Impact of systemic factors in shaping the periodontal microbiome

Abstract

Since 2010, next‐generation sequencing platforms have laid the foundation to an exciting phase of discovery in oral microbiology as it relates to oral and systemic health and disease. Next‐generation sequencing has allowed large‐scale oral microbial surveys, based on informative marker genes, such as 16S ribosomal RNA, community gene inventories (metagenomics), and functional analyses (metatranscriptomics), to be undertaken. More specifically, the availability of next‐generation sequencing has also paved the way for studying, in greater depth and breadth, the effect of systemic factors on the periodontal microbiome. It was natural to investigate systemic diseases, such as diabetes, in such studies, along with systemic conditions or states, , pregnancy, menopause, stress, rheumatoid arthritis, and systemic lupus erythematosus. In addition, in recent years, the relevance of systemic “variables” (ie, factors that are not necessarily diseases or conditions, but may modulate the periodontal microbiome) has been explored in detail. These include ethnicity and genetics. In the present manuscript, we describe and elaborate on the new and confirmatory findings unveiled by next‐generation sequencing as it pertains to systemic factors that may shape the periodontal microbiome. We also explore the systemic and mechanistic basis for such modulation and highlight the importance of those relationships in the management and treatment of patients.

Self-reported prevalence of periodontal disease among the Spanish population and immigrants: 2006, 2011/12 and 2017: a population-based study

“…Finally, in relation to the variables studied, only some sociodemographic factors, such as sex and age, were controlled for, but there may be others that influence oral health, such as smoking [ 28 , 29 ], psychological stress [ 29 ], diabetes, pregnancy [ 30 ], menopause, rheumatoid arthritis, systemic lupus erythematosus [ 31 ], vitamin C consumption [ 32 , 33 ] or other nutritional factors [ 33 , 34 ]. Other self-reported surveys to evaluate periodontitis collect more factors that can influence periodontal diseases, such as sociodemographic characteristics, oral hygiene behaviors, and periodontal measurements [ 9 , 10 ].…”

Oral Microbiota: A Major Player in the Diagnosis of Systemic Diseases

“…During pregnancy, physiological, immunological, and hormonal modifications occur in the mother, increasing her susceptibility to infections, including oral and periodontal diseases [153,154]. Also, changes in estrogen and progesterone levels affect the composition of the oral microbiota, which becomes compatible with the development of gingivitis and periodontitis [157,158]. Oral saliva of pregnant women that underwent 16S rRNA gene sequencing shows that the oral microbial diversity is relatively stable during pregnancy.…”

“…As summarized in Figure 2, the literature shows increased evidence on the links between the oral cavity, its dysbiotic microbiota, and systemic diseases [8,157,242]. Oral diseases are now considered to be the consequence of a deleterious change in the balance of the oral microbiota making oral microbiota identification and management a major research axis of great interest for practitioners (Figure 3).…”

Microbiomics: Were we all wrong before?

“…We are also discovering that modulating the oral microbiome has beneficial effects on conditions such as gut dysbiosis and hyperglycemia 29,30 . In their treatise, Teles et al 31 explore the links between systemic conditions and diseases—such as pregnancy, diabetes, and rheumatoid arthritis—and the oral microbiome, highlighting the importance of periodontal infectogenomics as an emerging field of study.…”