The Caries Microbiome: Implications for Reversing Dysbiosis.
Tanner ACR, Kressirer CA, Rothmiller S, Johansson I, Chalmers NI
Adv Dent Res. Feb 2018. doi: 10.1177/0022034517736496
COMMENT: The oral microbiota is a complex community that, under the influence of a carbohydrate-frequent diet, produces an acidic environment on the tooth that can lead to demineralization and dental caries. Knowledge of the caries-associated microbiome is key in planning approaches to reverse the dysbiosis to achieve health.
16S ribosomal RNA (rRNA) probes confirmed the wide diversity of species in oral and caries microbiomes. Anaerobic culture highlighted the caries association of Actinomyces and related species. Scardovia wiggsiae, in the Actinomyces/Bifidobacterium family, and several Actinomyces species have the cariogenic traits of acid production and acid tolerance.
Next-generation sequencing combined with polymerase chain reaction methods revealed a strong association with mutans streptococci in a high caries population with poor oral hygiene and limited access to care. A population with a lower caries experience generally had lower or no Streptococcus mutans detection but harbored other acidogenic taxa in the microbiome. Study of the microbiome suggests a role for the assay of selected putative cariogenic species in more aggressive diseases. For many populations with caries progression, however, assay of multiple species will likely be warranted to determine the caries profile of the population and/or individuals under study.
The authors describe that a major consideration is what components of the microbiome are most efficient, effective, and realistic to monitor to evaluate reversal of the microbiome dysbiosis to that compatible with health. In this short review, the authors consider 2 hypotheses:
1) monitoring target putative caries pathogens (e.g., S. mutans and Lactobacillus species) or
2) monitoring the community seeking upset of balance away from health.