{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:42:58Z","timestamp":1793040178634,"version":"4.5.0"},"reference-count":92,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"a subsidy from Wroclaw Medical University","award":["SUBK.B180.25.012"],"award-info":[{"award-number":["SUBK.B180.25.012"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: This systematic review aimed to evaluate the association between oral health\u2014particularly dental caries and dysbiosis of the oral microbiome\u2014and respiratory diseases across different age groups and clinical settings, with emphasis on microbial overlap, clinical outcomes, and preventive strategies. Methods: A systematic search was conducted in PubMed, Scopus, Embase, Web of Science, and the Cochrane Library up to June 2025. Eligible studies included randomized controlled trials, cohort, case\u2013control, and cross-sectional investigations examining the relationship between oral diseases or microbiome alterations and respiratory outcomes. Data on study design, population, oral health parameters, microbial taxa, and respiratory endpoints were extracted. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT, 2018). Results: Twenty studies met the inclusion criteria, encompassing pediatric, adult, and elderly populations. Poor oral health, reflected by higher caries indices and periodontal inflammation, was consistently associated with increased risk of lower respiratory tract infections (LRTI), aspiration events, ventilator-associated pneumonia (VAP), and impaired pulmonary function. Oral microbiome analyses revealed enrichment of Veillonella, Prevotella, Klebsiella, and Pseudomonas species in both oral and airway samples, supporting the oral cavity as a reservoir for respiratory pathogens. Interventional evidence from intensive care and nursing home settings demonstrated that structured oral care\u2014particularly daily toothbrushing and chlorhexidine-based plaque control\u2014significantly reduced pneumonia incidence. Conclusions: This review confirms a clinically relevant and biologically plausible link between oral dysbiosis, dental caries, and respiratory disease. Oral biofilms contribute to infection risk through microaspiration and microbial seeding of the lower airways. Integrating oral screening, hygiene maintenance, and treatment of active oral disease into respiratory care pathways may reduce respiratory morbidity and mortality, particularly among high-risk populations such as ICU patients, older adults, and individuals with chronic lung disease.<\/jats:p>","DOI":"10.3390\/jcm14217670","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T03:44:39Z","timestamp":1761795879000},"page":"7670","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The Role of the Oral Microbiome and Dental Caries in Respiratory Health: A Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4761-2675","authenticated-orcid":false,"given":"\u0141ukasz","family":"Zygmunt","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Wroclaw University of Science and Technology, building C-7, pl. Grunwaldzki 11, 50-377 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9062-4156","authenticated-orcid":false,"given":"Sylwia","family":"Kiryk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"Weso\u0142ek","sequence":"additional","affiliation":[{"name":"J\u00f3zef Stru\u015b Multi-Specialty Municipal Hospital with a Care and Treatment Facility, Independent Public Health Care Facility, Szwajcarska 3, 61-285 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5442-1412","authenticated-orcid":false,"given":"Jan","family":"Kiryk","sequence":"additional","affiliation":[{"name":"Dental Surgery Department, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5797-7336","authenticated-orcid":false,"given":"Izabela","family":"Nawrot-Hadzik","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Biology and Biotechnology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8988-1515","authenticated-orcid":false,"given":"Zbigniew","family":"Rybak","sequence":"additional","affiliation":[{"name":"Pre-Clinical Research Centre, Wroclaw Medical University, Bujwida 44, 50-345 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaudia","family":"Sztyler","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5187-5324","authenticated-orcid":false,"given":"Agata","family":"Ma\u0142yszek","sequence":"additional","affiliation":[{"name":"Department of Biostructure and Animal Physiology, Wroc\u0142aw University of Environmental and Life Sciences, Ko\u017cuchowska 1, 51-631 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3801-0218","authenticated-orcid":false,"given":"Jacek","family":"Matys","sequence":"additional","affiliation":[{"name":"Dental Surgery Department, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2368-1534","authenticated-orcid":false,"given":"Maciej","family":"Dobrzy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Dong, J., Li, W., Wang, Q., Chen, J., Zu, Y., Zhou, X., and Guo, Q. 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