Age-group-specific association of oral health and systemic health on cognitive function: a cross-sectional study of Korean elders.

BACKGROUND: Although the importance of oral and systemic healthcare for elderly people is increasing owing to the rapid ageing of the population in South Korea, studies on the relationship between oral health, systemic health, and cognitive function, as well as on the prediction of cognitive function by oral and systemic health depending upon age groups are lacking. METHODS: We included 5,975 out of 6,488 participants from the 8th wave of the Korean Longitudinal Study of Aging (KLoSA) panel data, divided the participants into three age groups, and performed a hierarchical multiple linear regression analysis to explain cognitive function with four types of predictors: oral health status, sociodemographic factors, objective health status, and subjective health status. RESULTS: Oral health status was positively correlated with systemic health status and cognitive function. Of all ages over 54, cognitive function was significantly predicted by oral health variables, such as the number of functional teeth, masticatory ability, and Geriatric Oral Health Assessment Index (GOHAI); sociodemographic variables, such as age, sex, education level, and residence; and systemic health variables, such as diagnosis of diabetes mellitus, cancer or malignant tumours, cerebrovascular disease and rheumatoid arthritis, depressive symptom, and self-rated health status. Oral health variables explained cognitive function differently by age group; GOHAI appeared important predictor in the group aged < 75 years, whereas the number of functional teeth did in the group aged ≥ 75 years. Educational level, masticatory ability, depressive symptoms, and self-rated health status were pivotal factors age-independently. CONCLUSIONS: The general and age-group-specific association between oral health, systemic health, and cognitive function were confirmed, suggesting that age-group-specific oral healthcare should be emphasized for the effective management of systemic and cognitive health in the elderly group.

Activation of Persulfate by Nanosized Zero-Valent Iron (NZVI): Mechanisms and Transformation Products of NZVI.

The mechanisms involved in the activation of persulfate by nanosized zero-valent iron (NZVI) were elucidated and the NZVI transformation products identified. Two distinct reaction stages, in terms of the kinetics and radical formation mechanism, were found when phenol was oxidized by the persulfate/NZVI system. In the initial stage, lasting 10 min, Fe0(s) was consumed rapidly and sulfate radicals were produced through activation by aqueous Fe2+. The second stage was governed by Fe catalyzed activation in the presence of aqueous Fe3+ and iron (oxyhydr)oxides in the NZVI shells. The second stage was 3 orders of magnitude slower than the initial stage. An electron balance showed that the sulfate radical yield per mole of persulfate was more than two times higher in the persulfate/NZVI system than in the persulfate/Fe2+ system. Radicals were believed to be produced more efficiently in the persulfate/NZVI system because aqueous Fe2+ was supplied slowly, preventing sulfate radicals being scavenged by excess aqueous Fe2+. In the second stage, the multilayered shell conducted electrons, and magnetite in the shell provided electrons for the activation of persulfate. Iron speciation analysis (including X-ray absorption spectroscopy) results indicated that a shrinking core/growing shell model explained NZVI transformation during the persulfate/NZVI process.

Translocation Pathway-Dependent Assembly of Streptavidin- and Antibody-Binding Filamentous Virus-Like Particles.

Compared to well-tolerated p3 fusion, the display of fast-folding proteins fused to the minor capsid p7 and the major capsid p8, as well as in vivo biotinylation of biotin acceptor peptide (AP) fused to p7, are found to be markedly inefficient using the filamentous phage. Here, to overcome such limitations, the effect of translocation pathways, amber mutation, and phage and phagemid display systems on p7 and p8 display of antibody-binding domains are examined, while comparing the level of in vivo biotinylation of AP fused to p7 or p3. Interestingly, the in vivo biotinylation of AP occurs only in p3 fusion and the fast-folding antibody-binding scaffolds fused to p7 and p8 are best displayed via a twin-arginine translocation pathway in TG1 cells. The lower the expression level of the wild-type p8 and the smaller the size of the guest protein, the better the display of Z-domain fused to the recombinant p8. The in vivo biotinylated multifunctional filamentous virus-like particles can be vertically immobilized on streptavidin (SAV)-coated microspheres to resemble cellular microvilli-like structures, which reportedly enhance protein-protein interactions due to dramatically expanded flexible surface area.

Development of an MgO-based binder for stabilizing fine sediments and storing CO2.

