The purpose of this prospective cohort study was to investigate the influence of the salivary microbiome on the worsening of the periodontal health status among Japanese young adults. We assessed the data of systemically healthy and non-smoking young (18-22 years) university students (n = 457) from Okayama University at baseline (2013) and follow-up (2016). The worsening group was defined based on an increase in the percentage of bleeding on probing (%BOP) or an increase in probing pocket depth (PPD) from <4 mm to ≥4 mm. Unstimulated saliva samples were randomly collected from 69 students for microbiome analysis at follow-up. The salivary microbiome was assessed through 16S rRNA metagenomic sequencing. The type of community in the salivary microbiome clustered by statistical analysis and diversity was not significantly associated with the worsening of the periodontal health status in cases of increasing %BOP and PPD (p > 0.05). The prevalence of some species was significantly higher in the worsening group than in the non-worsening group (p < 0.05) in both cases. The worsening of the periodontal health status was associated with some species, but not the type of community and diversity in the salivary microbiome among Japanese young adults. , Table S1. Comparison between the worsening and non-worsening groups (increase in gingival bleeding) among all students (n = 457); Table S2. Comparison between the worsening and non-worsening groups (increase in probing pocket depth) among all students (n = 457); Table S3. Conditional odds ratios (ORs) and 95% confidence intervals (CIs) for an increase in gingival bleeding and probing pocket depth among all students (n = 457); Table S4. Comparisons between the two communities; Figure S1. Differences in the salivary microbiome between the two communities; Figure S2. Microbial co-occurrence networks of species. Author Contributions: Conceptualization, D.E., Y.I., and M.M.; methodology, D.E., M.M.I., N.T., and M.M.; validation, K.K. and D.E.; formal analysis, M.M.I; investigation, D.resources, M.M.; data curation, M.M.I., N.T., Y.U., and A.T.-T.; writing-original draft preparation, M.M.I.; writing-review and editing, all authors; project administration, M.M. All authors have read and agreed to the published version of the manuscript.