Session Details

CME: The Oral Microbiome: A New Determinant of Women’s and Systemic Health?

Feb 21 2025

1:30 PM - 2:30 PM EDT

Grand Ballroom West

Background. The human body’s various microbiomes are being increasingly implicated in a range of health and disease conditions. Whilst the gut microbiome is the body’s best known and most well studied microbiome, the oral cavity has the second largest and most diverse microbiome after the gut, with an estimated 700 or more species of bacteria colonising the oral mucosa, the tongue, the hard and soft palate, the tonsils and in biofilms on the teeth. In two recent surveys, ~93% of dentists and physicians agreed that oral and systemic health are connected, yet few know that >100 systemic conditions show oral manifestations. Even fewer practitioners recognize the importance of the oral microbiome and its relation to systemic health. Pathogenic oral bacteria, in particular P. gingivalis and Fusobacterium spp are known to cause a range of oral diseases, including gingivitis and periodontitis. Periodontal disease is a polymicrobial infection that leads to autoimmune-like activity, affects almost 30% of adults aged 25-35 and 67% of adults aged over 65. Some of the periodontal-associated bacteria, in particular P. gingivalis and F. nucleatum, have also been associated with a range of systemic diseases, notably cardiovascular diseases, pre-term birth, autoimmune diseases, diabetes, some cancers including head and neck, oesophageal and pancreatic cancer, and Alzheimer’s disease. Both the systemic and women’s health topics will be covered in this presentation.

Less well studied is whether oral pathogens are also associated with diseases and conditions specifically experienced by women.

Aim: This presentation examines the relationship between oral pathogens and women’s health and explores newly emerging interventional approaches that can be deployed for the diagnosis and modulation of the oral microbiome.

Methods: The scientific literature was searched via PubMed between February and June 2024 using the following terms: oral pathogens AND: periodontitis; gingivitis; pregnancy; endometriosis; bacterial vaginosis; breast cancer; ovarian cancer; cervical cancer.

Results: Several oral pathogens, in particular Fusobacterium spp., were identified as being associated with women’s health issues including pregnancy complications, endometriosis and adenomyosis, bacterial vaginosis and cancers that afflict women specifically. 

Pregnancy complications: Consistent evidence from systematic reviews indicates that maternal periodontal disease is strongly associated with poor pregnancy outcomes, in particular preterm birth, low birth weight, and pre-eclampsia.

Endometriosis: A 2023 study implicated Fusobacterium infection specifically as a significant contributor to the pathogenesis of endometriosis.

Bacterial vaginosis: There is some evidence of an association between oral and vaginal dysbiosis.

Breast, cervical, and ovarian cancer: Fusobacterium spp. is enriched in breast tumor tissue, and is the dominant vaginal species in cervical cancer. Fusobacterium has also been identified as an oral pathogen that promotes ovarian cancer.

Conclusion: There is emerging evidence of an association of oral pathogens with a range of women’s health conditions. This poses serious implications for diagnostics, therapeutics, and prevention strategies for these conditions. This is an area that demands further research.

Session Learning Objectives:

1.) Illustrate the importance of the oral microbiome in both oral and systemic health, particularly in women’s health.

2.) Assess the significance of the presence of oral pathogens in select female diseases and conditions.

3.) Describe key oral pathogens involved in periodontal disease, including Fusobacterium spp and P. gingivalis.

4.) Review the accepted systemic effects of the oral microbiome and their implications for women’s health.

5.) Discuss the need for further research into associations between oral pathogens and women’s health conditions.

Speakers

The Center for Functional Medicine

- President

Primal Health LLC

- CEO

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