From disease to health: Making sense of the oral microbiome

Summary

The oral microbiome is a particularly important topic for oral health professionals, or at least it should be. This vast ecosystem of microorganisms in the mouth has the potential to change the way oral health professionals practice and could even lead to a new era of personalised, evidence-based, interdisciplinary medicine. 

The importance of the oral microbiome lies in its explanatory potential: understanding it better would put health and disease in a precise and integrated context. Oral health professionals are at the forefront of this revolution, so it is important they integrate research findings into their daily practice. This article offers a general overview of what you need to know about the oral microbiome.

Table of contents

• Tracing the origins of the oral microbiome
• The players – Bacteria, fungi, and more
• From health to disease: the role of biofilms
• The oral-systemic connection – We are holobionts
• How diet can improve our oral health
• New opportunities of interdisciplinary care for oral health professionals
• The workflow of the future
• 10 essential studies for understanding the oral microbiome

Tracing the origins of the oral microbiome

The first tentative steps towards exploring the oral microbiome date back to the 17th century. Since then, our understanding of the oral microbiome has expanded dramatically, from the rudimentary focal infection theory to today’s advanced genetic sequencing techniques.

The first observations of microorganisms in the oral cavity were made by the pioneering Dutch microbiologist Antonie van Leeuwenhoek, whose homemade microscope enabled him to make the first drawing of dental plaque in 1683.

In a letter to the Royal Society of London in 1683, he described "numerous tiny living creatures moving in a lively manner" within his own dental plaque. His illustrations from that time depict recognisable bacterial forms, such as cocci, fusiform bacteria, and spirochetes. Struck by their sheer abundance, he remarked that the number of these microorganisms in the plaque on human teeth likely exceeded the population of an entire kingdom.