Oral Microbiome Resilience: From Ecological Stability to Precision Oral Healthcare

Abstract

Introduction: The concept of oral microbiome resilience has emerged as a new paradigm that emphasizes the ability of the oral microbial ecosystem to maintain ecological stability and recover from environmental disturbances. This concept provides a broader perspective than dysbiosis alone and supports the development of precision oral healthcare. This narrative review aimed to summarize current evidence on oral microbiome resilience, its underlying biological mechanisms, and its potential applications in precision oral healthcare. Methods: A narrative review was conducted following the SANRA guidelines. Literature published in English between January 2016 and June 2026 was identified through PubMed and Google Scholar. Eligible studies included original research, randomized controlled trials, observational studies, systematic reviews, meta-analyses, and narrative reviews investigating oral microbiome ecology, resilience, dysbiosis, and microbiome-based interventions. Results: Current evidence indicates that oral microbiome resilience is influenced by microbial diversity, host immunity, salivary function, and microbial interactions. Probiotics, xylitol, and mechanical biofilm disruption were shown to promote ecological recovery and improve oral health, whereas dietary interventions demonstrated limited short-term effects. Emerging microbiome-based strategies support restoration of ecological balance rather than indiscriminate microbial elimination. Conclusion: Oral microbiome resilience provides a promising framework for precision oral healthcare by promoting personalized prevention and ecological modulation of the oral microbiome. Future longitudinal multi-omics studies are needed to validate resilience biomarkers and facilitate clinical translation.