Severity-dependent alterations in oral microbiota and antibiotic resistance in children with dental fluorosis

In the paper

“For instance, Wang et al. demonstrated significant alterations in the oral microbial community structure among adolescents with severe dental fluorosis, compared to those without oral health issues [10].”

What the sources say

• Partly supported

  The Abstract reports significant differences in oral microbial community structure between the Healthy group and a combined Moderate/Severe group of adolescents. The Conclusion likewise reports changes in moderate and severe fluorosis compared with healthy teeth, but the passages do not establish a separate result for severe fluorosis alone. (LLM, conf=0.85)

  cites [10] Wang Q, Chen X, Hu H, et al. Structural changes in the oral microbiome of the adolescent patients with moderate or severe dental fluorosis. Sci Rep. 2021; 11(1): 2897. doi: 10.1038/s41598-021-82709-z 33536555 PMC7859183 sourceExperimental — accuracy not yet measured

In the paper

“These species are known to play roles in dental biofilm maturation and oral inflammatory conditions [35,36].”

What the sources say

• Partly supported

  The Abstract and Discussion describe roles for oral bacteria in dental plaque development, including early colonization and links to later colonizers. The Discussion says that whether the plaque structures studied contribute to oral health or progression toward disease remains a question for future study, so the claimed role in oral inflammatory conditions is not established by this paper. (LLM, conf=0.85)

  cites [35] Mark Welch JL, Rossetti BJ, Rieken CW, et al. Biogeography of a human oral microbiome at the micron scale. Proc Natl Acad Sci USA. 2016; 113(6). doi: 10.1073/pnas.1522149113 PMC4760785 26811460 sourceExperimental — accuracy not yet measured
• ?Could not verify

  The 16S rRNA gene clone library-based studies section lists dental-plaque and periodontitis samples, but does not establish that the species meant by “these species” play roles in those conditions. Searches for biofilm maturation and inflammatory conditions found no passage establishing the claimed roles; the species are not identified in the citing sentence provided. (LLM, conf=0.72)

  cites [36] Dewhirst FE, Chen T, Izard J, et al. The human oral microbiome. J Bacteriol. 2010; 192(19): 5002– 5017. doi: 10.1128/jb.00542-10 20656903 PMC2944498 sourceExperimental — accuracy not yet measured

In the paper

“which has been supported by recent evidence showing that moderate disturbance can maximize microbial diversity in human-associated microbial communities [34].”

What the sources say

• Supported

  The Discussion reports a peak in pneumococcal serotype diversity at intermediate levels of vaccine uptake in a study of carriage among children in Portugal. This is evidence that moderate disturbance can maximize diversity in a human-associated microbial community. (LLM, conf=0.90)

  cites [34] Paulo AC, Sá-Leão R. Evidence for the intermediate disturbance hypothesis and exponential decay in replacement in streptococcus pneumoniae following use of conjugate vaccines. Sci Rep. 2022; 12(1): 7510. doi: 10.1038/s41598-022-11279-5 35525872 PMC9079081 source

In the paper

“Previous studies conducted by our team and other laboratories have demonstrated that the supplementation of trace elements, such as copper and zinc, in agricultural environments may lead to an increased incidence of ARGs [13–16].”

What the sources say

• ?Not checked — no full text of the sourcecites [13] Peng S, Zheng H, Herrero-Fresno A, et al. Co-occurrence of antimicrobial and metal resistance genes in pig feces and agricultural fields fertilized with slurry. Sci Total Environ. 2021; 792: 148259. doi: 10.1016/j.scitotenv.2021.148259 34147788 source
• Partly supported

  The Introduction says zinc oxide feed supplementation may increase antimicrobial resistance in bacteria from animals and their excretions; the References also identify a study reporting more resistance genes in zinc-fed pigs. The discussion (p. 233) links copper to induced resistance and plasmid mobilization, but does not establish that copper supplementation increases the incidence of ARGs in agricultural environments. (LLM, conf=0.86)

  cites [14] Peng S, Herrero-Fresno A, Olsen JE, et al. Influence of zinc on CTX-M-1 β-lactamase expression in escherichia coli. Journal of Global Antimicrobial Resistance. 2020; 22: 613– 619. doi: 10.1016/j.jgar.2020.06.004 32540482 sourceExperimental — accuracy not yet measured
• Supported

