We're not just human. We're hosts to millions of microbes. In fact, there are approximately ten times more microbial cells than human cells on the typical healthy human body.
The dental and medical communities have a basic understanding of how microbes play a key role in digestion, nutrition, drug metabolism and the immune system. But a lot of the what, why and hows of human microbiota remain a mystery.
Advent of Metagenomics
Refinement of DNA sequencing technologies has created a new field of study, metagenomics, which focuses on these human microorganisms to understand their role in human development and health.
Research into the human microbiome has already yielded intriguing results, suggesting links between microbiota and auto-immune disease (e.g. diabetes, rheumatoid arthritis, multiple sclerosis), a host of neuro-chemical imbalances (e.g. depression, bipolar disorder, schizophrenia), cognitive impairments (e.g. autism, anxiety), and obesity.
Tiny Organisms, Big Business
To wit, entire industries are popping up in response to the advances made in metagenomics. Dental probiotic treatments have blossomed in recent years; products like GUM® PerioBalance® claim to improve gum health in 30 days, as well as reduce plaque and prevent bad breath. It's plausible that probiotic products could improve oral health, but at this point there is no concrete evidence to back it up. On a grander scale, commercialized microbiome sequencing service companies like uBiome in San Francisco sell kits for people to take samples from a range of microbiomes, oral, gut, skin or genitals. Their labs analyze the swabs and send a personalized microbial profile to the customers in a few weeks. Kits range in price from around $70 to hundreds of dollars for analyzing multiple sites.
The Oral Microbiome
Study and classification of the microorganisms in the oral cavity, the oral microbiome, are not being neglected. It is believed that upwards of 700 different bacterial species reside in the mouth, but only half have been named and even fewer cultivated. Needless to say, there's a lot of room for research and discoveries.
A 2014 study reported in Immunology Letters (December 2014) claims that periodontitis and caries are not be attributed to a single pathogen, Porphyromonas gingivalis for periodontitis and Streptococcus mutans for caries. Although the number of these keystone pathogens increase at the initiation of each disease, they are not the only causes:
Contemporary microbiome studies now indicate that singular pathogens are not obvious in either caries or periodontitis. Both diseases appear to result from a perturbation among relatively minor constituents in local microbial communities resulting in dysbiosis. Emergent consortia of the minor members of the respective microbiomes act synergistically to stress the ability of the host to respond and protect.
This type of research is still in its early stages. Gaining greater insight into the mechanisms of the various microbes could be the key to preventing a whole host of oral diseases.
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