{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:23:03Z","timestamp":1793607783376,"version":"4.5.0"},"reference-count":49,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Periodontitis can disrupt oral and gut microbiota, leading to dysbiosis that affects overall systemic health. Besides the spread of periodontal pathogens by the hematogenous route, they can also be translocated into the gastrointestinal tract, possibly intervening in the neoplastic process in the gastrointestinal tract. This manuscript reviews the relationship between oral and gut microbiota due to periodontitis, discussing systemic health implications and potential links to gastrointestinal cancer. This article highlights the significance and effect of dysbiosis in the gut, emphasizing the importance of maintaining oral health to prevent systemic diseases. Lastly, it will go through therapeutic innovations such as probiotics and oral microbiota analysis tools for systemic disease detection. These findings will mark the integration of oral health management in clinical practice to lower systemic disease risk and improve overall patient outcomes. Aim of work: This manuscript aims to unravel the pathological interaction between oral and gut microbiota and their bidirectional effect on systemic diseases. Materials and methods: The review was performed using the MEDLINE and ScienceDirect databases. Reviewed articles were published in English between the year 2015 and 2024. The search used keywords such as (\u201coral microbiota\u201d AND \u201cperiodontal disease\u201d) OR (\u201coral microbiota\u201d AND \u201cgastrointestinal cancer\u201d) OR (\u201cPorphyromonas gingivalis\u201d AND \u201cperiodontal disease\u201d) OR (\u201cHelicobacter pylori\u201d AND \u201cgastric cancer\u201d) OR (\u201cgut microbiome\u201d AND \u201cinflammatory bowel disease\u201d) OR (\u201coral microbiome\u201d AND \u201csystemic diseases\u201d). Conclusions: The dysbiotic change in the oral cavity due to periodontitis is linked directly and indirectly to systemic diseases such as IBS, neurodegenerative diseases, muscle joint diseases, respiratory infections, and gastrointestinal cancer; this underscores the importance of maintaining oral hygiene for prophylaxis of oral diseases and the prevention of systemic diseases. A better understanding of the interconnections between oral health and systemic diseases will integrate oral health management to offer new prevention, diagnostic, and treatment opportunities to improve overall patient outcomes.<\/jats:p>","DOI":"10.3390\/medicina60091416","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T11:12:13Z","timestamp":1724929933000},"page":"1416","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Oral and Gut Microbiota Dysbiosis Due to Periodontitis: Systemic Implications and Links to Gastrointestinal Cancer: A Narrative Review"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7671-4687","authenticated-orcid":false,"given":"Yaman","family":"Sulaiman","sequence":"first","affiliation":[{"name":"Clinic of Dental and Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7170-8768","authenticated-orcid":false,"given":"Ingrida Marija","family":"Pacauskien\u0117","sequence":"additional","affiliation":[{"name":"Clinic of Dental and Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"\u0160adzevi\u010dien\u0117","sequence":"additional","affiliation":[{"name":"Clinic of Dental and Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rugile","family":"Anuzyte","sequence":"additional","affiliation":[{"name":"Clinic of Dental and Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 Str. 2, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Di Stefano, M., Santonocito, S., Polizzi, A., Mauceri, R., Troiano, G., Lo Giudice, A., Romano, A., Mascitti, M., and Isola, G. (2023). A Reciprocal Link between Oral, Gut Microbiota during Periodontitis: The Potential Role of Probiotics in Reducing Dysbiosis-Induced Inflammation. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24021084"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.chom.2020.12.006","article-title":"Maturation of the neonatal oral mucosa involves unique epithelium-microbiota interactions","volume":"29","author":"Koren","year":"2021","journal-title":"Cell Host Microbe"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jdsr.2023.08.003","article-title":"Oral-gut axis as a novel biological mechanism linking periodontal disease and systemic diseases: A review","volume":"59","author":"Yamazaki","year":"2023","journal-title":"Jpn. Dent. Sci. