health and is currently studying her Masters in Public Health. She was previously the National Vice-President for the DHAA. Tabitha currently works as a clinical educator for implant maintenance and non-surgical periodontal therapy and lectures nationally and internationally on motivating patients, implant maintenance, disease prevention and periodontal therapy. Outside of her busy work life of lecturing and working clinically in private practice, Tabitha enjoys volunteering both locally and internationally to raise awareness and education of the benefits of good oral health. She was the winner of the 2018 leadership award in dental hygiene and 2019 award for clinical excellence.

Understanding the oral microbiome

TQuestion 1. The oral microbiome contains?

a. Bacteria b. Viruses c. Fungi d. All of the above

Question 2. How many different species of bacteria does the oral microbiome contain: a. 200+ b. 400+ c. 800+ d. 1000+ e. 2000+

Question 3. Dysbiosis is: a. The process by which bacteria feed on sugar and form plaque. b. An imbalance in the oral microbiome. c. The inflammatory response that destroys the periodontal ligament. d. A reduced immune response based on poor oral hygiene.

Question 4. The bacteria responsible for periodontitis are primarily: a. Porphyromonas Gingivalis and Treponema denticola b. Streptococcus salivarius c. Lactobacillus salivarius d. Granulicatella adiacens

Question 5. The health of the oral microbiome has been associated with systemic health conditions such as: a. Diabetes b. Cardiovascular disease c. Cancers d. All of the above

Seven ways to achieve brighter teeth

Question 6. A common contributor to external stains on teeth are: a. Tannins and polyphenols from beverages such as tea, coffee and red wine. b. Coloured molecules from beverages such as cola drinks. c. Pigments from foods such as berries and soy sauce. d. Mouth rinses like chlorhexidine and quaternary ammonium compounds. e. All of the above.

Question 7. The most widely used abrasive particle in toothpastes has an RDA rating of: a. Low b. Medium c. Highly d. Harmful a. CPP-ACP b. Sodium hexametaphosphate c. Copper phthalocyanine d. PAP+ and nano hydroxyapatite

Question 8. A short term improvement in the optical properties of teeth can be achieved with the toothpaste ingredient...

Question 9. A highly abrasive ingredient in toothpaste is: a. Sodium bicarbonate b. Brushite c. Perlite d. Hydrated silica e. Calcium pyrophosphate

Question 10. Shade reversion agents remove extrinsic stains and provide a permanent brightening effect: a. True b. False

Tooth surface protectionfrom concept to clinic

acid produced by dental plaque biofilms coming into contact with the enamel. Later work done in my lab by Jason Yap showed that modern fissure sealant materials and nano filled resins protect enamel from acid attack in the same way as the early materials of the 1960s. At the edge of the resin material, where a cariogenic dental plaque biofilm is present, a zone of demineralisation develops. Hence, with such materials, it is important to cover the area that you want to protect. This then leads onto the major problem with resin-based materials, which was the difficulty of reliably bonding a resin to partially erupted teeth where crevicular fluid, dental plaque and saliva were likely to be present. All of these local factors can impede the adhesion of resin to etched enamel. Adding to this, on erupting teeth, the most superficial layers of the enamel are aprismatic and as a result, do not etch particularly well. Areas of enamel may be present on newly erupted teeth that are not fully mineralised. To address these concerns, the concept of using glass ionomer cement as a less technique-sensitive and

Question 11. A zone of demineralisation develops at the edge of resin-based sealants: a. Due to the difficulty of reliably bonding. b. As the most superficial layers of enamel are aprismatic. c. As a cariogenic dental plaque biofilm is present. d. All of the above.

Question 12. Fluoride containing glass ionomer cements are “recharged” when exposed to: a. Fluoride containing toothpaste. b. Fluoride gel. c. Fluoride mouth rinse. d. All of the above.

Question 13. Fuji VII EP contains: a. Hydroxyapatite. b. Fluorapatite. c. CPP-ACP d. All of the above.

Question 14. A fundamental limitation of the concept of chemical synthesis of enamel is that it lacks the organic matrix structure which guides the formation of enamel by ameloblasts: a. True b. False

Question 15. Pellicle acts as a semipermeable ionic membrane protecting teeth from strong erosive challenges: a. True b. False

Question 16. Correct and proper instrument reprocessing is the responsibility of the: a. The chairside nurse. b. The sterilisation area nurse. c. The treating clinician. d. The practice manager.

Question 17. When using cassettes in an optimal workflow, instruments are removed from the cassette: a. Chairside. b. On entering the sterilistion area. c. Prior to ultrasonic cleaning or automated washing. d. Prior to sterilisation. e. All of the above.

Question 18. Using cassettes: a. Keeps instruments organised in sets. b. Mitigates the risks of sharps injury due to reduced instrument handling. c. Eliminates manual instrument cleaning and sorting. d. All of the above.

Question 19. The “magic window” is a reference to: a. Large internal windows into the sterilising room to give patients an opportunity to view reprocessing. b. The dispensary at dental school where students collected their instruments. c. The limited understanding of students about how instruments are reprocessed. d. All of the above.

Question 20. Patients are more impressed by instruments in a cassette than a scary pile of instruments on a tray: a. True b. False