Cited by 1,256Oral microbiology and periodontitis researchBacterial biofilms and quorum sensingDental Health and Care Utilization

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Are dental diseases examples of ecological catastrophes?

Marsh, P. D.·2003·Microbiology

DOI 10.1099/mic.0.26082-0

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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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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
DOI: 10.1099/mic.0.26082-0
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 › General Dentistry › 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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