An MgO-based binder was developed that could stabilize fine dredged sediments for reuse and store CO2. Initially, a binder consisting of fly ash (FA) and blast furnace slag (BFS) was developed by using alkaline activators such as KOH, NaOH, and lime. The FA0.4-BFS0.6 binder (mixed at a FA-to-BFS weight ratio of 4:6) showed the highest compressive strength of 10.7 MPa among FA/BFS binders when 5 M KOH was used. When lime (L) was tested as an alkaline activator, the strength was comparable with those obtained when KOH or NaOH was used. The L0.1-(FA0.4BFS0.6)0.9 binder (10 % lime mixed with the FA/BFS binder) showed the highest strength of 11.0 MPa. Finally, by amending this L0.1-(FA0.4BFS0.6)0.9 binder with MgO, a novel MgO-based binder (MgO0.5-(L0.1-(FA0.4BFS0.6)0.9) 0.5) was developed, which demonstrated the 28th day strength of 11.9 MPa. The MgO-based binder was successfully applied to stabilize a fine sediment to yield a compressive strength of 4.78 MPa in 365 days, which was higher than that obtained by the Portland cement (PC) system (3.22 MPa). Carbon dioxide sequestration was evidenced by three observations: (1) the decrease in pH of the treated sediment from 12.2 to 11.0; (2) the progress of the carbonation front inward the treated sediment; and (3) the presence of magnesium carbonates. The thermogravimetric analysis (TGA) results showed that 67.2 kg of CO2 per ton of the treated sediment could be stored under the atmospheric condition during 1 year.

Virus outbreaks in chemical and biological sensors.

Filamentous bacteriophages have successfully been used to detect chemical and biological analytes with increased selectivity and sensitivity. The enhancement largely originates not only from the ability of viruses to provide a platform for the surface display of a wide range of biological ligands, but also from the geometric morphologies of the viruses that constitute biomimetic structures with larger surface area-to-volume ratio. This review will appraise the mechanism of multivalent display of the viruses that enables surface modification of virions either by chemical or biological methods. The accommodation of functionalized virions to various materials, including polymers, proteins, metals, nanoparticles, and electrodes for sensor applications will also be discussed.

In situ treatment of contaminated soil using persulfate activated by sulfidated zero-valent iron.

Soil contamination with hazardous substances like phenol poses significant environmental and health risks. In situ soil mixing can be a promising technological solution to this challenge. A persulfate and sulfidated zero-valent iron (S-ZVIbm) system for remediating contaminated soil was developed and tested to be suited to in situ soil mixing. S-ZVIbm was synthesized using a ball mill process, and the optimal sulfur to iron molar ratio for effectively removing phenol from soil removal without pyrophoric risks was 0.12. Soil slurry experiments were performed, and the best phenol oxidation results (high stoichiometric efficiency and sustained oxidation after mixing) were achieved at a persulfate to S-ZVIbm molar ratio of 2:1 and a persulfate to phenol molar ratio of 8:1. A high organic matter content of the silty clay fraction of the soil strongly suppressed persulfate activation, so suppressed phenol removal and increased persulfate consumption. Electron spin resonance and radical scavenging tests confirmed that hydroxyl and sulfate radicals were present during the degradation of phenol. While sulfate radicals predominantly facilitated degradation in the soil, both sulfate and hydroxyl radicals were crucial in the aqueous phase in the absence of soil organic matter. In situ soil mixing simulation tests indicated that the persulfate and S-ZVIbm doses and the mixing rate and duration strongly affected the efficacy of the system, and the optimal conditions for phenol removal were determined. The results indicated that the persulfate/S-ZVIbm system could be tuned to achieve sustained persulfate activation and to remediate contaminated soil employing in situ soil mixing technique.

Roles of silica coating on nanosized zero-valent iron in sequential reduction-oxidation process in a system containing persulfate.

A sequential reduction-oxidation process using silica-coated nanosized zero-valent iron (nZVI) particles (nZVI@SiO2) and persulfate for mineralizing recalcitrant compounds was developed, and the effects of the process on nitrobenzene were evaluated. This sequential process significantly enhanced contaminant mineralization, which could not be effectively achieved by reduction or oxidation alone. The nZVI@SiO2 rapidly reduced nitrobenzene to aniline, then the aniline concentration gradually decreased after persulfate had been added and initiated sequential oxidative degradation. The SiO2 coating on the nZVI@SiO2 limited outward mass transfer of reaction products and increased the efficiency with which nitrobenzene was converted into aniline. Slow release of Fe(II) caused by the coating caused persulfate activation and subsequent aniline oxidation to be more sustained and efficient than without the coating. The final nitrobenzene-aniline mineralization efficiency was higher for the nZVI@SiO2/persulfate system than the nZVI/persulfate system. The SiO2 coating of the nZVI@SiO2 particles was an excellent protective layer, protecting the particles from undesirable consumption through reactions with groundwater components. nZVI@SiO2 particle transformations during the sequential process were investigated, and the operating conditions were optimized to maximize the recalcitrant compound removal efficiency. The results indicated that nZVI@SiO2 and persulfate could be used to mineralize organic contaminants in groundwater through sequential reduction-oxidation.

