{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:50:08Z","timestamp":1787010608134,"version":"build-2736575974"},"posted":{"date-parts":[[2024,12,5]]},"group-title":"Epidemiology","reference-count":35,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,12,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Importance<\/jats:title>\n                  <jats:p>The oral microbiome is increasingly recognized to play key roles in human health and disease; yet, population-representative characterizations are lacking.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Characterize the composition, diversity, and correlates of the oral microbiome among US adults.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Cross-sectional population-representative survey.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>The National Health and Nutrition Examination Survey (NHANES, 2009-2012), a stratified multistage probability sample of the US population.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>NHANES participants aged 18-69 years (n=8,237, representing 202,314,000 individuals).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Exposures<\/jats:title>\n                  <jats:p>Demographic, socioeconomic, behavioral, anthropometric, metabolic, and clinical characteristics.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Main outcomes<\/jats:title>\n                  <jats:p>Oral microbiome, characterized through 16S rRNA sequencing. Microbiome metrics were alpha diversity (number of observed Amplicon Sequence Variants [ASV], Faith\u2019s Phylogenetic diversity, Shannon-Weiner Index, and Simpson Index); beta diversity (unweighted UniFrac, weighted UniFrac, and Bray-Curtis dissimilarity); and prevalence and relative abundance at taxonomic levels (phylum through genus). Analyses accounted for the NHANES complex sample design.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Among US adults aged 18-69 years, the oral microbiome encompassed 37 bacterial phyla, 99 classes, 212 orders, 446 families, and 1,219 genera. Five phyla\u2014\n                    <jats:italic>Firmicutes, Actinobacteria, Bacteroidetes, Proteobacteria,<\/jats:italic>\n                    and\n                    <jats:italic>Fusobacteria<\/jats:italic>\n                    and six genera\u2014\n                    <jats:italic>Veillonella, Streptococcus, Prevotella7, Rothia, Actinomyces, and Gemella<\/jats:italic>\n                    , were present in nearly all US adults (weighted-prevalence &gt;99%). These genera also were the most abundant, accounting for 65.7% of abundance. Observed ASVs showed a quadratic pattern with age (peak at 30 years), was similar by sex, significantly lower among non-Hispanic White individuals, and increased with higher body mass index (BMI) categories, alcohol use, and periodontal disease severity. All covariates together accounted for a modest proportion of oral microbiome variability, as measured by beta diversity (unweighted UniFrac=8.7%, weighted UniFrac=7.2%, and Bray-Curtis=6.3%). By contrast, relative abundance of a few genera explained a high percentage of variability in beta diversity (weighted UniFrac:\n                    <jats:italic>Aggregatibacter<\/jats:italic>\n                    =22.4%,\n                    <jats:italic>Lactococcus<\/jats:italic>\n                    =21.6%,\n                    <jats:italic>Haemophilus<\/jats:italic>\n                    =18.4%). Prevalence and relative abundance of numerous genera were significantly associated (Bonferroni-corrected Wald-p&lt;0.0002) with age, race and ethnicity, smoking, BMI categories, alcohol use, and periodontal disease severity.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We provide a contemporary reference standard for the oral microbiome of the US adult population. Our results indicate that a few genera were universally present in US adults and a different set of genera explained a high percentage of oral microbiome diversity across the population.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2024.12.03.24318415","type":"posted-content","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T18:00:16Z","timestamp":1733421616000},"source":"Crossref","is-referenced-by-count":6,"title":["The mouth of America: the oral microbiome profile of the US population"],"prefix":"10.64898","author":[{"given":"Anil K.","family":"Chaturvedi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1355-5593","authenticated-orcid":false,"given":"Emily","family":"Vogtmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxin","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Yano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J.","family":"Blaser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1784-8935","authenticated-orcid":false,"given":"Nicholas A.","family":"Bokulich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8865-1670","authenticated-orcid":false,"given":"J. 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