Oral microbiota–immune crosstalk in the pathogenesis and progression of periodontitis: mechanisms and therapeutic potential
Year: 2026
Type: review
Abstract: Periodontitis is a common oral inflammatory disease characterized by chronic inflammation and progressive destruction of the tooth-supporting tissues. Its initiation and progression are not driven solely by infection with specific periodontal pathogens, but rather arise from complex interactions among oral microbial dysbiosis, dysregulated host immune responses, and tissue remodeling. In recent years, oral microbiota-immune crosstalk has emerged as a central mechanistic link between microbial dysbiosis and periodontal tissue damage. Accumulating evidence indicates that oral microorganisms can modulate both innate and adaptive immune responses through microbial structural components, biofilm-associated factors, and metabolites. Conversely, persistent immune-inflammatory responses may reshape the composition and function of the oral microbiota by disrupting barrier integrity, altering the local metabolic milieu, and remodeling ecological niches, thereby establishing a potential self-reinforcing feedback loop. This review focuses on oral microbiota-immune crosstalk in periodontitis, summarizing the molecular mechanisms through which the microbiota regulates host immunity and, reciprocally, immune responses reshape the microbial ecosystem. Particular emphasis is placed on the dynamic changes in these interactions across disease-associated states, including inflammatory initiation, maintenance of chronic inflammation, periodontal tissue destruction, and establishment of a disease-associated microbial ecosystem. We further review the therapeutic and translational advances targeting the microbiota-immune network, including conventional periodontal therapy, biofilm modulation, probiotics, prebiotics and dietary interventions, adjunctive antimicrobial therapy, bacteriophage-based approaches, and engineered bacteria. Finally, we discuss future directions involving multi-omics integration, precision microbiota modulation, and individualized therapeutic strategies, with the aim of providing a conceptual framework and new avenues for the precision prevention and treatment of periodontitis and for the development of microbiota-immune-targeted therapies.
Source: Frontiers in Microbiology
Authors: Yelin Jin, Hua Xu
Institution: The First People's Hospital of Wenling
Language: English
Subfield: Periodontics
Field: Dentistry
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7221936828