  The Data source table reports that Cu and Zn exerted selection pressure associated with ARG abundance in feedlot manure and soils. The Conclusion also says trace-metal exposure may contribute to antibiotic resistance and that Zn supplementation in animal feed may increase the proportion of multiresistant E. coli. These passages support the citing sentence’s hedged claim in agricultural settings. (LLM, conf=0.90)

  cites [15] Yazdankhah S, Rudi K, Bernhoft A. Zinc and copper in animal feed – development of resistance and co-resistance to antimicrobial agents in bacteria of animal origin. Microb Ecol Health Dis. 2014; 25(0). doi: 10.3402/mehd.v25.25862 PMC4179321 25317117 source
• Supported

  The Results and discussion report increased tetA and sul1 resistance-gene copy numbers in weaned pigs given high dietary zinc. The same section states that heavy metals including copper and zinc can increase antibiotic resistance, supporting the citing sentence’s hedged claim about trace-element supplementation in an agricultural setting. (LLM, conf=0.88)

  cites [16] Vahjen W, Pietruszyńska D, Starke IC, et al. High dietary zinc supplementation increases the occurrence of tetracycline and sulfonamide resistance genes in the intestine of weaned pigs. Gut Pathog. 2015; 7(1): 23. doi: 10.1186/s13099-015-0071-3 26322131 PMC4551370 source

In the paper

“The overall median UF level was 1.1 mg/L (range 0.4–2.6 mg/L)”

In the paper

“Compared with the Normal and Dubious groups, the Very mild and Mild groups showed a noticeable increase in the number of significant associations, with the Mild group exhibiting the most densely connected network.”

In the paper

“A total of 16 biomarkers were identified in the Normal group, 23 in the Severe group, 6 in the Mild group, 4 in the Very mild group and 3 each in the Dubious and Moderate groups (LDA > 3.5, P < 0.05).”

In the paper

“Among these, Actinomyces sp. HMT 175 exhibited the highest connectivity and co-occurred with 24 ARGs.”

In the paper

“Actinomyces sp. HMT 175, Fusobacterium nucleatum and the carbapenem resistance gene GRD33_1 emerged as central nodes and showed strong positive correlations with UF.”

In the paper

“Yellow edges specifically highlight strong positive associations between UF and three central nodes: Actinomyces sp. HMT 175, Fusobacterium nucleatum and the carbapenem resistance gene GRD33_1, which also shows mutual associations among themselves.”

In the paper

“The most pronounced differences were observed between the Normal and Moderate groups and between the Normal and Severe groups, whereas differences among the Dubious, Very mild and Mild groups were less evident.”

In the paper

“Significant correlations are observed between UF and Actinomyces sp. HMT 175 as well as ARG GRD33_1.”

In the paper

“In contrast, groups with fluorosis (especially Very mild, Mild, Moderate and Severe) generally showed higher diversity, with the Severe group often demonstrating the highest median values.”

In the paper

“However, a recent metagenomic study reported an enrichment of Neisseria sicca in severe dental fluorosis [53], which contrasts with our observed depletion of Neisseria sicca at the species level.”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [53] Ajrithirong P, Krasaesin A, Sriarj W, et al. The metagenome and metabolome signatures of dental biofilms associated with severe dental fluorosis. J Oral Microbiol. 2025; 17(1): 2560591. doi: 10.1080/20002297.2025.2560591 41000239 PMC12459186 source

In the paper

“For example, research by Willis et al. indicated a strong correlation between the composition of tap water and the prevalence of specific bacterial species [11], highlighting the significant impact of drinking water on the oral microbiota.”

