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- W2332936507 abstract "The human body carries orders of magnitude more micro-organisms on its external and internal surfaces than the number of eukaryotic cells of which we are made. A normal microflora is essential to life, and has to be protected. This is very true of the health-associated flora of the mouth, which should not be compromised by excessive oral hygiene measures, especially broad spectrum disinfectants such as are found in many commercial preparations. A full range of organisms from multicellular through unicellular paracytes, fungi, bacteria, viruses and prions are found: often in health, sometimes as pathogens. In respect of bacteria, the health-associated flora is incompletely understood: less than half of over 1000 species are cultivable, and thus their role in health and disease cannot be understood. These derive their nutrients predominantly from saliva and to a lesser extent from the serum of gingival crevicular fluid. Unusually in our knowledge of microbiology some of these commensals are capable of causing disease – notably dental caries in the presence of excess fermentable carbohydrate. Sequencing of the Salivary Microbiome reveals great diversity within and between individuals and over 60 totally unknown organisms: the microbiome of surface biofilms—’dental plaque’ perhaps being of greatest interest because of its clear association with dental caries and with periodontal diseases—will prove to be even more complex. Such biofilms are communities with multiple synergisms and antagonisms. They exist in health and may demonstrate ecological shifts in response to environmental changes to become potentially pathogenic – for example cario-genic or periodontopathic. The host response to a wide range of microbial antigens is perhaps more important than the nature of the microflora in pathogenesis: it is by-stander tissue injury associated with an incompletely effective host immune inflammatory response which destroys tissue in periodontal diseases. The extent to which a short list of key pathogens, or key virulence factors, is critical to aetiopathogenesis remains unanswered. Animal and human trials with vaccines against these putative virulence factors will assist understanding, whether or not they prove of ultimate clinical benefit. There is no doubt that bacteraemia and endotoxaemia from oral bacteria can contribute to cardiovascular diseases but again this may be more quantitative than specific: another example of ecological shifts within a commensal flora being key to patho-genesis. Oral diseases and cardiovascular diseases share common risk factors: inherited predisposition; and life-style factors, notably poor diet and intemperate use of tobacco and alcohol." @default.
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- W2332936507 date "2011-01-01" @default.
- W2332936507 modified "2023-09-27" @default.
- W2332936507 title "Microbiota of the human mouth: the mostly good, occasionally bad. the role of oral biofilms in local and distant disease" @default.
- W2332936507 doi "https://doi.org/10.1016/s0031-3025(16)33103-8" @default.
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