title: Acquiring and maintaining a normal oral microbiome: current perspective.
abstract: The oral microbiota survives daily physical and chemical perturbations from the intake of food and personal hygiene measures, resulting in a long-term stable microbiome. Biological properties that confer stability in the microbiome are important for the prevention of dysbiosis-a microbial shift toward a disease, e.g., periodontitis or caries. Although processes that underlie oral diseases have been studied extensively, processes involved in maintaining of a normal, healthy microbiome are poorly understood. In this review we present our hypothesis on how a healthy oral microbiome is acquired and maintained. We introduce our view on the prenatal development of tolerance for the normal oral microbiome: we propose that development of fetal tolerance toward the microbiome of the mother during pregnancy is the major factor for a successful acquisition of a normal microbiome. We describe the processes that influence the establishment of such microbiome, followed by our perspective on the process of sustaining a healthy oral microbiome. We divide microbiome-maintenance factors into host-derived and microbe-derived, while focusing on the host. Finally, we highlight the need and directions for future research.
authors.affiliation: Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam Amsterdam, Netherlands.
authors.forename: Egija
authors.initials: E
authors.lastname: Zaura
authors.affiliation: Department of Periodontology, Academic Centre for Dentistry Amsterdam Amsterdam, Netherlands.
authors.forename: Elena A
authors.initials: EA
authors.lastname: Nicu
authors.affiliation: Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam Amsterdam, Netherlands.
authors.forename: Bastiaan P
authors.initials: BP
authors.lastname: Krom
authors.affiliation: Microbiology and Systems Biology, TNO Earth, Environmental and Life Sciences Zeist, Netherlands ; Top Institute Food and Nutrition Wageningen, Netherlands.
authors.forename: Bart J F
authors.initials: BJ
authors.lastname: Keijser
mesh_terms: D005260:Female; D006801:Humans; D064307:Microbiota; D009055:Mouth / Q000382:microbiology*; D011247:Pregnancy
keywords: colonization resistance; mucosal immunity; oral microbiome; placenta; stability; tolerance