The role of the oral microbiota in chronic non-communicable disease and its relevance to the Indigenous health gap in Australia

Abstract

Background Aboriginal Australians and Torres Strait Islanders (hereafter respectfully referred to as Indigenous Australians) experience disproportionately poor health and low life expectancy compared to non-Indigenous Australians. Poor oral health is a critical, but understudied, contributor to this health gap. A considerable body of evidence links poor oral health to increased risks of other chronic non-communicable conditions, such as diabetes, cardiovascular disease, chronic kidney disease, and poor emotional wellbeing. Main The oral microbiota is indisputably associated with several oral diseases that disproportionately affect Indigenous Australians. Furthermore, a growing literature suggests direct and indirect links between the oral microbiota and systemic chronic non-communicable diseases that underpin much of the Indigenous health gap in Australia. Recent research indicates that oral microbial communities are shaped by a combination of cultural and lifestyle factors and are inherited from caregivers to children. Systematic differences in oral microbiota diversity and composition have been identified between Indigenous and non-Indigenous individuals in Australia and elsewhere, suggesting that microbiota-related diseases may be distinct in Indigenous Australians. Conclusion Oral microbiota research involving Indigenous Australians is a promising new area that could benefit Indigenous communities in numerous ways. These potential benefits include: (1) ensuring equity and access for Indigenous Australians in microbiota-related therapies; (2) opportunities for knowledge-sharing and collaborative research between scientists and Indigenous communities; and (3) using knowledge about the oral microbiota and chronic disease to help close the gaps in Indigenous oral and systemic health.

Biocultural Drivers of Salivary Microbiota in Australian Aboriginal and Torres Strait Islander Children

“…Many host-related and environmental factors, including vertical transmission, diet, and antibiotic use have been reported to influence the diversity and composition of an individual's oral microbiota [17][18][19][20][21][22][23]. In turn, these factors may contribute to broader-scale microbiota differences among members of human groups with different heritage and lifestyles [24,25]. For example, studies from Venezuela, the Philippines and Uganda have reported differences in saliva microbiota diversity and composition between Indigenous groups with hunter-gatherer lifestyles and counterparts living agricultural or industrialized lifestyles [26][27][28].…”

The Oral-Microbiome-Brain Axis and Neuropsychiatric Disorders: An Anthropological Perspective

“…For example, although there is still limited research regarding oral microbial diversity among Indigenous groups, analyses of oral microbiota from Native American individuals indicated that the microbial communities of Indigenous participants significantly differed from their non-native counterparts, including high abundances of the genus Prevotella , which have been implicated in periodontal disease ( 68 ). In addition, it is also established that Aboriginal Australians and Torres Strait Islanders also suffer from higher incidences of NPDs and NCDs than their non-Indigenous counterparts ( 69 ). Recent research suggests that this health disparity may be complicated by the higher prevalence of oral disease, such as tooth decay and moderate to severe periodontal disease, experienced by Indigenous Australians in comparison to non-Indigenous Australians ( 69 ).…”

“…In addition, it is also established that Aboriginal Australians and Torres Strait Islanders also suffer from higher incidences of NPDs and NCDs than their non-Indigenous counterparts ( 69 ). Recent research suggests that this health disparity may be complicated by the higher prevalence of oral disease, such as tooth decay and moderate to severe periodontal disease, experienced by Indigenous Australians in comparison to non-Indigenous Australians ( 69 ). These systemic differences were correlated with established differences microbial diversity and composition of Indigenous and non-Indigenous Australians, suggesting that these differences in oral microbiota-related diseases may be specific to Indigenous Australians via a unique oral microbiome ( 69 ).…”

“…Recent research suggests that this health disparity may be complicated by the higher prevalence of oral disease, such as tooth decay and moderate to severe periodontal disease, experienced by Indigenous Australians in comparison to non-Indigenous Australians ( 69 ). These systemic differences were correlated with established differences microbial diversity and composition of Indigenous and non-Indigenous Australians, suggesting that these differences in oral microbiota-related diseases may be specific to Indigenous Australians via a unique oral microbiome ( 69 ). This oral microbial dysbiosis may be the result of evolutionary or sociocultural differences or, more likely, are reinforced by economic and social inequalities that result in greater burdens of disease.…”

Core of the saliva microbiome: an analysis of the MG-RAST data

“…The oral microbiota refers to the collection of microorganisms that inhabit the oral cavity in different locations, such as the tongue, saliva and teeth [ 7 ]. Saliva has been shown to be a biological material capable of reflecting the dynamics of health conditions and metabolic, immunological or infectious diseases, reflecting dysbiosis of local and systemic origin, as observed in dental caries, periodontal diseases, diabetes, rheumatoid arthritis [ 8 ], cancer and, more recently, SARS-COV-2 [ 9 , 10 ].…”