Antimicrobial Resistance in Periodontal Microbiota

The subgingival environment hosts a complex consortium of bacteria that collectively form the periodontal microbiota. Under healthy conditions these communities exist in a balanced state, but perturbations such as poor oral hygiene, systemic illness or antibiotic exposure can provoke dysbiosis, favouring opportunistic pathogens. Antimicrobial agents have long been used to manage periodontitis and other inflammatory gum diseases, yet the widespread application of broad-spectrum antibiotics has led to the emergence and dissemination of resistance traits among key periodontal pathogens. Gene exchange within multispecies biofilms facilitates the horizontal transfer of resistance determinants, while the dense matrix of extracellular polymeric substances impedes antibiotic penetration. The resulting antimicrobial resistance not only compromises the efficacy of local periodontal therapy but also poses a broader public-health threat as the oral cavity serves as a reservoir for resistance genes. Contemporary research aims to characterise the resistome of periodontal biofilms, understand the ecological drivers of resistance selection, and identify alternative therapeutic strategies that restore microbial homeostasis without fostering further resistance.

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Antimicrobial Resistance in Periodontal Microbiota publication trend

The graph below shows the total number of articles in antimicrobial resistance in periodontal microbiota across all publications each year (not limited to Nature Index journals).

Technical terms

Antimicrobial resistance (AMR): The ability of microorganisms to withstand the effects of an antibiotic that would normally kill them or inhibit their growth.

Periodontal microbiota: The community of microorganisms residing in the gingival crevice and periodontal pocket regions of the mouth.

Biofilm: A structured consortium of microorganisms encapsulated within a self-produced matrix of extracellular polymeric substances, adherent to each other and/or surfaces.

Resistome: The collection of all antibiotic resistance genes present in a microbial community, whether expressed or latent.

Minimal inhibitory concentration (MIC): The lowest concentration of an antimicrobial agent required to prevent visible growth of a microorganism in vitro.

References

1. Emergence of Antibiotic-Resistant Porphyromonas gingivalis in United States Periodontitis Patients. Antibiotics (2023).
2. The oral microbiota is a reservoir for antimicrobial resistance: resistome and phenotypic resistance characteristics of oral biofilm in health, caries, and periodontitis. Annals of Clinical Microbiology and Antimicrobials (2023).
3. Tetracycline and multidrug resistance in the oral microbiota: differences between healthy subjects and patients with periodontitis in Spain. Journal of Oral Microbiology (2020).