Are dental diseases examples of ecological catastrophes?
Abstract
Dental diseases are among the most prevalent and costly diseases affecting industrialized societies, and yet are highly preventable. The microflora of dental plaque biofilms from diseased sites is distinct from that found in health, although the putative pathogens can often be detected in low numbers at normal sites. In dental caries, there is a shift towards community dominance by acidogenic and acid-tolerant Gram-positive bacteria (e.g. mutans streptococci and lactobacilli) at the expense of the acid-sensitive species associated with sound enamel. In contrast, the numbers and proportions of obligately anaerobic bacteria, including Gram-negative proteolytic species, increase in periodontal diseases. Modelling studies using defined consortia of oral bacteria grown in planktonic and biofilm systems have been undertaken to identify environmental factors responsible for driving these deleterious shifts in the plaque microflora. Repeated conditions of low pH (rather than sugar availability per se) selected for mutans streptococci and lactobacilli, while the introduction of novel host proteins and glycoproteins (as occurs during the inflammatory response to plaque), and the concomitant rise in local pH, enriched for Gram-negative anaerobic and asaccharolytic species. These studies emphasized (a). significant properties of dental plaque as both a biofilm and a microbial community, and (b). the dynamic relationship existing between the environment and the composition of the oral microflora. This research resulted in a novel hypothesis (the 'ecological plaque hypothesis') to better describe the relationship between plaque bacteria and the host in health and disease. Implicit in this hypothesis is the concept that disease can be prevented not only by directly inhibiting the putative pathogens, but also by interfering with the environmental factors driving the selection and enrichment of these bacteria. Thus, a more holistic approach can be taken in disease control and management strategies.
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Caries and periodontal disease are polymicrobial, plaque-mediated infections thought to result from perturbation of a healthy, ecologically balanced oral biofilm that can occur from dietary changes such as increased consumption of fermentable carbohydrates.
“Caries and periodontal disease are both polymicrobial, plaque-mediated infections, thought to result from perturbation of a healthy, ecologically balanced oral biofilm23,24 that can occur from dietary changes, such as the increased consumption of fermentable carbohydrates25,26.”
From Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions (2013) · cites this paper as [24]
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- Authors
- Marsh, P. D.
- Affiliations
- Research Division, Centre for Applied Microbiology and Research, Salisbury SP4 0JG, and Division of Oral Biology, Leeds Dental Institute, Clarendon Way, Leeds LS2 9LU, UK
- Corresponding author
- Marsh, P. D.
- ORCID
- Marsh, P. D.
- Venue
- Microbiology
- Publisher
- Microbiology Society
- Published
- 2003-02-01
- Volume
- 149
- Issue
- 2
- Pages
- 279-294
- ISSN
- 1350-0872 (ISSN-L)
- 1465-2080
- OpenAlex
- W2098976315
- Cited by
- 1,256
- References
- 105
- Citations by year
- 2026: 40 · 2025: 54 · 2024: 56 · 2023: 50 · 2022: 74 · 2021: 79 · 2020: 63 · 2019: 76 · 2018: 58 · 2017: 76 · 2016: 75 · 2015: 81 · 2014: 83 · 2013: 57 · 2012: 54
- FWCI
- 24.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Microbiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Keywords
- dental plaque, oral microbiota, dental caries, periodontal disease, mutans streptococci, lactobacilli, Gram-negative anaerobic bacteria, acidogenic bacteria, microbial community dynamics, disease prevention, oral microbiology
- MeSH terms
- Bacteria, Anaerobic, Dental Plaque, Gram-Negative Anaerobic Bacteria, Gram-Positive Bacteria, Homeostasis, Humans, Mouth, Periodontal Diseases, Tooth Diseases, Ecosystem
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