What the sources say

• Not checked yetcites [11] Willis JR, González-Torres P, Pittis AA, et al. Citizen science charts two major “stomatotypes” in the oral microbiome of adolescents and reveals links with habits and drinking water composition. Microbiome. 2018; 6(1): 218. doi: 10.1186/s40168-018-0592-3 30522523 PMC6284318 source

In the paper

“Fluoride primarily exerts its effects through topical mechanisms, including inhibiting the demineralization of tooth enamel, enhancing remineralization at crystal surfaces (thereby forming a highly acid-resistant layer) and suppressing bacterial enzymatic activity [9].”

What the sources say

• Not checked yetcites [9] Featherstone JDB. Prevention and reversal of dental caries: role of low level fluoride. Community Dent Oral Epidemiol. 1999; 27(1): 31– 40. doi: 10.1111/j.1600-0528.1999.tb01989.x 10086924

In the paper

“These actions could alter both the oral microbiota and the composition of the tooth surface.”

In the paper

“However, excessive fluoride intake through food, beverages, dental materials or supplements [3], particularly during the critical period of dental development [4,5], can lead to the formation of dental fluorosis, which poses a significant threat to oral health [6].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [3] Medjedovic E, Medjedovic S, Deljo D, et al. IMPACT OF FLUORIDE ON DENTAL HEALTH QUALITY. Mater Sociomed. 2015; 27(6): 395– 398. doi: 10.5455/msm.2015.27.395-398 26889098 PMC4733546 source
• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [4] Kebede A, Retta N, Abuye C, et al. Dietary fluoride intake and associated skeletal and dental fluorosis in school age children in rural Ethiopian rift valley. Int J Environ Res Public Health. 2016; 13(8): 756. doi: 10.3390/ijerph13080756 27472351 PMC4997442 source
• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [5] Petersen PE, Lennon MA. Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach. Community Dent Oral Epidemiol. 2004; 32(5): 319– 321. doi: 10.1111/j.1600-0528.2004.00175.x 15341615 source
• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [6] Green R, Till C, Cantoral A, et al. Associations between urinary, dietary, and water fluoride concentrations among children in Mexico and Canada. Toxics. 2020; 8(4): 110. doi: 10.3390/toxics8040110 33233802 PMC7711675 source

In the paper

“This condition is characterized by hypomineralization of the enamel, manifesting as white spots, yellow to brown discoloration, surface pitting, mottling and increased enamel porosity [7].”

What the sources say

• ?Not checked — no full text of the sourcecites [7] Fomon SJ, Ekstrand J, Ziegler EE. Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants: REVIEW & COMMENTARY. J Public Health Dent. 2000; 60(3): 131– 139. doi: 10.1111/j.1752-7325.2000.tb03318.x 11109209 source

In the paper

“Willis et al. further demonstrated that long-term fluoride exposure in adolescents is associated with distinct oral microbial profiles and environmental influences such as drinking water [11].”

What the sources say

• Not checked yetcites [11] Willis JR, González-Torres P, Pittis AA, et al. Citizen science charts two major “stomatotypes” in the oral microbiome of adolescents and reveals links with habits and drinking water composition. Microbiome. 2018; 6(1): 218. doi: 10.1186/s40168-018-0592-3 30522523 PMC6284318 source

In the paper

“Dental fluorosis was diagnosed jointly by two trained dental practitioners using Dean's criteria, with any discrepancies resolved by a third expert.”

In the paper

“Of the six fluorosis severity groups, the dubious group (Dean's score 0.5) comprised only 10 participants. This limited sample size reduced statistical power for comparisons involving this subgroup and increases the risk of type II error (false negative).”

