Tanner A C R, Kressirer C A, Rothmiller S, Johansson I, Chalmers N I
1 The Forsyth Institute, Cambridge, MA, USA.
2 Harvard School of Dental Medicine, Boston, MA, USA.
Adv Dent Res. 2018 Feb;29(1):78-85. doi: 10.1177/0022034517736496.
The oral microbiome plays a critical role in maintaining oral health. Frequent dietary carbohydrate intake can lead to dysbiosis of the microbial community from overproduction of acid with selection for increases in acidogenic, acid-tolerant bacteria. Knowledge of the caries-associated microbiome is key in planning approaches to reverse the dysbiosis to achieve health. For risk assessment and treatment studies, it would be valuable to establish whether microbial monitoring requires assay of multiple species or whether selected key species would suffice. Early investigations of the oral microbiota relied on culture-based methods to determine the major bacteria in health and disease. Microbial monitoring using gene probes facilitated study of larger populations. DNA probe methods confirmed and expanded the importance of transmission of bacteria from mother to infant and association of preselected species, including mutans streptococci and lactobacilli with caries in larger populations. 16S ribosomal RNA (rRNA) probes confirmed the wide diversity of species in oral and caries microbiomes. Open-ended techniques provide tools for discovery of new species, particularly when strain/clone identification includes gene sequence data. 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.
口腔微生物群落在维持口腔健康方面起着关键作用。频繁摄入膳食碳水化合物会导致微生物群落失调，因为产酸过多会促使产酸菌和耐酸菌数量增加。了解与龋齿相关的微生物群是规划逆转失调以实现口腔健康方法的关键。对于风险评估和治疗研究而言，确定微生物监测是需要检测多种菌种还是选定的关键菌种就足够了，这将很有价值。早期对口腔微生物群的研究依赖基于培养的方法来确定健康和疾病状态下的主要细菌。使用基因探针进行微生物监测有助于对更多人群进行研究。DNA探针方法证实并扩展了细菌从母亲传播给婴儿的重要性，以及在更多人群中某些预选菌种（包括变形链球菌和乳酸杆菌）与龋齿的关联。16S核糖体RNA（rRNA）探针证实了口腔和龋齿微生物群中菌种的广泛多样性。开放式技术为发现新菌种提供了工具，特别是当菌株/克隆鉴定包括基因序列数据时。厌氧培养突出了放线菌及相关菌种与龋齿的关联。放线菌/双歧杆菌科的斯氏放线菌以及几种放线菌具有产酸和耐酸的致龋特性。下一代测序结合聚合酶链反应方法显示，在口腔卫生差且获得治疗机会有限的高龋齿人群中，变形链球菌与之有很强的关联。龋齿发生率较低的人群通常检测到的变形链球菌数量较少或未检测到，但微生物群中存在其他产酸类群。对微生物群的研究表明，在更严重的疾病中，检测选定的假定致龋菌种可能具有作用。然而，对于许多龋齿进展人群而言，可能需要检测多种菌种来确定所研究人群和/或个体的龋齿情况。