Development and application of an advanced algorithm for environmental risk assessment and safety management of pesticide residues in agricultural soils: Monitoring of currently used pesticide in upland soils.

This study conducted the development of an advanced risk assessment algorithm system and safety management strategies using pesticide residue monitoring data from soils. To understand the status of pesticide residues in agricultural soils, monitoring was performed on 116 types of pesticides currently in use across 300 soil sites. The analysis of the monitoring results, alongside the physicochemical properties of the pesticides, led to the selection of soil half-life as a critical component in residue analysis. The use of Toxicity Exposure Ratio (TER) and Risk Quotient (RQ) for environmental risk assessment, based on monitoring data, presents limitations due to its single-component, conservative approach, which does not align with actual field conditions. Therefore, there is a necessity for a risk assessment process applicable in real-world scenarios. In this research, an efficient and accurate risk assessment algorithm system, along with a safety management model, was developed. Using the physicochemical properties of pesticides (such as soil half-life), monitoring results, and toxicity data, cluster analysis and Principal Component Analysis (PCA) validation identified four pesticides: boscalid, difenoconazole, fluquinconazole, and tebuconazole. The k-mean cluster analysis selected three priority management sites where the contribution of these four pesticides to the RQ was between 94-99 %, showing similar results to the RQ calculated for all pesticides. Predictions made with the developed model for the time required for soil half-life based RQ to drop below 1 at these priority sites showed only a 1-9 day difference between the four pesticides of concern and all pesticides, indicating comparable outcomes. The scenario of replacing high-risk pesticides with those of lower risk demonstrated that the RQ could be consistently maintained at about 50 % level. The results of this study suggest that through monitoring, evaluation, and management, effective and accurate environmental safety management of pesticides in soil can be achieved.

Ethanol extract from Astilbe chinensis inflorescence suppresses inflammation in macrophages and growth of oral pathogenic bacteria.

Chronic oral inflammation and biofilm-mediated infections drive diseases such as dental caries and periodontitis. This study investigated the anti-inflammatory and antibacterial potential of an ethanol extract from Astilbe chinensis inflorescence (GA-13-6) as a prominent candidate for natural complex substances (NCS) with therapeutic potential. In LPS-stimulated RAW 264.7 macrophages, GA-13-6 significantly suppressed proinflammatory mediators, including interleukin-6 (IL-6), tumor necrosis factor (TNF), and nitric oxide (NO), surpassing purified astilbin, a known bioactive compound found in A. chinensis. Furthermore, GA-13-6 downregulated the expression of cyclooxygenase-2 (COX2) and inducible nitric oxide synthase (iNOS), indicating an inhibitory effect on the inflammatory cascade. Remarkably, GA-13-6 exhibited selective antibacterial activity against Streptococcus mutans, Streptococcus sanguinis, and Porphyromonas gingivalis, key players in dental caries and periodontitis, respectively. These findings suggest that complex GA-13-6 holds the potential for the treatment or prevention of periodontal and dental diseases, as well as various other inflammation-related conditions, while averting the induction of antibiotic resistance.

Highly accurate measurement of the relative abundance of oral pathogenic bacteria using colony-forming unit-based qPCR.

PURPOSE: Quantitative polymerase chain reaction (qPCR) has recently been employed to measure the number of bacterial cells by quantifying their DNA fragments. However, this method can yield inaccurate bacterial cell counts because the number of DNA fragments varies among different bacterial species. To resolve this issue, we developed a novel optimized qPCR method to quantify bacterial colony-forming units (CFUs), thereby ensuring a highly accurate count of bacterial cells. METHODS: To establish a new qPCR method for quantifying 6 oral bacteria namely, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Prevotella intermedia, Fusobacterium nucleatum, and Streptococcus mutans, the most appropriate primer-probe sets were selected based on sensitivity and specificity. To optimize the qPCR for predicting bacterial CFUs, standard curves were produced by plotting bacterial CFU against Ct values. To validate the accuracy of the predicted CFU values, a spiking study was conducted to calculate the recovery rates of the predicted CFUs to the true CFUs. To evaluate the reliability of the predicted CFU values, the consistency between the optimized qPCR method and shotgun metagenome sequencing (SMS) was assessed by comparing the relative abundance of the bacterial composition. RESULTS: For each bacterium, the selected primer-probe set amplified serial-diluted standard templates indicative of bacterial CFUs. The resultant Ct values and the corresponding bacterial CFU values were used to construct a standard curve, the linearity of which was determined by a coefficient of determination (r²) >0.99. The accuracy of the predicted CFU values was validated by recovery rates ranging from 95.1% to 106.8%. The reliability of the predicted CFUs was reflected by the consistency between the optimized qPCR and SMS, as demonstrated by a Spearman rank correlation coefficient (ρ) value of 1 for all 6 bacteria. CONCLUSIONS: The CFU-based qPCR quantification method provides highly accurate and reliable quantitation of oral pathogenic bacteria.