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1002\/JPER.21-0120","article-title":"Dysbiosis revisited. Understanding the role of the oral microbiome in the pathogenesis of gingivitis and periodontitis: A critical assessment","volume":"92","author":"Scannapieco","year":"2021","journal-title":"J. Periodontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"FSO856","DOI":"10.2144\/fsoa-2023-0062","article-title":"The increasing importance of the oral microbiome in periodontal health and disease","volume":"9","author":"Siddiqui","year":"2023","journal-title":"Future Sci. OA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"122","DOI":"10.4103\/jomfp.JOMFP_304_18","article-title":"Oral microbiome: Unveiling the fundamentals","volume":"23","author":"Deo","year":"2019","journal-title":"J. Oral Maxillofac. Pathol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Perera, M., Al-Hebshi, N., Speicher, D.J., Perera, I., and Johnson, N.W. (2016). Emerging role of bacteria in oral carcinogenesis: A review with special reference to perio-pathogenic bacteria. J. Oral Microbiol., 8.","DOI":"10.3402\/jom.v8.32762"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1111\/apm.12688","article-title":"Dental biofilm infections\u2013an update","volume":"125","author":"Larsen","year":"2017","journal-title":"APMIS"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Damgaard, C., Danielsen, A.K., Enevold, C., Massarenti, L., Nielsen, C.H., Holmstrup, P., and Belstr\u00f8m, D. (2019). Porphyromonas gingivalis in saliva associates with chronic and aggressive periodontitis. J. Oral Microbiol., 11.","DOI":"10.1080\/20002297.2019.1653123"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lundmark, A., Hu, Y.O.O., Huss, M., Johannsen, G., Andersson, A.F., and Yucel-Lindberg, T. (2019). Identification of salivary microbiota and its association with host inflammatory mediators in periodontitis. Front. Cell. Infect. Microbiol., 9.","DOI":"10.3389\/fcimb.2019.00216"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Belstr\u00f8m, D. (2020). The salivary microbiota in health and disease. J. Oral Microbiol., 12.","DOI":"10.1080\/20002297.2020.1723975"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1038\/sj.bdj.2018.217","article-title":"The oral microbiota\u2013a mechanistic role for systemic diseases","volume":"224","author":"Jia","year":"2018","journal-title":"Br. Dent. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s43066-024-00340-9","article-title":"Oral microbiome dysbiosis and gastrointestinal diseases: A narrative review","volume":"14","author":"Elghannam","year":"2024","journal-title":"Egypt. Liver J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1038\/s41392-022-00974-4","article-title":"Microbiota in health and diseases","volume":"7","author":"Hou","year":"2022","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Zhao, M., Chu, J., Feng, S., Guo, C., Xue, B., He, K., and Li, L. (2023). Immunological mechanisms of inflammatory diseases caused by gut microbiota dysbiosis: A review. Biomed. Pharmacother., 164.","DOI":"10.1016\/j.biopha.2023.114985"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"8787","DOI":"10.3748\/wjg.v21.i29.8787","article-title":"Role of the normal gut microbiota","volume":"21","author":"Jandhyala","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Hrncir, T. (2022). Gut Microbiota Dysbiosis: Triggers, Consequences, Diagnostic and Therapeutic Options. Microorganisms, 10.","DOI":"10.3390\/microorganisms10030578"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Louren\u03c2o, T.G.B., Spencer, S.J., Alm, E.J., and Colombo, A.P.V. (2018). Defining the gut microbiota in individuals with periodontal diseases: An exploratory study. J. Oral Microbiol., 10.","DOI":"10.1080\/20002297.2018.1487741"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Zhou, T., Xu, W., Wang, Q., Jiang, C., Li, H., Chao, Y., Sun, Y., and A, L. (2023). The effect of the \u201cOral-Gut\u201d axis on periodontitis in inflammatory bowel disease: A review of microbe and immune mechanism associations. