The role of oral fungal dysbiosis in periodontitis and caries among pregnant women

Pregnancy triggers profound physiological transformations across hormonal, immunological, and metabolic systems, which collectively disrupt the natural equilibrium of the body’s microbial communities. This state of dysbiosis is particularly consequential in the oral cavity, where a shift in the microbial balance can promote the overgrowth of opportunistic pathogens. Such oral dysbiosis is a key driver of local inflammatory processes and enamel demineralization, directly contributing to the development of periodontitis and dental caries. While bacteria have traditionally been the focus of oral microbiome research, recent investigations have underscored the critical role of fungal species, especially Candida, in the pathogenesis of these common oral diseases. Emerging evidence further emphasizes the importance of cross-kingdom interactions, where the fungus Candida albicans synergistically interacts with cariogenic bacteria such as Streptococcus mutans and periodontal pathogens such as Porphyromonas gingivalis. These interactions enhance biofilm formation, increase structural complexity, and increase overall virulence, exacerbating disease progression. A detailed understanding of dysbiosis within the oral mycobiome—the fungal component of the microbiome—in pregnant women is therefore crucial. Our review provides valuable insights not only for managing maternal oral health but also for understanding the vertical transmission of fungal species to the infant and the potential impact on adverse prenatal outcomes. This review synthesizes current knowledge on the pregnancy-related oral mycobiome, explores the role of cross-kingdom interactions in the etiology of periodontitis and caries, and discusses the implications for the initial establishment of the oral mycobiome in infants.