ORAL MICROBIOTA: PERIODONTAL HEALTH, SYSTEMIC EFFECTS, AND CARDIOVASCULAR RISK

The oral microbiota plays a fundamental regulatory role in the maintenance of oral health through complex and dynamic interactions established between periodontal tissues and the host immune system. Under physiological conditions, this microbial ecosystem supports the integrity of periodontal tissues by maintaining a eubiotic balance, whereas quantitative and qualitative alterations in microbial composition referred to as dysbiosis are pivotal in the initiation and persistence of periodontal inflammation. Oral dysbiosis associated with the development of periodontal diseases is not confined to local tissue damage but also creates a permissive environment for the activation of systemic inflammatory responses and the involvement of distant organ systems. In this book chapter, the structural and functional characteristics of the oral microbiota and their relationships with periodontal health are examined, and the effects of periodontal inflammation on the systemic circulation are illustrated in light of current scientific evidence. In particular, the roles of periodontal pathogens, microbial products, and host derived inflammatory mediators in endothelial function, atherogenesis, and vascular inflammation are discussed. The potential biological mechanisms linking oral dysbiosis driven periodontal diseases to the development and progression of cardiovascular diseases are presented through a holistic framework encom-passing immune responses, chronic lowgrade inflammation, and thromboinflammatory processes. In conclusion, this chapter demonstrates that disruption of the balance between the oral microbiota and periodontal health may exert significant effects on cardiovascular risk. It is emphasized that the commensal oral microbiota, by positively influencing periodontal health, holds strategic importance not only for oral health but also for the prevention and risk management of cardiovascular diseases.