In the paper

“Moreover, we recognize that the formation of dental plaque is a complex biofilm process influenced by multiple factors, including oral hygiene habits, diet and fluoride use [33].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [33] Rajasekaran JJ, Krishnamurthy HK, Bosco J, et al. Oral microbiome: a review of its impact on oral and systemic health. Microorganisms. 2024; 12(9): 1797. doi: 10.3390/microorganisms12091797 39338471 PMC11434369 source

In the paper

“For most individuals, the primary source of fluoride exposure is drinking water [12].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [12] Martignon S, Bartlett D, Manton DJ, et al. Epidemiology of erosive tooth wear, dental fluorosis and molar incisor hypomineralization in the American continent. CRE. 2021; 55(1): 1– 11. doi: 10.1159/000512483 33440378 source

In the paper

“They possess diverse metabolic capabilities, including the degradation of organic compounds and the production of acidic metabolites such as lactic acid, which can significantly alter the oral pH [39].”

What the sources say

• ?Not checked — no full text of the sourcecites [39] Valliappan K, Sun W, Li Z. Marine actinobacteria associated with marine organisms and their potentials in producing pharmaceutical natural products. Appl Microbiol Biotechnol. 2014; 98(17): 7365– 7377. doi: 10.1007/s00253-014-5954-6 25064352 source

In the paper

“This suggests that elevated UF levels may be associated with bacterial taxa enriched in ARGs, implying a fluoride-associated shift in oral microbiome resistance potential.”

In the paper

“Direct antimicrobial effect: fluoride inhibits sensitive taxa (e.g. Streptococcus, Haemophilus) while favoring tolerant species that possess efficient fluoride export systems [37].”

What the sources say

• Not checked yetcites [37] Banerjee A, Kang CY, An M, et al. Fluoride export is required for the competitive fitness of pathogenic microorganisms in dental biofilm models. mBio. 2024; 15(5): e0018424. doi: 10.1128/mbio.00184-24 38624207 PMC11077948 source

In the paper

“Functional pathway differences were assessed based on KEGG Orthology profiles derived directly from shotgun metagenomic sequencing data. These profiles represent the relative abundance of functional genes (i.e. functional potential) rather than gene expression.”

In the paper

“At first, fluoride exposure may create environmental stress in the oral cavity, and this stress can suppress fluoride-sensitive taxa while allowing fluoride-tolerant species to proliferate, leading to a more diverse community structure [31].”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [31] Mechanisms of action of fluoride for caries control. Monogr Oral Sci. Vol. 22 S. Karger AG; 2011. p. 97– 114. doi: 10.1159/000325151 21701194

In the paper

“This differentiation likely arises from interactions within microbial communities and changes in ecological balance during the development of dental fluorosis”

In the paper

“However, given that all correlation coefficients had absolute rho values ≤ 0.4, these findings should be interpreted with caution and are not indicative of causal relationships.”

In the paper

“Beyond its role in oral disease, Fusobacterium nucleatum has also been associated with cerebral small vessel disease and asymptomatic brain injury in patients with ischemic stroke [43,44].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [43] Chen Y, Shi T, Li Y, et al. Fusobacterium nucleatum: the opportunistic pathogen of periodontal and peri-implant diseases. Front Microbiol. 2022; 13: 860149. doi: 10.3389/fmicb.2022.860149 35369522 PMC8966671 source
• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [44] Patel A, Patel M, Glowacki J. Fusobacterium nucleatum: more than just an oral anaerobe. Cureus. 2022; 7(14): e26989. doi: 10.7759/cureus.26989 PMC9386311 35989742 source

In the paper

“Metagenomic binning was not performed in this study, and thus we cannot determine whether GRD33_1 is physically located within the genome of Actinomyces sp. HMT 175 or any other specific taxon.”

In the paper

“as a well-recognized opportunistic pathogen associated with periodontal disease [43].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [43] Chen Y, Shi T, Li Y, et al. Fusobacterium nucleatum: the opportunistic pathogen of periodontal and peri-implant diseases. Front Microbiol. 2022; 13: 860149. doi: 10.3389/fmicb.2022.860149 35369522 PMC8966671 source

In the paper

“Additionally, the porous enamel as habitats in dental fluorosis provides distinct ecological niches for microbial colonization, potentially supporting a wider array of microorganisms [32]”

What the sources say

• Not checked yetcites [32] Colombo APV, Do Souto RM, Da Silva-Boghossian CM, et al. Microbiology of oral biofilm-dependent diseases: have we made significant progress to understand and treat these diseases?. Curr Oral Health Rep. 2015; 2(1): 37– 47. doi: 10.1007/s40496-014-0041-8

In the paper

“Furthermore, we also find that UF levels, water intake, drinking water source, sleep duration and various dietary and lifestyle factors may influence changes in the dental plaque microbiota of children.”

