Towards Understanding Oral Health

Abstract

During the last century, dental research has focused on unraveling the mechanisms behind various oral pathologies, while oral health was typically described as the mere absence of oral diseases. The term ‘oral microbial homeostasis' is used to describe the capacity of the oral ecosystem to maintain microbial community stability in health. However, the oral ecosystem itself is not stable: throughout life an individual undergoes multiple physiological changes while progressing through infancy, childhood, adolescence, adulthood and old age. Recent discussions on the definition of general health have led to the proposal that health is the ability of the individual to adapt to physiological changes, a condition known as allostasis. In this paper the allostasis principle is applied to the oral ecosystem. The multidimensionality of the host factors contributing to allostasis in the oral cavity is illustrated with an example on changes occurring in puberty. The complex phenomenon of oral health and the processes that prevent the ecosystem from collapsing during allostatic changes in the entire body are far from being understood. As yet individual components (e.g. hard tissues, microbiome, saliva, host response) have been investigated, while only by consolidating these and assessing their multidimensional interactions should we be able to obtain a comprehensive understanding of the ecosystem, which in turn could serve to develop rational schemes to maintain health. Adapting such a ‘system approach' comes with major practical challenges for the entire research field and will require vast resources and large-scale multidisciplinary collaborations.

Bacterial salivary microbiome associates with asthma among african american children and young adults

“…Third, we did not take into account as confounder factors the use of antibiotics or diet since this information was not surveyed during recruitment. However, the salivary microbiota composition is very stable over time and has been found that is not easily altered by antibiotic use . In fact, a previous study analyzing the salivary microbiome in relation to asthma showed that antibiotic treatment was not a confounder factor .…”

Periodontal health

“…Rather, they are complex diseases of multifactorial nature involving an intricate interplay between the subgingival microbiota, the host immune and inflammatory responses, and environmental modifying factors . Thus, periodontal health must not be considered solely in the context of plaque/bacteria levels and control but must embrace a holistic consideration and evaluation of all factors responsible for the emergence of disease, as well as the restoration and maintenance of health …”

What Are We Learning and What Can We Learn from the Human Oral Microbiome Project?

“…Changes in one or more of these components of a microbial niche may cause a potential pathobiont to become dominant, creating a dysbiotic, or disease-favoring environment. Perhaps most interestingly, the microbial communities associated with dental caries show reduced diversity in the extent of microbial species [21, 22]; whereas, the periodontal disease pockets exhibit greater diversity [27, 12, 28, 29], likely indicating that availability of human cell constituents, crevicular fluid, and blood provide abundant substrates for growth of many bacterial species. Whereas, on the tooth surfaces, erosion of enamel by bacteria is caused by prolonged exposure to organic acids, leading to localized pH values well below the limits of survival by many competing bacteria.…”

“…The combination of meta-genomics and metabolomics has recently been reported in studies with multiple oral bacterial species, in work designed to follow the development of bacterial products over time, as would be expected in healthy and disease sites [37]. As impressive as the science has been, it is clear that the models, and technologies are rapidly advancing, with their potential usefulness in personalized dental medicine now in the realm of the conceivable [29, 28, 38, 39]. …”