Abstract:

Recent microbiological insights point towards a large role for the local respiratory and oral microbiomes in the aetiology of inflammatory and infectious diseases that affect the respiratory tract and oral cavity during childhood. Complex interactions exist in the respiratory tract and oral cavity between viral, bacterial and fungal pathogens, and non-pathogenic members of the respiratory and oral microbiomes. The recent application of culture-independent molecular methods have highlighted the substantial differences in microbiota composition and activity between the niches within these regions. It has been demonstrated that many bacterial pathogens involved in respiratory or oral disease are in fact common local residents of these niches. In addition, the presence of certain bacterial members of each local microbiome have been associated with respiratory and oral health or disease. Altogether it is becoming more evident that disease might result from dysbiosis of the normal functioning microbiome and associated biofilms supporting a polymicrobial involvement in inflammatory and infectious diseases of the respiratory tract and oral cavity. These emerging microbiological insights can be used to develop ecological approaches towards diagnostics and therapeutic strategies for the management of respiratory and oral inflammatory and infectious diseases, with a focus on the long-term health consequences of the therapeutic strategies used. This chapter will address common respiratory or oral diseases that affect children and those that highlight different mechanisms of microbial involvement. It will especially emphasise the role of microbial dysbiosis in health and disease in acute respiratory tract infections, dental caries, periodontal disease, and oral candidiasis.