The relationship between the composition of the oral microbiome and the development of dental caries lesions. Project acronym: MIRACLE (Microbiome Risk FActor Caries Lesions)

The overall aim of MIRACLE is to find new strategies for risk-identification and progression-control of dental caries making use of the knowledge derived about the healthy oral microbiome. The Erasmus MC address this aim by partnering with the leading companies specialised in oral health care and oral imaging, i.e. Dentaid and Inspector Research Systems BV.

Dental caries is a major public health problem among children with prevalences exceeding 80% worldwide. In the Netherlands, children’s oral health problems carry a socioeconomic burden of more than €437 million as yearly care expenditure. Each prevented caries lesion during childhood will save approximately €1800 throughout the patient’s life, especially relevant to people from lower socioeconomic status as they are generally more affected. Intervention strategies, focusing on risk factors like sugar-consumption and oral-hygiene, have not been successful to universally detain the disease. Recently, unfavorable changes in the oral microbiome composition have been postulated to underlie its origin.

With the combination of an exceptional large data set (n=4800) and state-of the-art technological innovations, we seek to understand the composition and function of the oral microbiome in the health and disease process.

The expectation is that the knowledge about the composition of a healthy oral microbiome serves as basis for the development of specialised oral health products in the future, and ultimately leads to optimised and sustainable oral health in the general population. Oral health affects general health and vice versa in diverse ways, therefore investing in it is extremely useful to improve overall well-being of patients and society.

At the end of the project, we have generated the largest dataset on the oral microbiome of adolescents (n = 4,842) and gained the skills and expertise necessary to study such a large dataset. We disseminated this knowledge through scientific publications. Additionally, we presented our findings on the composition of the oral microbiome in healthy, caries-free children. We also identified several factors that potentially modify the composition of the oral microbiome, including lung function, orthodontic treatment, oral hygiene behavior, and puberty. Understanding some of the dynamics of the oral microbiota brings us a step closer to developing new targets for preventive dental care. The results have been, and some will be soon, presented in scientific journals.