Sustained activation of persulfate by slow release of Fe(II) from silica-coated nanosized zero-valent iron for in situ chemical oxidation.

Sustained activation of persulfate through the slow release of Fe(II) from silica-coated nanosized zero-valent iron (nZVI) particles (nZVI@SiO2) was investigated. Slow release of Fe(II) prevented radical scavenging by excess Fe(II) and increased the radical yield, which improved the stoichiometric efficiency of phenol degradation. Sulfate and hydroxyl radicals were found to be the main oxidative species produced during phenol degradation and were found to make comparable contributions to oxidation. The nZVI@SiO2 particle silica shell thickness controlled the release of Fe(II) and therefore the sustained activation of persulfate and was strongly affected by the synthesis conditions, including the [Si]/[Fe] ratio and silica supply rate. Optimal sustained phenol degradation was achieved when nZVI@SiO2 particles were synthesized using a [Si]/[Fe] ratio of 0.5 and a tetraethyl orthosilicate supply rate of 0.5 mL/min, and this was attributed to the nZVI@SiO2 particles giving an optimal Fe(II) release rate and therefore a high persulfate activation rate and a high phenol removal efficiency. Sustained persulfate activation induced by Fe(II) being slowly released was described well by single-stage first-order kinetics rather than two-stage first-order kinetics typical of unmodified nZVI/persulfate systems. Persulfate was found still to be activated by iron (oxyhydr)oxides minerals after the nZVI@SiO2 particles had been exhausted but the persulfate sustained activation induced by the slow release of Fe(II) played a crucial role in determining the overall degradation efficiency. The results highlight the importance of the slow release of Fe(II) from nZVI-based materials for in situ chemical oxidation through sustained persulfate activation.

Evaluation of the use of biochar to stabilize polycyclic aromatic hydrocarbons and phthalates in sediment.

Three types of biochar (BC) (mulberry biochar (MB), wheat straw biochar, and pine tree sawdust biochar) were prepared and used to stabilize hydrophobic organic compounds (HOCs) in contaminated sediment. The kinetics of HOC adsorption to the BCs had two distinct stages. The second stage adsorption process was longer for MB than the other BCs, presumably because MB contained large pores, mesopores, and micropores. The adsorption isotherms for the three BCs were described well by the Freundlich model. The adsorption capacities of MB, WS and PT for HOCs ranged between 106.7 and 1202 µg/g, 135.1 and 1002 µg/g, and 255.6 and 909 µg/g, respectively. The apparent HOC adsorption coefficients (KBC-w) for the three BCs were determined from the isotherm data and were similar. The HOC logKOW values correlated well with the logKBC-w values. In sediment slurry experiments, HOCs were much more effectively stabilized by MB than wheat straw and pine tree sawdust biochar. This was probably because of the MB pore characteristics that favored adsorption of HOCs of various molecular sizes. The Fourier-transform infrared and Raman spectra indicated that the main binding mechanisms were hydrogen boding, hydrophobic interactions, and π-π interactions. MB was found to be a possible agent for stabilizing HOCs in contaminated sediment. HOCs in sediment slurry continued to become adsorbed to MB for a long time, indicating that relatively long reaction times should be allowed for in situ remediation using MB.

Antimicrobial activity of Limosilactobacillus fermentum strains isolated from the human oral cavity against Streptococcus mutans.

Oral probiotics have been recently gaining much attention owing to their potential to inhibit the progression of dental caries by controlling the cariogenic effects of Streptococcus mutans. We isolated and genotypically identified 77 lactic acid bacteria including 12 Limosilactobacillus fermentum probiotic candidates from the oral cavity of healthy volunteers. Among the 12 L. fermentum isolates, nine isolates effectively inhibited the growth of S. mutans via hydrogen peroxide (H2O2) production. The others neither suppressed the growth of S. mutans nor produced H2O2. Eight out of the nine H2O2-producing L. fermentum isolates exhibited strong adherence to oral epithelial KB cells while inhibiting the adherence of S. mutans to KB cells. The eight H2O2-producing isolates were neither haemolytic based on a blood-agar test, cytotoxic according to lactate dehydrogenase assay, nor resistant to eight antibiotics represented by the European Food Safety Authority guideline, indicating that the isolates have potential to suppress the cariogenesis driven by S. mutans while providing general probiotic benefits.