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1132420"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Quigley, M., Gubatan, J., Boye, T.L., Temby, M., Sojwal, R.S., Holman, D.R., Sinha, S.R., Rogalla, S.R., and Nielsen, O.H. (2022). Gut Microbiome in Inflammatory Bowel Disease: Role in Pathogenesis, Dietary Modulation, and Colitis-Associated Colon Cancer. Microorganisms, 10.","DOI":"10.3390\/microorganisms10071371"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1093\/ecco-jcc\/jjae028","article-title":"Unravelling the oral\u2013gut axis: Interconnection between periodontitis and inflammatory bowel disease, current challenges, and future perspective","volume":"18","author":"Tanwar","year":"2024","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.identj.2023.05.002","article-title":"Mendelian Randomisation Study on Association of Gut Microbiota and Periodontitis","volume":"73","author":"Song","year":"2023","journal-title":"Int. Dent. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1177\/0022034520924633","article-title":"The Bacterial Connection between the Oral Cavity and the Gut Diseases","volume":"99","author":"Kitamoto","year":"2020","journal-title":"J. Dent. Res."},{"key":"ref_24","first-page":"1021","article-title":"Periodontitis, Helicobacter pylori infection, and gastrointestinal tract cancer mortality","volume":"48","author":"Sung","year":"2021","journal-title":"J. Clin. Periodontol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.bj.2018.12.001","article-title":"Association between periodontal pathogens and systemic disease","volume":"42","author":"Bui","year":"2019","journal-title":"Biomed. J."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Baima, G., Ribaldone, D.G., Romano, F., Aimetti, M., and Romandini, M. (2023). The Gum-Gut Axis: Periodontitis and the Risk of Gastrointestinal Cancers. Cancers, 15.","DOI":"10.3390\/cancers15184594"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Sheikh, M., Roshandel, G., McCormack, V., and Malekzadeh, R. (2023). Current status and prospects for esophageal cancer. Cancers, 15.","DOI":"10.3390\/cancers15030765"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1136\/gutjnl-2020-321949","article-title":"Periodontal disease, tooth loss, and risk of oesophageal and gastric adenocarcinoma: A prospective study","volume":"70","author":"Lo","year":"2021","journal-title":"Gut"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/j.sdentj.2023.05.030","article-title":"The analysis of periodontal diseases and squamous cell esophageal cancer: A retrospective study","volume":"35","author":"Haque","year":"2023","journal-title":"Saudi Dent. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s13402-020-00573-x","article-title":"Porphyromonas gingivalis promotes tumor progression in esophageal squamous cell carcinoma","volume":"44","author":"Chen","year":"2021","journal-title":"Cell. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1002\/ags3.12014","article-title":"Review of the gut microbiome and esophageal cancer: Pathogenesis and potential clinical implications","volume":"1","author":"Baba","year":"2017","journal-title":"Ann. Gastroenterol. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.canlet.2022.01.014","article-title":"Fusobacterium nucleatum promotes esophageal squamous cell carcinoma progression via the NOD1\/RIPK2\/NF-\u03baB pathway","volume":"530","author":"Nomoto","year":"2022","journal-title":"Cancer Lett."},{"key":"ref_33","first-page":"e24703","article-title":"The Association Between Oral Helicobacter pylori and Gastric Complications: A Comprehensive Review","volume":"14","author":"Alkhaldi","year":"2022","journal-title":"Cureus"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.lfs.2018.05.026","article-title":"Association of oral Helicobacter pylori with gastric complications","volume":"205","author":"Ansari","year":"2018","journal-title":"Life Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"174","DOI":"10.14740\/wjon1596","article-title":"The Association Between Oral Anaerobic Bacteria and Pancreatic Cancer","volume":"14","author":"Ogrendik","year":"2023","journal-title":"World J. