Concurrent bacterial infections in oral cancer: risk and mitigation strategies

The oral microbiome plays a major role in health, while its dysbiosis can contribute to oral and systemic disorders. The oral cavity hosts a complex community of commensal and pathogenic microbes, and disruptions in this balance, through bacterial infections, can contribute to cancer development and progression through chronic inflammation, inhibition of cell-death, and the release of carcinogenic substances. Microbial shifts driven by prolonged inflammation resulting from chronic oral diseases can escalate dysbiosis and promote neoplastic changes. Despite growing interest, oral microbiome-cancer-axis remains an emerging field. Current research focuses on a small number of microorganisms and associated virulence factors within the tumor-microenvironment, underscoring the need for more comprehensive, systems-level analyses. In this review, we conducted a comprehensive search of PubMed and Google Scholar (2019-2025), to identify and screen studies examining the association between bacterial infections and oral cancer. This review aims to examine and summarize the existing literature to elucidate risks and potential mitigation strategies associated with concurrent bacterial infections in oral cancer. In conclusion, more comprehensive, large-scale, and interdisciplinary studies are needed to understand the microbial influence on cancer, its impact on therapeutic responses, use of probiotics to enhance chemosensitivity and targeted-antibiotic therapy to reduce pathogenic load.