The butterfly effect: collateral damage and impacts of antimicrobial strategies on the oral microbiome

Jason L. Brown; Mark C. Butcher; Mia Burleigh; Gordon Ramage

doi:10.1038/s44259-025-00156-6

The butterfly effect: collateral damage and impacts of antimicrobial strategies on the oral microbiome

Jason L. Brown
, Mark C. Butcher
, Mia Burleigh
, Gordon Ramage^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

The oral cavity is a complex environment hosting diverse microbial biofilms on different surfaces, all immersed in saliva that enables recolonisation and spread. These microbial populations fluctuate with diet, hygiene, antimicrobials, and disease. While biofilm control measures aim to protect health, they may cause unintended effects, including antimicrobial resistance (AMR). Persistent resistant microbes reshape oral and systemic niches through ecological disruption and genetic adaptation, which may negatively impact human health.

Original language	English
Article number	84
Number of pages	12
Journal	NPJ Antimicrobials and Resistance
Volume	3
DOIs	https://doi.org/10.1038/s44259-025-00156-6
Publication status	Published - 1 Oct 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

antibiotics
antifungal agents
antimicrobial resistance

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10.1038/s44259-025-00156-6Licence: CC BY 4.0

2025 09 09 Brown et al Butterfly finalFinal published version, 1.47 MBLicence: CC BY 4.0

Cite this

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title = "The butterfly effect: collateral damage and impacts of antimicrobial strategies on the oral microbiome",

abstract = "The oral cavity is a complex environment hosting diverse microbial biofilms on different surfaces, all immersed in saliva that enables recolonisation and spread. These microbial populations fluctuate with diet, hygiene, antimicrobials, and disease. While biofilm control measures aim to protect health, they may cause unintended effects, including antimicrobial resistance (AMR). Persistent resistant microbes reshape oral and systemic niches through ecological disruption and genetic adaptation, which may negatively impact human health.",

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AU - Ramage, Gordon

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AB - The oral cavity is a complex environment hosting diverse microbial biofilms on different surfaces, all immersed in saliva that enables recolonisation and spread. These microbial populations fluctuate with diet, hygiene, antimicrobials, and disease. While biofilm control measures aim to protect health, they may cause unintended effects, including antimicrobial resistance (AMR). Persistent resistant microbes reshape oral and systemic niches through ecological disruption and genetic adaptation, which may negatively impact human health.

KW - antibiotics

KW - antifungal agents

KW - antimicrobial resistance

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DO - 10.1038/s44259-025-00156-6

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JF - NPJ Antimicrobials and Resistance

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ER -

The butterfly effect: collateral damage and impacts of antimicrobial strategies on the oral microbiome

Abstract

UN SDGs

Keywords

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