单词
oral candidosis 口腔念珠菌病
endowed赐予
deleterious有害的
pulmonary
disease肺病
diabetes mellitus糖尿病
feats 本领
Helicobacter pylori 幽门螺旋菌
mucus 粘
Notice
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge,
changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check
the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications.
书里知识随时都是变换的，可以随时查阅最新资料。
even with the most sophisticated of techniques only around 50% of
the microflora can be cultured in the laboratory.
即便用最先进技术，也只有百分之50微生物能在实验室培育。
Introduction
The human microflora 1
The oral microflora in health and disease 2
The scale of oral diseases 3
Microbial ecology 4
The oral microflora and general health 5
Chapter summary 6
Further reading 7
The mouth is the gateway of the body to the external
world and represents one of the most biologically
complex and significant sites in the body.
口腔是身体和外部世界的入口，这个入口是微生物复杂聚集地，在身体占有重要地位。
This is where the first stages of the digestive process
take place and, consequently, the mouth is richly
endowed赐予 with sensory functions (taste, smell, temperature
and texture).
口腔是消化系统的第一阶段，因此，口腔被赐予了多种感知，例如味道，温度
It also plays a critical role in
communication, whether by speech or via facial
expressions, and makes a significant contribution
to our appearance. Recent studies have re-affirmed
an earlier concept that oral health is inextricably
linked to general health, and vice versa.
口腔健康和全身健康有密切联系。
Maintaining
a healthy mouth, therefore, is of vital importance for
a person’s self-esteem and general well-being.
保持口腔健康对个人自信和身体健康非常重要。
The mouth is an easily accessible part of the
body and so can provide health care workers with
a window into a person’s oral and general health.
Disease that is localized elsewhere in the body can
be reflected in the mouth and, as a result, saliva is
becoming increasingly recognized as a key diagnostic诊断的
fluid.
嘴是最容易通往身体的地方。嘴对于口腔和全身健康非常重要。通过唾液分析，能检测身体局部器官疾病。
For example, oral candidosis 口腔念珠菌病(Ch. 9) in previously
healthy young adults can be the first sign of
HIV infection, while antibodies against a range of
viruses can be detected in saliva.
例如，如果在健康的青年嘴里发现口腔念珠菌，这可能是HIV感染初期征兆。这时唾液里可以测出抗体。
Risk factors for general
health, such as tobacco habits, alcohol abuse
and an inadequate diet, can also have a deleterious有害的
effect on oral health while, in an analogous相似的 manner,
oral disease can also have an impact on the overall
health of the individual.
对于身体健康的风险因素包括吸烟，烂酒，非均衡饮食。同样的，口腔疾病也是一个风险因子。
Recent studies suggest
that severe periodontal disease in some populations
might be a risk factor for premature or low birth
weight babies, ischaemic heart disease缺血性中风心脏病, pulmonary
disease肺病 and diabetes mellitus糖尿病 (see later, and Ch. 6).
一些调查显示：某些严重牙周病患者可能与产不健康婴儿，缺血性中风心脏病，肺病，糖尿病有关。
The mouth is one of the key interfaces between the
body and the external environment, and can act as a
site of entry for some microbial pathogens, especially
from the air or via ingestion from the diet.
空气或消化的食物的微生物可以轻松进入口腔
Therefore,
it is equipped with a comprehensive array of defence
strategies that includes elements of both the innate
and adaptive immune system (see Ch. 2).
为了对付复杂外来微生物，口腔拥有复杂免疫系统（天生和特异免疫）
Indeed,
the ability of the host to recognise and respond to
invading pathogens while simultaneously tolerating
a diverse resident microflora (see Ch. 3) remains one
of the most remarkable feats 本领of evolution, and the
precise mechanisms that permit this level of discrimination
are still not fully understood.
的确，口腔免疫系统可以识别和反应外来入侵微生物，并同时协调大量微生物居住。具体机制我们不能完全弄明白。
It has been estimated that the human body is made
up of over 1014 cells of which only around 10% are
mammalian哺乳动物的. The remainder剩余物 are the microorganisms
that comprise the resident microflora of the host.
人体细胞只有10%属于哺乳动物，其它细胞是寄生于人体微生物。
This resident microflora does not have merely a passive
relationship with its host, but contributes directly and
indirectly to the normal development of the physiology生理学,
nutrition and defence systems of the organism.
寄生于人体微生物在人体扮演重要角色，包括生理学，营养，和器官免疫。
In general, these natural microfloras live in harmony
with humans and animals and, indeed, all parties
benefit from the association.
平时微生物与人体和平相处。
Loss or perturbation 破坏of
this resident microflora can lead to colonization by
exogenous 外生的(and often pathogenic) microorganisms,
thereby predisposing （使宜于..病）sites to disease.
人体内在微生物被破坏或丢失，导致外生微生物入侵，使器官容易受到疾病困扰。
The microbial colonization of all environmentally
accessible surfaces of the body (both external
and internal) begins at birth.
身体微生物繁殖开始于出生
Such surfaces are exposed to a wide range of microorganisms derived
from the environment and from other persons.
