The Oral Microecological Theory of Dental Caries

Abstract

The microecological theory represents the current understanding of dental caries etiology, emphasizing that the dynamic balance of the structure and function of the oral microbial community plays a central role in the initiation and progression of caries. This theory posits that dental caries is not caused by a single specific pathogen, but rather results from dysbiosis—an imbalance—of the entire oral microecosystem. By redefining caries from an "infectious disease" to an "ecological imbalance disorder," the microecological theory offers a novel perspective for caries prevention, early intervention, and precision treatment. It underscores that maintaining the homeostasis of the oral microecology is more critical than simply eradicating bacteria, and that ecological approaches represent a key strategy for population-level caries prevention. Homeostatic medicine emphasizes that the dynamic equilibrium of the body's internal environment is fundamental to health. As a major microbial habitat and immunological interface, the oral cavity plays a pivotal role in the body's overall homeostatic network. The stability of the oral microbiome is thus a crucial node in systemic homeostasis. Homeostatic medicine provides a systems-oriented framework for understanding dental caries, shifting the paradigm ofcaries management from “fighting pathogens ”toward “preserving ecological balance”. This integrative approach aims to achieve the broader goal of promoting systemic homeostasis through local oral health promotion.

Keywords: Dental caries, Microecological theory, Homeostatic medicine, Oral microbiome, Ecological prevention, Review