In the paper

“Indirect ecological effect: increased enamel porosity and surface roughness in dental fluorosis create retentive micro-niches that protect colonizing bacteria from mechanical removal and alter local nutrient availability, facilitating adhesion of specific species such as Fusobacterium nucleatum[38].”

What the sources say

• ?Not checked — no full text of the sourcecites [38] Hu D, Gong J, He B, et al. Surface properties and streptococcus mutans - streptococcus sanguinis adhesion of fluorotic enamel. Arch Oral Biol. 2021; 121: 104970. doi: 10.1016/j.archoralbio.2020.104970 33202357 source

In the paper

“A total of 118 children were initially recruited; however, 22 were excluded due to incomplete survey data or sample collection. Ultimately, 96 children were included in the final analysis.”

In the paper

“These findings link fluorosis severity not only to compositional changes but also to functional attenuation of the oral microbiota.”

In the paper

“For example, copper has been proven to promote tetracycline resistance more effectively than exposure to tetracycline alone [17].”

What the sources say

• ?Not checked — no full text of the sourcecites [17] Song J, Rensing C, Holm PE, et al. Comparison of metals and tetracycline as selective agents for development of tetracycline resistant bacterial communities in agricultural soil. Environ Sci Technol. 2017; 51(5): 3040– 3047. doi: 10.1021/acs.est.6b05342 28198616 source

In the paper

“Once dental fluorosis occurs, it is irreversible and can significantly affect a child's oral health as well as their psychological well-being, since the brown stains on teeth are often perceived as unsightly [20,21].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [20] Akuno MH, Nocella G, Milia EP, et al. Factors influencing the relationship between fluoride in drinking water and dental fluorosis: a ten-year systematic review and meta-analysis. J Water Health. 2019; 17(6): 845– 862. doi: 10.2166/wh.2019.300 31850893 source
• ?Not checked — no full text of the sourcecites [21] Augustsson A, Berger T. Assessing the risk of an excess fluoride intake among Swedish children in households with private wells — expanding static single-source methods to a probabilistic multi-exposure-pathway approach. Environ Int. 2014; 68: 192– 199. doi: 10.1016/j.envint.2014.03.014 24747328 source

In the paper

“Among these taxa, Corynebacterium matruchotii is a calcifying bacterium that has been associated with urinary tract infections [40] and bacteremia [41], and in rare cases, fluoride-related bone pathology such as tibial osteomyelitis [42].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [40] Rusmir AV, Paunescu IA, Martis S, et al. Encrusted uretero-pyelitis caused by corynebacterium urealyticum: case report and literature review. Diagnostics. 2022; 12(9): 2239. doi: 10.3390/diagnostics12092239 36140640 PMC9497590 source
• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [41] Bouguerra L, Dupraz C, Plouzeau C, et al. First bacteremia due to corynebacterium gottingense in an immunocompromised child: a case report, 16S rDNA-Based phylogenetic analyses and review of the literature. Antibiotics. 2023; 12(3): 528. doi: 10.3390/antibiotics12030528 36978395 PMC10044508 source
• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [42] Ansari A, Shoaib D, Asfour M, et al. Corynebacterium minutissimum as a rare cause of tibial osteomyelitis: a case report and literature review. Cureus. 2024; 2(16): e75885. doi: 10.7759/cureus.75885 PMC11738086 39822436 source

In the paper

“Members of the phylum Actinobacteria are widely distributed in various environments, including soil, marine ecosystems and even the atmosphere [39].”

