{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:59:51Z","timestamp":1785214791495,"version":"3.55.0"},"reference-count":102,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>The oral microbiota represents a complex and dynamic microbial ecosystem that plays a critical role in preserving both oral and systemic homeostasis. Emerging evidence suggests that alterations in oral microbial milieu (dysbiosis) may contribute to the pathogenesis of neurodegenerative disorders, especially Alzheimer\u2019s disease (AD), through the oral\u2013brain axis. This review synthesizes current evidence on the pathways linking oral microbiota to cognitive decline, integrating microbial, immunological, and vascular perspectives. Oral pathogens may access the central nervous system via hematogenous dissemination or neural routes, including the trigeminal nerve, while simultaneously promoting systemic inflammation, immune activation, and blood\u2013brain barrier disruption. These processes converge on key neurodegenerative mechanisms, including chronic neuroinflammation, amyloid-\u03b2 accumulation, and tau pathology. In parallel, alterations in oral microbial composition have been linked to disease severity, supporting a potential role of dysbiosis in both initiation and progression of cognitive impairment. Diet emerges as a critical modifiable determinant of oral microbial ecology. Diets rich in refined sugars may promote dysbiosis and inflammatory signaling, whereas (poly)phenols, probiotics, and prebiotics may support microbial eubiosis and exert neuroprotective effects through modulation of host\u2013microbe interactions. Although current evidence remains largely observational and mechanistic, the diet\u2013oral microbiota\u2013brain axis represents a promising target for preventive and therapeutic strategies aimed at mitigating cognitive decline and promoting healthy aging. Future longitudinal and interventional studies are required to establish causality and translate these insights into clinical practice.<\/jats:p>","DOI":"10.3390\/antiox15080925","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:11:56Z","timestamp":1785168716000},"page":"925","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral Microbiota, the Oral\u2013Brain Axis, and Neurodegeneration: Mechanisms and Dietary Modulation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5809-5706","authenticated-orcid":false,"given":"Justyna","family":"Godos","sequence":"first","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-5327","authenticated-orcid":false,"given":"Giuseppe","family":"Caruso","sequence":"additional","affiliation":[{"name":"Departmental Faculty of Medicine, UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy"},{"name":"IRCCS San Camillo Hospital, 30126 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2778-9756","authenticated-orcid":false,"given":"Giuseppe","family":"Mainas","sequence":"additional","affiliation":[{"name":"Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King\u2019s College London, London SE1 9RT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8557-1774","authenticated-orcid":false,"given":"Agnieszka","family":"Micek","sequence":"additional","affiliation":[{"name":"Statistical Laboratory, Jagiellonian University Medical College, 31-126 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7668-3572","authenticated-orcid":false,"given":"Andrea","family":"Di Mauro","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3393-653X","authenticated-orcid":false,"given":"Lucia","family":"Buccarello","sequence":"additional","affiliation":[{"name":"Departmental Faculty of Medicine, UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy"},{"name":"IRCCS San Camillo Hospital, 30126 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nohora Milena","family":"Mart\u00ednez L\u00f3pez","sequence":"additional","affiliation":[{"name":"Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atl\u00e1ntico, Isabel Torres 21, 39011 Santander, Spain"},{"name":"Universidad Internacional Iberoamericana, Campeche 24560, Mexico"},{"name":"Universidad Internacional Iberoamericana, Arecibo, PR 00613, USA"},{"name":"Fundaci\u00f3n Universitaria Internacional de Colombia, Bogot\u00e1 111321, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-0141","authenticated-orcid":false,"given":"Evelyn","family":"Frias-Toral","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Esp\u00edritu Santo, Samborond\u00f3n 0901952, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8151-9132","authenticated-orcid":false,"given":"Francesca","family":"Giampieri","sequence":"additional","affiliation":[{"name":"Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atl\u00e1ntico, Isabel Torres 21, 39011 Santander, Spain"},{"name":"Dipartimento di Scienze Cliniche Specialistiche e Odontostomatologiche, Universit\u00e0 Politecnica delle Marche, Via Ranieri, 60131 Ancona, Italy"},{"name":"Joint Laboratory on Food Science, Nutrition, and Intelligent Processing of Foods, Polytechnic University of Marche, Italy, Universidad Europea del Atl\u00e1ntico Spain and Jiangsu University, China at the Polytechnic University of Marche, 60131 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lehoczki","sequence":"additional","affiliation":[{"name":"International Training Program in Geroscience, Doctoral College\/Institute of Preventive Medicine and Public Health, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Fodor Center for Prevention and Healthy Aging, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Institute for Translational Research, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4267-6992","authenticated-orcid":false,"given":"Gaetano","family":"Isola","sequence":"additional","affiliation":[{"name":"Unit of Periodontology, Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0644-0755","authenticated-orcid":false,"given":"Fabio","family":"Galvano","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoltan","family":"Ungvari","sequence":"additional","affiliation":[{"name":"International Training Program in Geroscience, Doctoral College\/Institute of Preventive Medicine and Public Health, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9048-9086","authenticated-orcid":false,"given":"Jos\u00e9 L.","family":"Quiles","sequence":"additional","affiliation":[{"name":"Department of Physiology, Institute of Nutrition and Food Technology \u201cJos\u00e9 Mataix Verd\u00fa\u201d, Biomedical Research Centre, University of Granada, 18100 Armilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7250-1782","authenticated-orcid":false,"given":"Maurizio","family":"Battino","sequence":"additional","affiliation":[{"name":"Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atl\u00e1ntico, Isabel Torres 21, 39011 Santander, Spain"},{"name":"Dipartimento di Scienze Cliniche Specialistiche e Odontostomatologiche, Universit\u00e0 Politecnica delle Marche, Via Ranieri, 60131 Ancona, Italy"},{"name":"Joint Laboratory on Food Science, Nutrition, and Intelligent Processing of Foods, Polytechnic University of Marche, Italy, Universidad Europea del Atl\u00e1ntico Spain and Jiangsu University, China at the Polytechnic University of Marche, 60131 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3930-5285","authenticated-orcid":false,"given":"Giuseppe","family":"Grosso","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"ref_1","first-page":"21","article-title":"Global trends in the incidence and prevalence of Alzheimer\u2019s disease","volume":"1","author":"Major","year":"2026","journal-title":"Adv. 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