HYPOTHESIS AND THEORY article
Front. Microbiol.
Sec. Microbial Symbioses
This article is part of the Research TopicProbiotics and Bioactive Agents in Modulating Harmful Oral BiofilmsView all 12 articles
From Periodontal Infection to Oral–Systemic Dysbiosis: Re-framing the Oral Microbiome’s Role in Systemic Health and the Prophylactic Potential of Streptococcus salivarius Probiotics
Provisionally accepted
Francesco Di Pierro1,2,3
Carlo Fornaini1,4,5
Chiara Maria Palazzi1*
Alexander Bertuccioli1,6
John Tagg7
Nicola Zerbinati3- 1Microbiota International Clinical Society, Torino, Italy
- 2Scientific & Research Department, Velleja Research, Milano, Italy, Milan, Italy
- 3Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy, Varese, Italy
- 4Department of Stomatology, 2nd Hospital, Shijiazhuang, Hebei Province, China, Hebei, China
- 5Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
- 6Universita degli Studi di Urbino Carlo Bo Dipartimento di Scienze Biomolecolari, Urbino, Italy
- 7Blis Technologies, South Dunedin, 9012, New Zealand., South Dunedin, New Zealand
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Since the late 19th century, the relationship between oral infections and systemic health has been widely debated. Recent advances in microbiome research suggest that oral microbial imbalance—dysbiosis—can contribute to systemic inflammatory and metabolic disorders. We propose that the term "oral-systemic dysbiosis" more accurately captures the complex interactions linking oral microbial disruption to systemic disease risk. This conceptual reframing moves beyond a purely infectious model toward a systems-based understanding of oral–body health connections. Furthermore, we hypothesize that oral administration of Generally Recognized as Safe (GRAS)-grade probiotic Streptococcus salivarius, such as strain K12, may help restore oral eubiosis and potentially reduce systemic inflammatory burden. While the hypothesis that oral probiotic maintenance may reduce risk of systemic disorders remains to be clinically verified, defining oral–systemic dysbiosis provides a useful conceptual foundation for the exploration of integrated preventive strategies linking oral and general health.
Keywords: Oral microbiota, S. salivarius strains K12 and M18, oral-systemic axis, CRC, diabetes, Obesity, Rheumatoid arthritis, Stroke
Received: 15 Aug 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Di Pierro, Fornaini, Palazzi, Bertuccioli, Tagg and Zerbinati. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chiara Maria Palazzi, pchiaramaria@gmail.com
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