What the sources say

• ?Not checked — no full text of the sourcecites [39] Valliappan K, Sun W, Li Z. Marine actinobacteria associated with marine organisms and their potentials in producing pharmaceutical natural products. Appl Microbiol Biotechnol. 2014; 98(17): 7365– 7377. doi: 10.1007/s00253-014-5954-6 25064352 source

In the paper

“Similar findings have been reported in environmental and animal studies, where metals and chemical compounds (e.g. sodium hypochlorite, artificial sweetener) co-select for resistance determinants in microbial communities [17,55–57].”

What the sources say

• ?Not checked — no full text of the sourcecites [17] Song J, Rensing C, Holm PE, et al. Comparison of metals and tetracycline as selective agents for development of tetracycline resistant bacterial communities in agricultural soil. Environ Sci Technol. 2017; 51(5): 3040– 3047. doi: 10.1021/acs.est.6b05342 28198616 source
• ?Not checked — no full text of the sourcecites [55] Li X, Yu Z, Ye J, et al. Dual disinfectants synergistically drive adaptation and evolution toward higher antimicrobial resistance and pathogenicity in escherichia coli. Environ Sci Technol. 2025; 59(25): 12472– 12484. doi: 10.1021/acs.est.4c13071 40518995 source
• ?Not checked — no full text of the sourcecites [56] Yang G, Cao JM, Cui HL, et al. Artificial sweetener enhances the spread of antibiotic resistance genes during anaerobic digestion. Environ Sci Technol. 2023; 57(30): 10919– 10928. doi: 10.1021/acs.est.2c08673 37475130 source
• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [57] Zhao Y, Cocerva T, Cox S, et al. Evidence for co-selection of antibiotic resistance genes and mobile genetic elements in metal polluted urban soils. Sci Total Environ. 2019; 656: 512– 520. doi: 10.1016/j.scitotenv.2018.11.372 30529954 source

In the paper

“support the hypothesis that dental fluorosis is associated not only with changes in microbial composition but also with impaired or restructured metabolic potential of the oral microbiome.”

In the paper

“In addition, Rothia dentocariosa, although its direct relationship with dental fluorosis remains unclear, has been implicated in oral leukoplakia [45], endocarditis and meningitis [46].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [45] Amer A, Whelan A, Al-Hebshi NN, et al. Acetaldehyde production by rothia mucilaginosa isolates from patients with oral leukoplakia. J Oral Microbiol. 2020; 12(1): 1743066. doi: 10.1080/20002297.2020.1743066 32341761 PMC7170386 source
• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [46] Elkattawy S, Alyacoub R, Younes I, et al. A rare report of rothia dentocariosa endocarditis. J Community Hosp Intern Med Perspect. 2021; 11(3): 413– 415. doi: 10.1080/20009666.2021.1880539 34234918 PMC8118413 source

In the paper

“suggests that chronic fluoride intake may exert co-selective stress that favors the proliferation of fluoride-tolerant taxa and the enrichment of ARGs.”

In the paper

“a single spot urinary UF measures recent exposure only, not reflecting long-term oral pressure”

In the paper

“Furthermore, Rothia and other Actinobacteria are dominant in the oral microbiome of patients with hematologic malignancies [47]”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [47] Amer A, Galvin S, Healy CM, et al. The microbiome of potentially malignant oral leukoplakia exhibits enrichment for fusobacterium, leptotrichia, campylobacter, and rothia species. Front Microbiol. 2017; 8: 2391. doi: 10.3389/fmicb.2017.02391 29250055 PMC5717034 source

In the paper

“First, the sample size is unbalanced across fluorosis severity groups, with the dubious group containing only ten participants, which may reduce statistical power and increase the risk of type II error.”

