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Chapter 2 : The Oral Microbiome
Category: Genomics and Bioinformatics
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This chapter summarizes the recent advancement of our knowledge of the healthy oral microbiome, and address the potential role of the oral microbiome in systemic diseases, including cardiovascular disease and pneumonia. An understanding of the composition of the oral microbial community with respect to oral health is essential for diagnosis, prevention, and treatment of oral diseases. The chapter describes oral microbiome associated with periodontal disease, microbiome associated with endodontic infections, apical periodontitis and tooth decay, and oral microbiome associated with oral cancer. Diseases caused by the oral microbiome are not limited to oral infections. Recognition that disease conditions associated with the oral microbiome contribute to systemic infections may require clinicians to consider alternative preventative and therapeutic approaches. The current data on two of the most-studied systemic conditions, cardiovascular and respiratory diseases are reviewed in the chapter. A community-and microbial ecology-based pathogenic concept that forms the basis for understanding relationships between the oral microbiome and the host, as well as developing novel strategies for therapeutics and disease prevention is discussed in the chapter. A better understanding of the oral microbiome structure and function and the dynamics between the commensals and pathogens is needed to selectively modulate composition of the microbiome and prevent oral disease.
The community-based microbial pathogenesis model. A schematic representation of the interrelationship between health and disease in the human oral environment is shown. The prohibition sign above the arrow indicates a healthy state, in which the host and indigenous commensal microbiome provide essential natural defense mechanisms to maintain an ecological balance in the oral ecosystem. Bacteriocins or other inhibitory metabolites produced by commensal bacteria play a significant role by selecting for the growth of specific species. The host contributes to oral health through the production of antibody (secretory immunoglobulin A [IgA]) and antimicrobial agents such as defensins and histatins, which control pathogenic microorganisms. The “plus” sign below the arrow indicates the shift from a healthy to a disease state, in which the impaired host defense and exogenous factors such as lifestyle (e.g., smoking and drinking alcohol) play dynamic and synergistic roles resulting in an increase in pathogenic members of the microbiome, leading to disease initiation and progression.