Mira A
1 Center for Advanced Research in Public Health, FISABIO Foundation, Valencia, Spain.
Adv Dent Res. 2018 Feb;29(1):71-77. doi: 10.1177/0022034517737024.
Understanding the microbiology of dental caries is not a mere academic exercise; it provides the basis for preventive, diagnostic, and treatment strategies and gives the dentist a theoretical framework to become a better professional. The last years have seen the development of new research methodologies, ranging from high-throughput sequencing or "omics" techniques to new fluorescence microscopy applications and microfluidics, which have allowed the study of the oral microbiome to an unprecedented level of detail. Those studies have provided new insights about oral biofilm formation, biomarkers of caries risk, microbial etiology, appropriate sampling, identification of health-associated bacteria, and new anticaries strategies, among others. Several pitfalls are associated with the new technologies, including a small number of samples per study group, elevated cost, and genus- or species-based analyses that do not take into consideration intraspecies variability. However, the new data strongly suggest that saliva may not be an appropriate sample for etiological studies or for bacterial caries-risk tests, that microbial composition alone may be insufficient to predict caries risk, and that antimicrobial or immunization strategies targeting single species are unlikely to be effective. Strategies directed toward modulation of the oral biofilm, such as pre- and probiotics, emerge as promising new approaches to prevent tooth decay.
了解龋齿的微生物学并非仅仅是一项学术活动；它为预防、诊断和治疗策略提供了基础，并为牙医提供了一个理论框架，使其成为更优秀的专业人员。近年来，新的研究方法不断发展，从高通量测序或“组学”技术到新的荧光显微镜应用和微流体技术，这些技术使口腔微生物组的研究达到了前所未有的详细程度。这些研究提供了关于口腔生物膜形成、龋齿风险生物标志物、微生物病因、合适的采样、与健康相关细菌的鉴定以及新的防龋策略等方面的新见解。新技术存在一些缺陷，包括每个研究组的样本数量少、成本高以及基于属或种的分析未考虑种内变异性。然而，新数据强烈表明，唾液可能不是病因学研究或细菌龋齿风险测试的合适样本，仅微生物组成可能不足以预测龋齿风险，而且针对单一物种的抗菌或免疫策略不太可能有效。针对口腔生物膜调节的策略，如益生元和益生菌，成为预防龋齿的有前景的新方法。
