Over the past two decades, the importance of the microbiota in health and disease has become evident. Pathological changes to the oral bacterial microbiota, such as those occurring during periodontal disease, are associated with multiple inflammatory conditions, including inflammatory bowel disease. However, the degree to which this association is a consequence of elevated oral inflammation or because oral bacteria can directly drive inflammation at distal sites remains under debate. In this Perspective, we propose that in inflammatory bowel disease, oral disease-associated bacteria translocate to the intestine and directly exacerbate disease. We propose a multistage model that involves pathological changes to the microbial and immune compartments of both the oral cavity and intestine. The evidence to support this hypothesis is critically evaluated and the relevance to other diseases in which oral bacteria have been implicated (including colorectal cancer and liver disease) are discussed.

在过去的二十年里，微生物群在健康和疾病中的重要性已经变得显而易见。口腔细菌微生物群的病理变化，例如牙周病期间发生的变化，与多种炎症状况有关，包括炎症性肠病。然而，这种关联在多大程度上是口腔炎症升高的结果，或者是因为口腔细菌可以直接驱动远端部位的炎症，这仍然存在争议。在此观点中，我们提出在炎症性肠病中，口腔疾病相关细菌转移到肠道并直接加剧疾病。我们提出了一个多阶段模型，该模型涉及口腔和肠道的微生物和免疫区室的病理变化。