人体表面暴露于大量微生物，这些微生物来自周围环境和其它人。
Each surface, however, because of its physical and biological
properties, is suitable for colonization by only
a proportion of these microbes.
由于身体和生物属性，每种表面只适合一定量的微生物繁殖。
This results in the acquisition, selection and natural development of a
diverse but characteristic microflora at distinct sites
(Fig. 1.1).
这导致身体不同部位微生物不同（个性化），多样化。
For example, staphylococci 葡萄球菌and micrococci状球细菌
predominate 占据on the skin surface but rarely become
established in significant numbers in the mouth of
a healthy person.
葡萄球菌和状球细菌占据皮肤表面但很少在健康人口腔中大量繁殖。
Similarly, less than 30 out of over
700 types of microorganism found in the mouth were
able to colonize the gastrointestinal tract胃肠道, despite the
continual passage of these microbes through the gut肠.
口腔内微生物超过700种，尽管微生物能够通过口腔进入肠道，但只有不到30种微生物能在胃肠道内繁殖。
Furthermore, the predominant species of bacteria
can differ 相异markedly 显著的at distinct surfaces in the mouth
despite these organisms having equal opportunities
to
colonize each site, and this is due again to subtle variations in key
parameters than influence microbial growth and competitiveness (see Ch.
4).
Fig. 1.1 Distribution of the resident human microflora. The
predominant groups of microorganism at some distinct
anatomical解刨结构的 sites are listed.
人体不同器官微生物分布图。
THE ORAL MICROFLORA IN HEALTH
AND DISEASE
The mouth is similar to other sites in the body in
having a natural microflora with a characteristic
composition and existing, for the most part, in a
harmonious relationship with the host. This microflora
is described in Chapter 3 and its intra-oral distribution
is presented in Chapter 4. Perhaps more
commonly than elsewhere in the body, this relationship
can break down in the mouth and disease can
occur.
口腔内微生物和平共处关系呗破坏，疾病能产生。
通常原因：
（1）抗生素治疗
（2）饮食中发酵的碳水化合物摄入量过多
（3）因破损或创伤，一个器官微生物进入另一个器官
This is usually associated with:
• major changes to the biology of the mouth from
exogenous sources (examples include: antibiotic
treatment or the frequent intake of fermentable发酵的
carbohydrates碳水化合物 in the diet) or from endogenous
changes such as alterations in the integrity of
the host defences following drug therapy, which
perturb破坏 the natural stability of the microflora, or
• the presence of microorganisms at sites not
normally accessible to them; for example, when
oral bacteria enter the blood stream following
tooth extraction拔牙 or other traumas and are
disseminated 传播to distant organs, where they can
cause abscesses or endocarditis心内膜炎.
一个器官微生物不正常进入另一个器官，例如拔牙或破损，口腔细菌进入血液，容易引起心内膜炎等疾病。以这种方式进入其他器官细菌叫做投机病菌。许多口腔微生物是潜在的投机病菌。
Bacteria with the potential to cause disease in this way
are termed ‘opportunistic pathogens投机病菌’, and many oral
microorganisms have the capacity to behave in this
manner. Indeed, most individuals suffer at some time
in their life from localized episodes of disease in the
mouth caused by imbalances in the composition of
their resident oral microflora.
的确，大多数人因口腔内微生物不平衡而遭遇疾病。例如蛀齿和牙周病。
The commonest clinical
manifestations显示 of such imbalances are dental caries蛀齿
and periodontal diseases牙周病 (see Ch. 6), both of which
are highly prevalent in industrialized societies and are
now on the increase in developing countries; other
acute and chronic infections occur but less frequently
(see Ch. 7). Dental caries is the dissolution腐朽 of enamel
or root surfaces (demineralization) by acid produced
primarily from the metabolism of fermentable carbohydrates
in the diet by bacteria colonizing the tooth
surface (dental plaque).
牙周病产生原因：饮食中发酵的碳水化合物与细菌结合，新陈代谢后，细菌产生酸，破坏牙齿根部。甜食(饮料)后应及时漱口。。。
牙斑也和牙周病有关，牙斑是一个微生物生物膜，抗生素和牙刷不能清除，微生物生物膜对牙齿组织破坏越来越大。
Dental plaque牙斑 is also associated
with the aetiology病原 of periodontal diseases in
which the host mounts an inappropriate inflammatory
response to an increased microbial load (due to
plaque accumulation) around the gingivae齿龈, resulting
in damage to the supporting tissues of the teeth.
Caries and periodontal diseases pose distinct challenges
when it comes to determining their microbial
aetiology. These diseases occur at sites with a preexisting
diverse, natural resident microflora, while
even more complex but distinct consortia of microorganisms
are implicated with pathology. It is necessary,
therefore, to determine which microbial species
are implicated directly in active disease, which are
present as a result of disease and which are merely
innocent bystanders. Numerous studies have shown
that these common diseases are caused by shifts
in the balance of the resident microflora, in which
some minor components of dental plaque become
predominant due to a change in local environmental
conditions. These shifts in dental plaque composition
in caries and periodontal disease are described
in detail in Chapter 6.
大多数疾病起源于体内微生物失衡。因为局部环境条件改变，微生物分布可能失衡。