In the paper

“Specifically, daily tooth brushing frequency (BF) [61], sugar-containing snacks (Sugar) [62], sugary drinks (SD) [63] and starchy snacks (Starch) may impact the composition of the oral microbiota [11]”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [61] Barbe AG, Küpeli LS, Hamacher S, et al. Impact of regular professional toothbrushing on oral health, related quality of life, and nutritional and cognitive status in nursing home residents. Int J Dental Hygiene. 2020; 18(3): 238– 250. doi: 10.1111/idh.12439 32329175 source
• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [62] Haque M, McKimm J, Sartelli M, et al. A narrative review of the effects of sugar-sweetened beverages on human health: a key global health issue. jptcp. 2020; 27(1): e76– e103. doi: 10.15586/jptcp.v27i1.666 32170920 source
• Not checked yetcites [63] Katarzyna G, Alina K, Paweł R, et al. Consumption of sweetened beverages as a risk factor of colonization of oral cavity by fungi – eating habits of university students. Annals of Parasitology. 2015;(3): 175– 182. doi: 10.17420/ap6103.04 26568990

In the paper

“These results suggest that, beyond fluoride exposure, daily behaviors and dietary patterns may modulate the oral microbiome, but due to the weak correlation strengths, these findings are preliminary and require validation in larger, well-controlled cohorts with consideration of potential confounders.”

In the paper

“As common members of the healthy oral microbiota and human pharyngeal community [50].”

What the sources say

• ?Not checked — no full text of the sourcecites [50] Shan X, Chen S, Bai A, et al. Dynamic pharyngeal carriage of neisseria species in healthy population. Infect Genet Evol. 2024; 125: 105684. doi: 10.1016/j.meegid.2024.105684 39454929 source

In the paper

“This discrepancy may arise from differences in fluoride exposure sources, sampling sites or population characteristics, highlighting the need for harmonized multicohort validation.”

In the paper

“Neisseria species are generally regarded as beneficial colonizers.”

In the paper

“Fluoride is known for its antimicrobial properties; however, many microorganisms have developed fluoride exporters to mitigate its toxic effects [59], which may provide a survival advantage in high-fluoride environments.”

What the sources say

• ?Not checked — no full text of the sourcecites [59] Kouidhi B, Al Qurashi YMA, Chaieb K. Drug resistance of bacterial dental biofilm and the potential use of natural compounds as alternative for prevention and treatment. Microb Pathog. 2015; 80: 39– 49. doi: 10.1016/j.micpath.2015.02.007 25708507 source

In the paper

“Bacterial metabolic pathways play a crucial role in maintaining oral health by supporting microbial balance and host [54].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [54] Ran S, Sun N, Liu Y, et al. Fluoride resistance capacity in mammalian cells involves complex global gene expression changes. FEBS Open Bio. 2017; 7(7): 968– 980. doi: 10.1002/2211-5463.12236 PMC5494298 28680810 source

In the paper

“and our questionnaire's highest frequency category further limits the ability to distinguish higher exposure levels.”

In the paper

“hinting at a possible regulatory role of hydration in the oral microenvironment [60], although this association is modest.”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [60] Nascimento MM, Alvarez AJ, Huang X, et al. Metabolic profile of supragingival plaque exposed to arginine and fluoride. J Dent Res. 2019; 98(11): 1245– 1252. doi: 10.1177/0022034519869906 31454264 PMC6755720 source

In the paper

“This pattern may suggest a dual effect of fluoride on these bacteria, but the weak correlation precludes definitive conclusions.”

In the paper

“This ecological shift disfavors Neisseria and promotes pathogenic taxa, explaining its subsequent decline and the establishment of a more disease-associated ecosystem.”

In the paper

“Likewise, Haemophilus species are common respiratory pathogen, and oral whole-cell killing of non-typing Haemophilus influenzae have been shown to enhance respiratory tract protection [49].”

What the sources say

• Not checked yet

  Checked before — its earlier verdict is held back until a new check runs.

  cites [49] Clancy RL, Cripps AW. An oral whole-cell killed nontypeable haemophilus influenzae immunotherapeutic for the prevention of acute exacerbations of chronic airway disease. COPD. 2019; 14: 2423– 2431. doi: 10.2147/COPD.S217317 PMC6821045 31695359 source

In the paper

“Our findings highlight the potential impact of UF on oral microbiota and its ARGs characteristics.”