The specific pathogen-free human: a new frontier in oral infectious disease research

The indigenous flora acts as a deterrent to the establishment of some pathogenic species. We propose that advances in oral health research will lead to control of oral infections by altering the indigenous microflora to create a specific pathogen-free human. Investigations of important endogenous and exogenous factors which affect the oral flora and the interactions among these parameters, in health and disease, will have to be undertaken for this goal to be achieved. Several approaches to produce a specific pathogen-free human include: (1) introduction of individual or collective moieties which inhibit detrimental interactions on a genetic and molecular level; (2) genetic modification of salivary flow and protein composition by use of transgenic techniques; (3) therapeutic replacement with altered bacterial strains; (4) alteration of host immune responses to produce specific isotype immunity at the most appropriate time in the ontogeny of the oral environment; (5) production of isotype and/or antigen-specific regulatory molecules at the most appropriate time in development; (6) use of synthetic vaccines; (7) genetic alteration or replacement of cells with defective protective capabilities; and (8) use of anti-idiotype vaccines.