Ecological Events in Oral Health and Disease: New Opportunities for Prevention and Disease Control?

The oral microbiome delivers important benefits to the host (symbiosis). Changes to the oral environment drive deleterious shifts in this microbiome (dysbiosis). Low biofilm pH from dietary sugar catabolism selects for acidogenic/acid-tolerating species and promotes dental caries, while inflammation following biofilm accumulation enriches for the proteolytic and anaerobic microbial communities associated with periodontal disease. Prevention depends not only on biofilm control but also on eliminating drivers of dysbiosis, i.e., an ecological approach to disease prevention.