today ADC Melbourne 17–21 May 2017

The link between lifestyle, the oral microbiome, health and well-being An interview with ADC speaker Prof. Philip Marsh, UK news n Philip Marsh is Professor of Oral Microbiology at the University of Leeds in the UK. He has received national and international awards for his research in the field and is a regular conference speaker. In Mel- bourne, he will be addressing the topics of dental biofilms and oral mi- crobial ecology in three lectures. Ahead of the event, today interna- tional had the opportunity to speak with him about the relationship be- tween lifestyle factors and the mi- crobial composition and how to best maintain a healthy bacterial bal- ance in the mouth. The microbial balance of the oral cavity is essential for dental (and overall) health. Could you brieﬂy ex- plain this relationship? Humans and microorganisms have evolved to have a close and im- portant symbiotic relationship, to the extent that we are 50 per cent micro- [the bial! These microorganisms AD 5 Prof. Philip Marsh The 65th Annual Meeting of Japanese Association for Dental Research JADR 2017 [ Dates ] Date [ Venue ] 11 / 18 (Sat.) - 19 (Sun.) , 2017 SHOWA UNIVERSITY, Tokyo, Japan Them Forefront of Dental Science [ Theme ] - Toward the Global Standard in Medical Science - Toward the Global Standard in Medical Science - Toward the Global Standard in Medical Science - Toward the Global Standard in Medical Science [ U R L ] U RU RU R h t t p : / / j a d r 6 5 . u m i n . j p h t t p : / / j a d r 6 5 . u m i n . j p h t t p : / / j a d r 6 5 . u m i n . j p h t t p : / / j a d r 6 5 . u m i n . j p h t t p : / / j a d r 6 5 . u m i n . j p [ Congress President ] Ryutaro Kamijo Department of Biochemistry, School of Dentistry, Showa University [ Congress Secretariat ] Department of Biochemistry, School of Dentistry, Showa University 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan TEL: +81-3-3784-8163 FAX: +81-3-3784-5555 [ Management Secretariat ] [ Management Secretariat ] Japanese Association for Dental Research Academic Square Co., LTD. 2-348-302, Ryogae-machi, Fushimi-ku, Kyoto 612-8082, Japan TEL: +81-75-468-8772 FAX: +81-75-468-8773 E-MAIL: jadr65@ac-square.co.jp 2 Australian Dental Congress 2017 human microbiome] are natural and deliver essential health benefits. In the mouth, the normal oral microbi- ome prevents colonisation by exter- nal microbes—some of which would be potentially pathogenic—and con- tributes to the development of our host defences and cardiovascular system. The natural oral microbiome is closely linked to oral health and is not associated with oral disease. The oral microbiota is vulnerable to disruption by lifestyle and environ- mental changes. What exactly can cause a shift and what are potential consequences? The symbiotic relationship be- tween the oral microbiota and the host is dynamic and can alter if the oral environment undergoes a sub- stantial change, often as a conse- quence of an altered lifestyle. A clear example is when salivary flow is reduced or when an individual more regularly consumes sugar-con- taining foods and beverages. In this situation, the dental biofilm spends more time at an acidic pH. This leads to an enrichment of acid-producing and -tolerating bacteria at the ex- pense of beneficial organisms and in- creases the risk of dental caries. Similarly, the host mounts an inflam- matory response if biofilm accumu- lates around the gingival margin. If this fails to reduce the microbial load, then the protein-rich gingival exudate that delivers the host de- fences inadvertently acts as a novel supply of nutrients for the proteo- lytic and obligately anaerobic bacte- ria in subgingival biofilms. These bacteria subvert the host response and continue to drive inflammation; this exaggerated response is respon- sible for host tissue damage. Is the composition of the oral micro- biota mainly based on heredity or can it be managed through external factors? Some elements of the make-up of the oral microbiota are linked to he- redity, but the general composition and activity of these microbes can be managed by effective oral hygiene and an appropriate lifestyle, for example reducing the amount and frequency of intake of fermentable sugars in the diet, avoidance of to- bacco-smoking, etc. An unintended side-effect of some medications can be a reduction of salivary flow; this would disturb the natural balance of the oral microbiota and increase the risk of dental caries. Dental care products aim to reduce harmful bacteria while maintaining the good ones. Is there a danger of using too much product and thereby destroying the oral ﬂora? The oral microbiota is natural and beneficial and therefore needs to be managed and maintained at levels compatible with oral health. Oral care products are designed and evaluated to support the patient in maintaining an appropriate level of oral microorganisms, so if they are used as intended, there is little dan- ger of negatively disrupting the oral At ADC 2017, Marsh will be holding the following lectures: · Friday, 19 May: “Are dental dis- eases examples of ecological ca- tastrophes?” (14:35–15:20) and “Oral bioﬁlms in sickness and in health” (16:00–16:45) · Saturday, 20 May: “The oral microbiome: The good, the bad and the ugly” (10:30–11:15). microbiota. In contrast, the long- term use of broad-spectrum antibiot- ics can lead to the suppression of sig- nificant numbers and types of beneficial oral bacteria, and this can result in overgrowth by yeasts or en- vironmental microbes. Bacteria play an important role in the development of diseases such as periodontitis or caries. Are there ways to manage harmful colonisa- tion other than with dental hygiene measures, for example with vac- cines, or will there be in the future? New strategies to promote bene- ficial oral bacteria and/or to sup- press the likelihood of disease are being developed. These strategies in- clude the development of oral probi- otic bacteria to prevent dental dis- ease and the use of prebiotics, which are supplements designed to boost the growth of beneficial bacteria. Novel anti-inflammatory agents are being evaluated that would promote wound healing and reduce the tissue damage caused by a subverted host response to subgingival dental bio- films. Molecules that reduce biofilm formation or inhibit species impli- cated in dental disease are under ac- tive investigation. Some snack foods and drinks contain sweeteners that cannot be metabolised into acid by oral bacteria. Is dentistry experiencing greater challenges with regard to bioﬁlms and bacterial shifts today than in the past, and if so, why? The main differences today com- pared with the past probably sur- round the increased amounts of sugar in snack foods and drinks. Also, people are living longer and are retaining their teeth into later life, so the dentition is vulnerable to dental disease for longer, and this is coupled with the fact that a side-effect of many medications taken by the el- derly is a reduction in salivary flow. What strategies for keeping a healthy balance in the mouth can dentists teach patients? The main strategies are for pa- tients to practise effective oral hy- giene and thereby reduce biofilm ac- cumulation and to appreciate the impact of sugar in their diet on their risk of dental caries. It may be help- ful if patients realise the relation- ship and direct link between their lifestyle, their oral microbiome, and their oral and general health and well-being. Thank you very much for the inter- view. 7

today ADC Melbourne 17–21 May 2017

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