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Microorganisms in the microbiota, immune cells, and neurons communicate via homeostatic nervous and hormonal systems, regulating vital body functions. By modulating pro\u2010inflammatory and anti\u2010inflammatory adaptive immune responses, these systems control the composition and number of microorganisms in the microbiota. The strength of these brain\u2010controlled responses is genetically determined but is sensitive to early childhood stressors, which can permanently alter their responsiveness via epigenetic mechanisms, and to adult stressors, causing temporary changes. Clinical evidence and research with humans and animal models indicate that factors linked to severe periodontitis enhance the responsiveness of these homeostatic systems, leading to persistent hyperactivation. This weakens the immune defense against invasive symbiotic microorganisms (pathobionts) while strengthening the defense against non\u2010invasive symbionts at the gingival margin. The result is an increased gingival tissue load of pathobionts, including Gram\u2010negative bacteria, followed by an excessive innate immune response, which prevents infection but simultaneously destroys gingival and periodontal tissues. Thus, the balance between pro\u2010inflammatory and anti\u2010inflammatory adaptive immunity is crucial in controlling the microbiota, and the responsiveness of brain\u2010controlled homeostatic systems determines periodontal health.<\/jats:p>","DOI":"10.1111\/prd.12610","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:55:22Z","timestamp":1725497722000},"page":"20-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Microbiota\u2010immune\u2010brain interactions: A new vision in the understanding of periodontal health and disease"],"prefix":"10.1111","volume":"96","author":[{"given":"Torbj\u00f8rn Jarle","family":"Breivik","sequence":"first","affiliation":[{"name":"Department of Periodontology, Faculty of Dentistry, Institute of Clinical Odontology University of Oslo  Oslo Norway"},{"name":"Division for Protection Norwegian Defence Research Establishment  Kjeller 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