As you near the end of this course, you have built a strong foundation in microbiome-based dentistry — what it is, why it matters, and how to begin integrating it into patient care.
To support your ongoing learning, we have curated a study library of ten essential papers. These publications offer key insights into the science behind the oral microbiome and its far-reaching effects on inflammation, chronic disease, systemic health, and future clinical strategies.
Use these studies to dive deeper, challenge your thinking, or share with colleagues as part of your practice transformation.
1. The composition of the oral microbiome
Li et al. (2022) offer a great general overview of the composition of the oral microbiota, the factors influencing its balance, and its role in oral and systemic diseases. This review article offers insights into how microbial dysbiosis contributes to conditions like periodontitis and caries. It also highlights emerging interventions such as probiotics, prebiotics, and microbiome-targeted therapies.
Li X, Liu Y, Yang X, Li C, Song Z. The Oral Microbiota: Community Composition, Influencing Factors, Pathogenesis, and Interventions. Front Microbiol. 2022 Apr 29;13:895537. doi: 10.3389/fmicb.2022.895537. PMID: 35572634; PMCID: PMC9100676.
2. The gut–oral axis and periodontitis
Nagao et al. (2022) demonstrated that Porphyromonas gingivalis can translocate to the gut, prompting an immune response that worsens periodontitis. This study highlights the gut–oral axis, suggesting that interventions targeting gut health could play a role in oral disease management.
Nagao, J. I., Kishikawa, S., Tanaka, H., Toyonaga, K., Narita, Y., Negoro-Yasumatsu, K., Tasaki, S., Arita-Morioka, K. I., Nakayama, J., & Tanaka, Y. (2022). Pathobiont-responsive Th17 cells in gut-mouth axis provoke inflammatory oral disease and are modulated by intestinal microbiome. Cell reports, 40(10), 111314. https://doi.org/10.1016/j.celrep.2022.111314
3. Periodontitis and Alzheimer’s disease
Liccardo et al. (2020) explored the bidirectional relationship between periodontal disease and Alzheimer’s, revealing that chronic gum inflammation may accelerate cognitive decline. Their findings reinforce the importance of oral health in neurodegenerative disease prevention.
Liccardo, D., Marzano, F., Carraturo, F., Guida, M., Femminella, G. D., Bencivenga, L., Agrimi, J., Addonizio, A., Melino, I., Valletta, A., Rengo, C., Ferrara, N., Rengo, G., & Cannavo, A. (2020). Potential Bidirectional Relationship Between Periodontitis and Alzheimer's Disease. Frontiers in physiology, 11, 683. https://doi.org/10.3389/fphys.2020.00683
4. Periodontal disease and cancer risk
Nwizu et al. (2020) reviewed epidemiological data linking periodontitis to an increased risk of gastrointestinal and pancreatic cancers. The study suggests that chronic inflammation and pathogenic bacteria may promote carcinogenesis.
Nwizu, N., Wactawski-Wende, J., & Genco, R. J. (2020). Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontology 2000, 83(1), 213–233. https://doi.org/10.1111/prd.12329
5. Oral microbiome signatures in diabetes mellitus and periodontal disease
Matsha et al. (2020) investigated distinct oral microbiome signatures in patients with diabetes mellitus and periodontal disease. Their findings suggest that oral microbiota analysis could serve as a biomarker for early detection and management of metabolic disorders.
Matsha, T. E., Prince, Y., Davids, S., Chikte, U., Erasmus, R. T., Kengne, A. P., & Davison, G. M. (2020). Oral Microbiome Signatures in Diabetes Mellitus and Periodontal Disease. Journal of dental research, 99(6), 658–665. https://doi.org/10.1177/0022034520913818
6. The role of Fusobacterium nucleatum in systemic health
Yang et al. (2023) explored innovative RNA-based therapies targeting pathogenic bacteria in periodontal disease, offering a potential alternative to antibiotics.
Yang, M., Dong, P. T., Cen, L., Shi, W., He, X., & Li, J. (2023). Targeting Fusobacterium nucleatum through chemical modifications of host-derived transfer RNA fragments. The ISME journal, 17(6), 880–890. https://doi.org/10.1038/s41396-023-01398-w
7. Dietary influence on the oral microbiome
Santonocito et al. (2022) highlighted the role of diet in shaping the oral microbiome, emphasizing the benefits of fibre, polyphenols, and probiotics in maintaining oral health.
Santonocito, S., Giudice, A., Polizzi, A., Troiano, G., Merlo, E. M., Sclafani, R., Grosso, G., & Isola, G. (2022). A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System's Response during Periodontitis. Nutrients, 14(12), 2426. https://doi.org/10.3390/nu14122426
8. Periodontitis and adverse pregnancy outcomes
This study is important because it investigates the link between periodontal disease and preterm birth, contributing to the understanding of how maternal oral health impacts pregnancy outcomes. Its findings could inform preventive strategies and healthcare policies to reduce the risk of preterm birth through improved periodontal care.
de Oliveira, L. J. C., Cademartori, M. G., Schuch, H. S., Barros, F. C., Silveira, M. F., Correa, M. B., & Demarco, F. F. (2021). Periodontal disease and preterm birth: Findings from the 2015 Pelotas birth cohort study. Oral diseases, 27(6), 1519–1527. https://doi.org/10.1111/odi.13670
9. Periopathogens in atheromatous plaques
This study investigates the presence of periodontal pathogens in atheromatous plaques from carotid and coronary arteries, aiming to explore a potential link between periodontal disease and cardiovascular conditions. By identifying specific periopathogens in these plaques, the research supports the hypothesis that oral infections may contribute to atherosclerosis and cardiovascular disease.
Pavlic, V., Peric, D., Kalezic, I. S., Madi, M., Bhat, S. G., Brkic, Z., & Staletovic, D. (2021). Identification of Periopathogens in Atheromatous Plaques Obtained from Carotid and Coronary Arteries. BioMed research international, 2021, 9986375. https://doi.org/10.1155/2021/9986375
10. Oral microbiota and diagnosing systemic disease
Thomas et al. (2021) explore the role of the oral microbiota in diagnosing systemic diseases, highlighting its potential as a biomarker for conditions like diabetes and cardiovascular disorders. The paper emphasises the connection between oral health and overall systemic health, suggesting that changes in the oral microbiome can serve as early indicators of broader health issues.
Thomas C, Minty M, Vinel A, Canceill T, Loubières P, Burcelin R, Kaddech M, Blasco-Baque V, Laurencin-Dalicieux S. Oral Microbiota: A Major Player in the Diagnosis of Systemic Diseases. Diagnostics (Basel). 2021 Jul 30;11(8):1376. doi: 10.3390/diagnostics11081376. PMID: 34441309; PMCID: PMC8391932.
Up next: Let us know