Oral microbiota dysbiosis is closely associated with the pathogenesis of common dental diseases such as dental caries and periodontal diseases. Probiotics, as functional microorganisms, have emerged as promising candidates for regulating oral microbial balance and promoting dental health. This review summarizes the mechanisms by which probiotics modulate oral microbiota, including inhibiting pathogenic bacteria, enhancing beneficial microbial colonization, and interfering with bacterial quorum sensing. We also synthesize clinical evidence from recent randomized controlled trials on the efficacy of probiotic interventions (e.g., Lacticaseibacillus rhamnosus, Ligilactobacillus salivarius) in improving early childhood caries, reducing oral malodor, and alleviating gingivitis. Additionally, factors influencing the effectiveness of probiotic therapies, such as strain specificity, dosage, and delivery methods, are discussed. Finally, we highlight future research directions, including the development of composite probiotic formulations and the application of omics technologies in probiotic mechanism studies. This review provides a comprehensive overview of the role of probiotics in oral health and offers insights for clinical practice and product development.

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The oral cavity, as the entry point of the human body, harbors a complex and dynamic microbial community known as the oral microbiome. In recent years, accumulating evidence has revealed that the oral microbiome is not only closely associated with oral diseases but also serves as a critical bridge linking oral health to systemic health. This review summarizes the bidirectional associations between the oral microbiome and major systemic diseases, including cardiovascular diseases, diabetes mellitus, neurological disorders, and respiratory diseases. We elaborate on the underlying mechanisms by which oral microbial dysbiosis contributes to systemic pathogenesis, such as the translocation of pathogenic microorganisms and their metabolites, the induction of chronic inflammation, and the modulation of host immune responses. Additionally, we discuss potential intervention strategies targeting the oral microbiome to simultaneously improve oral and systemic health, including probiotic/prebiotic supplementation, targeted antimicrobial therapies, oral hygiene management, and dietary interventions. Finally, we highlight the challenges and future research directions in this field, such as the establishment of causal relationships between oral microbiome alterations and systemic diseases, the development of personalized microbiome-based intervention strategies, and the application of multi-omics technologies in mechanism exploration. This review provides a comprehensive overview of the role of the oral microbiome in the crosstalk between oral and systemic health, offering new insights for the integrated prevention and treatment of oral and systemic diseases.

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The oral microbiome, a complex ecosystem of microorganisms colonizing the oral cavity, has been increasingly recognized as a pivotal regulator of human health beyond traditional oral diseases. While its associations with cardiovascular diseases and diabetes have been well-documented, recent advances have uncovered its critical roles in emerging fields of systemic health, including cancer, autoimmune diseases, and age-related disorders. This review focuses on the latest evidence linking the oral microbiome to these understudied systemic conditions, elaborating on novel mechanisms such as microbial metabolite-mediated epigenetic regulation, cross-talk with the gut-lung-brain axis, and modulation of immune checkpoint pathways. Additionally, we highlight cutting-edge intervention technologies targeting the oral microbiome, including nanocarrier-based probiotic delivery systems, CRISPR-Cas9-mediated microbial editing, and artificial intelligence (AI)-guided personalized microbiota modulation. Finally, we discuss the current challenges in translating these findings into clinical practice and propose future research directions to deepen our understanding of the oral microbiome‘s multifaceted roles in systemic health. This review provides a comprehensive update on the emerging roles of the oral microbiome, offering new perspectives for the prevention and treatment of a broader spectrum of systemic diseases.

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The oral microbiome, a highly diverse microbial ecosystem, has been established as a critical mediator of systemic health. Beyond its well-documented associations with cardiovascular and metabolic diseases, recent evidence has uncovered its profound implications in two emerging fields: metabolic liver diseases (MLDs), particularly non-alcoholic fatty liver disease (NAFLD), and hematological malignancies (HMs) such as multiple myeloma. This review systematically synthesizes the latest findings on the bidirectional interactions between the oral microbiome and these diseases, emphasizing the pivotal role of the „oral-gut-liver axis“ in MLD pathogenesis and the impact of oral dysbiosis on immune dysregulation in HMs. Key mechanisms highlighted include microbial translocation-induced inflammation, metabolite-mediated metabolic reprogramming, and disruption of host barrier function. Additionally, we explore cutting-edge therapeutic strategies targeting the oral microbiome, including quorum sensing quenching (QSQ) agents, precision probiotic supplementation, and integrated microbiome-immune intervention approaches. Finally, we discuss the current challenges in clinical translation, such as standardized sampling protocols and interindividual variability, and propose future research directions to advance microbiome-based precision medicine for MLDs and HMs. This review provides a comprehensive update on the expanding role of the oral microbiome in these understudied systemic diseases, offering novel therapeutic perspectives for improving patient outcomes.

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Cardiovascular diseases (CVDs) remain the leading cause of global mortality, accounting for approximately 17.9 million deaths annually. While traditional risk factors such as hypertension, dyslipidemia, and smoking have been extensively studied, emerging evidence highlights the oral microbiome as a novel and critical contributor to CVD pathogenesis. The oral cavity, a diverse microbial ecosystem, harbors hundreds of bacterial species that interact dynamically with the host. Disruption of oral microbiome homeostasis (dysbiosis) has been linked to various CVDs, including atherosclerosis, hypertension, and infective endocarditis. This review systematically summarizes the current understanding of the bidirectional crosstalk between the oral microbiome and CVDs, emphasizing key pathogenic mechanisms such as microbial translocation, inflammation amplification, immune dysregulation, and metabolite-mediated vascular damage. Specifically, we focus on the role of periodontal pathogens (e.g., Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans) in driving atherogenesis and vascular dysfunction. Additionally, we discuss the latest progress in microbiome-targeted therapeutic strategies for CVD prevention and management, including periodontal therapy, probiotic supplementation, and quorum sensing inhibitors. Finally, we address the challenges in translating basic research findings to clinical practice and propose future research directions to advance microbiome-based precision medicine for CVDs. This review provides a comprehensive update on the oral-cardiovascular axis, offering novel insights into the prevention and treatment of CVDs.

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