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1158\/1055-9965.EPI-17-0212","article-title":"Periodontal Disease and Incident Cancer Risk among Postmenopausal Women: Results from the Women\u2019s Health Initiative Observational Cohort","volume":"26","author":"Nwizu","year":"2017","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_37","unstructured":"Chung Shan Medical University (2024, June 05). Increased Risk of Cholecystitis Following Periodontitis and Other Chronic Inflammatory Conditions: A Nationwide Cohort Study. Available online: https:\/\/www.airitilibrary.com\/Article\/Detail\/16803108-202212-202210110005-202210110005-103-114."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1038\/s41586-024-07182-w","article-title":"A distinct Fusobacterium nucleatum clade dominates the colorectal cancer niche","volume":"628","author":"Minot","year":"2024","journal-title":"Nature"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s10552-021-01541-y","article-title":"Periodontal disease as a risk factor for sporadic colorectal cancer: Results from COLDENT study","volume":"33","author":"Karp","year":"2022","journal-title":"Cancer Causes Control"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Giordano-Kelhoffer, B., Lorca, C., March Llanes, J., R\u00e1bano, A., Del Ser, T., Serra, A., and Gallart-Palau, X. (2022). Oral Microbiota, Its Equilibrium and Implications in the Pathophysiology of Human Diseases: A Systematic Review. Biomedicines, 10.","DOI":"10.3390\/biomedicines10081803"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/prd.12324","article-title":"Probiotics, including nisin-based probiotics, improve clinical and microbial outcomes relevant to oral and systemic diseases","volume":"82","author":"Nguyen","year":"2020","journal-title":"Periodontology 2000"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Mazziotta, C., Tognon, M., Martini, F., Torreggiani, E., and Rotondo, J.C. (2023). Probiotics Mechanism of Action on Immune Cells and Beneficial Effects on Human Health. Cells, 12.","DOI":"10.3390\/cells12010184"},{"key":"ref_43","unstructured":"Schnirring, L. (2024, June 05). New Oral Rinse Could Help Detect Gastric Cancer in Early Stages. Med. News Today 2024. Available online: https:\/\/www.medicalnewstoday.com\/articles\/new-oral-rinse-could-help-detect-gastric-cancer-in-early-stages#Reaction-to-potential-oral-rinse-test-for-gastric-cancer."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1111\/idj.12484","article-title":"Periodontal treatment is more effective in gastric Helicobacter pylori eradication in those patients who maintain good oral hygiene","volume":"69","author":"Sert","year":"2019","journal-title":"Int. Dent. J."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Thomas, C., Minty, M., Vinel, A., Canceill, T., Loubi\u00e8res, P., Burcelin, R., Kaddech, M., Blasco-Baque, V., and Laurencin-Dalicieux, S. (2021). Oral Microbiota: A Major Player in the Diagnosis of Systemic Diseases. Diagnostics, 11.","DOI":"10.3390\/diagnostics11081376"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Zhang, J., Xie, M., Huang, X., Chen, G., Yin, Y., Lu, X., Feng, G., Yu, R., and Chen, L. (2021). The Effects of Porphyromonas gingivalis on Atherosclerosis-Related Cells. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.766560"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Bhuyan, R., Bhuyan, S.K., Mohanty, J.N., Das, S., Juliana, N., and Juliana, I.F. (2022). Periodontitis and Its Inflammatory Changes Linked to Various Systemic Diseases: A Review of Its Underlying Mechanisms. Biomedicines, 10.","DOI":"10.3390\/biomedicines10102659"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Olsen, I., and Yilmaz, \u00d6. (2019). Possible role of Porphyromonas gingivalis in orodigestive cancers. J. Oral Microbiol., 11.","DOI":"10.1080\/20002297.2018.1563410"},{"key":"ref_49","first-page":"1","article-title":"Periodontal pathogens and cancer development","volume":"00","author":"Zhou","year":"2024","journal-title":"Periodontology 2000"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/9\/1416\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:45:15Z","timestamp":1760111115000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/9\/1416"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":49,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["medicina60091416"],"URL":"https:\/\/doi.org\/10.3390\/medicina60091416","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,29]]}}}