Latest microbiome-supportive therapies

A microbiome-informed dental practice sees each patient not as a standard case, but as a unique ecosystem shaped by their microbial profile, systemic health, diet, and lifestyle. Thanks to advances in salivary diagnostics and oral microbiome research, oral health professionals can now provide personalised treatment plans that go far beyond mechanical cleanings or symptom-based care.

At the same time, new microbiome-supportive therapies are becoming available that aim to restore balance without disrupting the entire oral environment. These include:

• RNA therapy: Targets harmful bacterial gene expression while preserving beneficial microbes.
• Quorum quenching: Blocks communication between bacteria to prevent biofilm formation and reduce pathogenicity.
• Phage therapy: Uses viruses that selectively eliminate harmful bacteria like P. gingivalis or F. nucleatum.
• Prebiotics, probiotics, and synbiotics: Rebuild microbial diversity and support a stable, healthy oral environment.
• Xylitol: Reduces acid production, inhibits S. mutans, and helps prevent plaque adhesion.

Technology alone, however, is not enough. Lasting oral and systemic health improvements require patient interest and behaviour change, which could be achieved by motivational interviewing techniques. Instead of telling patients what to do, motivational engineering nudges the patient to collaborate and puts them in control.

Quick motivational interviewing tips for practice:

• Use open-ended questions:

“How do you think your eating habits affect your gums?”

• Offer affirmations:

“It is great that you are already paying more attention to your diet.”

• Reflect what you hear:

“Sounds like you are curious about reducing sugar but also feel overwhelmed.”

• Ask permission before giving advice:

“Would it be okay if I shared what we know about probiotics and gum health?”

This approach helps patients find their own motivation for change, leading to better outcomes and stronger trust.

Practical Example

A diabetic patient presents with early periodontal disease and elevated P. gingivalis levels in salivary testing. A microbiome-informed plan could include:

• Gentle mechanical debridement
• A probiotic lozenge containing Lactobacillus reuteri
• Xylitol chewing gum for pH support
• Nutrition coaching to reduce systemic inflammation
• A collaborative care plan with the patient’s physician
• A motivational interview to explore sugar habits and readiness for change