The Evolving Microbiome of Dental Caries

Summary

This narrative review examines the evolving microbial ecology of dental caries, highlighting how frequent carbohydrate consumption drives dysbiotic shifts in oral biofilm composition characterised by acid-producing and acid-tolerant species. The paper synthesises current understanding of caries-associated microbiota heterogeneity using molecular profiling techniques and discusses emerging therapeutic strategies, including targeted antimicrobial approaches with nanoparticles, that may offer improved clinical outcomes beyond conventional fluoride applications, particularly for high-risk populations.

Regional applicability

The findings are globally relevant given dental caries is described as a worldwide public health problem with particular impact on low-income populations. UK oral health policy and prevention programmes would benefit from considering microbiota-targeted interventions alongside established fluoride strategies, especially in socioeconomically disadvantaged communities with limited access to preventive care.

Key measures

Bacterial species composition (Streptococcus mutans, Lactobacillus, Actinomyces, Bifidobacterium, Scardovia); microbiota variation by tooth site and lesion extent; metagenomics and metatranscriptomics profiling; biofilm acidification; treatment efficacy of fluoride and nanoparticles

Outcomes reported

The paper reviews the microbial composition of dental caries biofilms, identifying acidogenic and acid-tolerant bacterial species associated with disease progression, and examines metagenomics and metatranscriptomics methods for characterising the metabolically active microbiome. It also evaluates emerging therapeutic approaches including fluoride and nanoparticle-based treatments targeting cariogenic bacteria.

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