Exploiting the oral microbiome to prevent tooth decay: Has evolution already provided the best tools?
Open accessAbstract
To compete in the relatively exposed oral cavity, resident microbes must avoid being replaced by newcomers. This selective constraint, coupled with pressure on the host cultivate a beneficial microbiome, has rendered a commensal oral microbiota that displays colonization resistance, protecting the human host from invasive species, including pathogens. Rapid increases in carbohydrate consumption have disrupted the evolved homeostasis between the oral microbiota and dental health, reflected by the high prevalence of dental caries. Development of novel modalities to prevent caries has been the subject of a breadth of research. This minireview provides highlights of these endeavors and discusses the rationale and pitfalls behind the major avenues of approach. Despite efficacy, fluoride and other broad-spectrum interventions are unlikely to further reduce the incidence of dental caries. The most promising methodologies in development are those that exploit the exclusive nature of the healthy oral microbiome. Probiotics derived from the dental plaque of healthy individuals sharply antagonize cariogenic species, such as Streptococcus mutans. Meanwhile, targeted antimicrobials allow for the killing of specific pathogens, allowing reestablishment of a healthy microbiome, presumably with its protective effects. The oral microbiota manufactures a massive array of natural products, some of which are correlated with health, are likely to antagonize pathogens, and await further exploration. The prohibitive cost associated with sufficiently rigorous clinical trials, and the status of dental caries as a non-life-threatening condition will likely continue to impede the advancement of new therapeutics to market. Nevertheless, there is room for optimism, as it appears evolution may have already provided the best tools.
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Intake of particular foods such as farmed animal meat, dairy products, refined vegetable oils, and processed cereals affects the composition of the microbiota, leading to an increased representation of acid-producing and acid-tolerant organisms and periodontal pathogens.
“it has been observed that the intake of particular foods, such as farmed animal meat, dairy products, refined vegetable oils, and processed cereals, affects the composition of the microbiota, leading to an increased representation of acid-producing and acid-tolerant organisms and periodontal pathogens.”
From A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis (2022) · cites this paper as [3]
The influence of diet on the oral microbiome has become more evident over the last decades while observing a shift toward a Westernized dietary pattern characterized by farmed animal meats, high-sugary dairy products, refined vegetable oils, and processed grains, accompanied by pathological changes in the oral microbiota, including increased representation of acid-producing and acid-tolerant.
“The influence of diet on the oral microbiome has become more evident over the last decades while observing a shift toward a “Westernized” dietary pattern characterized by staple foods, such as farmed animal meats, high-sugary dairy products, refined vegetable oils, and processed grains that were accompanied by pathological changes in the oral microbiota, including increased representation of acid-”
From A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis (2022) · cites this paper as [3]
Pioneer microbial colonizers of the oral cavity, such as Streptococcus mitis, Streptococcus sanguinis, Streptococcus gordonii, and Streptococcus salivarius, can bind selectively to tongue and cheek cells before the teeth emerge and can outcompete other microbial species.
“Pioneer microbial colonizers of the oral cavity, such as Streptococcus mitis, Streptococcus sanguinis, Streptococcus gordonii, and Streptococcus salivarius, display core characteristics that make them well suited to this specific niche as they are able to bind selectively to tongue and cheek cells before the teeth emerge and can outcompete other microbial species.17, 19”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [17]
Changes in diet were paralleled by pathologic changes to the oral microbiota, including greater representation of acid-producing and acid-tolerant organisms and periodontal pathogens.
“Such changes in diet were paralleled by pathologic changes to the oral microbiota, including greater representation of acid‐producing and acid‐tolerant organisms and periodontal pathogens.17, 22, 24, 25”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [17]
The Agricultural and Industrial Revolutions resulted in historic boosts of sugar intake, and rates of sugar intake have been rising ever since.
“The Agricultural (~10,000 years ago) and Industrial (~200 years ago) Revolutions resulted in historic boosts of sugar intake, and the rates of sugar intake have been rising ever since.”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [17]
Alcohol-containing mouthwashes can exacerbate bad breath by reducing production of saliva in the mouth.
“Furthermore, alcohol‐containing mouthwashes can exacerbate bad breath, a common driver of mouthwash use, by reducing production of saliva in the mouth.”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [17]
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- Authors
- Baker, J. L., & Edlund, A.
- Affiliations
- J. Craig Venter Institute (US)
- Corresponding author
- Edlund, Anna
- Venue
- Frontiers in Microbiology
- Publisher
- Frontiers Media SA
- Published
- 2019-01-11
- Volume
- 9
- Pages
- 3323-3323
- ISSN
- 1664-302X (ISSN-L)
- PMC
- PMC6338091
- OpenAlex
- W2910410162
- Cited by
- 118
- References
- 60
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 16 · 2023: 16 · 2022: 22 · 2021: 17 · 2020: 14 · 2019: 7 · 2017: 1
- FWCI
- 17.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Microbiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Dental and Craniofacial Research (R00DE024543, F32DE026947)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- oral microbiota, dental caries prevention, colonization resistance, probiotics, dental plaque, Streptococcus mutans, natural products, carbohydrate intake, fluoride, commensal bacteria, host-microbe interactions
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