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Sammanfattning

The immense diversity of the oral microbiota and the biofilm formation has implications for the treatment of oral infections. Microbiological sampling is indicated in severe and refractory cases. At present, the routine diagnostic method for oral bacterial and fungal infections is still culture whereas nucleic acid detection methods are widely used in virological diagnostics. The major advantage of culture over molecular methods is the possibility of performing antimicrobial susceptibility testing for bacteria and fungi. Although laboratory report is not available at the initiation of antimicrobial treatment of acute infections, the sample taken will help to redirect the treatment if the response is poor. Overall, culture samples allow surveillance of local antimicrobial susceptibility patterns. Therefore, the laboratories should continuously gather susceptibility data on the predominant bacteria discovered in dental infections. This is critically important for making appropriate treatment guidelines on the use of antimicrobials. With the recent advances in high-throughput sequencing it might be possible to detect a larger proportion of the microbiota and their associated resistance genes. In the future this could lead to cost-effective diagnostic molecular methods for clinical microbiological laboratories. How the results should then be interpreted and applied to treatment decisions needs to be clarified in further studies on the oral microbiome in health and disease.

MeSH