Comprehensive review highlighting the pregnancy microbiome as a key biomarker and intervention target to reduce preterm birth, including oral and gut microbiota.

Review summarizing oral bacteria detected in the intrauterine cavity, their routes of dissemination, and consequences for pregnancy outcomes, including the role of Fusobacterium nucleatum and omega-3 fatty acid modulation.

Cross-sectional study demonstrating that oral microbiota dysbiosis may contribute to pregnancy loss by disrupting immune function and metabolic processes.

Landmark study establishing the association between maternal periodontal disease and preterm birth/low birth weight, with adjusted odds ratios of 7.5 to 7.9.

Study of the PREDICT prenatal cohort finding that women with clinically significant depressive symptoms show altered salivary microbiomes, including lower abundance of health-associated Neisseria.

Review summarizing how estrogen decline during perimenopause and menopause reduces salivary flow, raises xerostomia and burning mouth, and increases susceptibility to periodontal disease, dental caries, and osteoporosis-related alveolar bone loss.

Evidence that estrogen maintains periodontal ligament stem-cell osteogenesis and collagen synthesis; estrogen deficiency in postmenopausal women is linked to greater clinical attachment loss and alveolar bone resorption, while hormone replacement therapy may attenuate these effects.

High-confidence systematic reviews supporting the association between periodontal disease, tooth loss, and cardiovascular diseases.

Meta-analysis assessing non-surgical periodontal therapy impact on cardiovascular risk biomarkers including inflammatory markers, endothelial function, and glycaemic control.

Narrative review (2000-2025) examining the bidirectional relationship between oral health and cardiovascular disease, mediated by systemic inflammation and endothelial dysfunction.

Comprehensive review of molecular mechanisms linking periodontal disease and cardiovascular disease, including inflammatory pathways, oxidative stress, epigenetic modifications, and bacterial translocation.

Direct detection of viable oral pathogens within coronary atherosclerotic tissue, supporting oral-systemic vascular invasion pathways.

Analysis of nationally representative NHANES data quantifying associations between periodontitis, dental caries, diabetes, and hypertension using Cramer’s V.

Review demonstrating how oral pathobionts translocate to the gut, evade mucosal defenses, and induce systemic inflammation and metabolic changes associated with distal organ disease.

Identification of P. gingivalis gingipains in Alzheimer’s disease brains, with experimental evidence proposing a causal role in neurodegeneration.

Prospective study linking periodontal inflammation to accelerated cognitive decline in older adults with mild to moderate Alzheimer’s disease.

Mechanistic review examining how oral bacteria and their inflammatory products cross the blood-brain barrier to contribute to neurodegeneration.

Evidence that periodontal disease contributes to systemic inflammatory burden via circulating inflammatory markers (CRP, IL-6).

Association between P. gingivalis antibody levels and rheumatoid arthritis severity and autoantibody production.

Evidence that oral bacteria can translocate to the gut and influence intestinal inflammation and colorectal cancer through metabolic pathways.

Review of complex connections between oral microbes and multiple human systemic diseases including cancer, cardiovascular, and autoimmune conditions.

Framework for understanding how imbalances in oral microbial communities lead to periodontal disease and systemic inflammation.

Cohort study showing that pregnant women with hypothyroidism exhibit reduced oral microbial richness and a distinct community structure, with disease-specific characteristics also detected in their one-month-old infants.

Comprehensive review highlighting the bidirectional relationship between oral health and systemic health with emerging mechanistic evidence.

Reference database cataloging over 700 prokaryotic species in the human oral cavity with phylogenetic and genomic information.