Standard operating procedures for the collection, processing, and storage of oral biospecimens at the Korea Oral Biobank Network.

PURPOSE: The Korea Oral Biobank Network (KOBN) was established in 2021 as a branch of the Korea Biobank Network under the Korea Centers for Disease Control and Prevention to provide infrastructure for the collection, management, storage, and utilization of human bioresources from the oral cavity and associated clinical data for basic research and clinical studies. METHODS: To address the need for the unification of the biobanking process, the KOBN organized the concept review for all the processes. RESULTS: The KOBN established standard operating procedures for the collection, processing, and storage of oral samples. CONCLUSIONS: The importance of collecting high-quality bioresources to generate accurate and reproducible research results has always been emphasized. A standardized procedure is a basic prerequisite for implementing comprehensive quality management of biological resources and accurate data production.

Continuous Fe(II)-dosing scheme for persulfate activation: Performance enhancement mechanisms in a slurry phase reactor.

Mechanisms involved in the superior performance of the continuous Fe2+ dosing scheme over the single Fe2+ dosing scheme was thoroughly investigated. The kinetics and stoichiometry of the phenol removal/persulfate consumption strongly depended on the volumetric or molar Fe2+ feeding rate, Fe2+ concentration in the feed solution, and Fe2+ feeding mode (continuous or single dose). The process performance was determined by the molar Fe2+ feeding rate rather than the volumetric Fe2+ feeding rate or the Fe2+ concentration in the feed solution. The phenol degradation rate increased as the molar Fe2+ feeding rate increased to 2.77 mmol/min but decreased as the Fe2+ feeding rate increased further. The sulfate radical was predominant radical species formed in continuous Fe2+ dosing mode. The hydroxyl and sulfate radicals were both important in single Fe2+ dose mode. The presence of hydroxyl radicals in single Fe2+ dosing mode decreased the amount of phenol oxidation that occurred, probably because the hydroxyl radicals were readily scavenged by soil organic matter. Continuous Fe2+ dosing facilitated phenol mineralization, which was indicated by total organic carbon measurements and toxicity tests performed using Hyalella azteca.

Association between body mass index and subcortical volume in pre-adolescent children with autism spectrum disorder: An exploratory study.

Conflicting associations exist between autism spectrum disorder (ASD) and subcortical brain volumes. This study assessed whether obesity might have a confounding influence on associations between ASD and brain subcortical volumes. A comprehensive investigation evaluating the relationship between ASD, obesity, and subcortical structure volumes was conducted. Data obtained included body mass index (BMI) and T1-weighted structural magnetic resonance images for children with and without ASD diagnoses from the Autism Brain Imaging Data Exchange database. Brain subcortical volumes were calculated using vol2Brain software. Hierarchical linear regression analyses were performed to explore the subcortical volumes similarly or differentially associated with BMI in children with or without ASD and examine association and interaction effects regarding ASD and subcortical volume impact on the Social Responsiveness Scale and Vineland Adaptive Behavior Scale (VABS) scores. Bilateral caudate nuclei were smaller in children with ASD than in control participants. Significant interactions were observed between ASD diagnosis and BMI regarding the left caudate, right and left putamen, and right and left ventral diencephalon (DC) volumes (ß = -0.384, p = 0.010; ß = -0.336, p = 0.030; ß = -0.317, p = 0.040; ß = 0.322, p = 0.010; ß = 0.295, p = 0.021, respectively) and between ASD diagnosis and right and left ventral DC volumes regarding the VABS scores (ß = 0.434, p = 0.014; ß = 0.495, p = 0.007, respectively). However, each subcortical structure volume included in the ventral DC area could not be measured separately. The results identified subcortical volumes differentially associated with obesity in children with ASD compared with typically developing peers. BMI may need to be considered an important confounder in future research examining brain subcortical volumes within ASD.

Activation of persulfate by humic substances: Stoichiometry and changes in the optical properties of the humic substances.

Persulfate activation through electron transfer from humic substances (HS) was investigated. Persulfate consumption in the presence of standard HS and HS model compounds linearly correlated with the phenol contents of the HS. Redox-active carbonyl groups such as aromatic ketones and quinone also contributed to persulfate consumption by donating electrons while being reduced. Phenols activated persulfate through direct electron transfer from the phenolate forms but reduced ketones activated persulfate through reactions between their organic radicals and persulfate. Persulfate was activated more by terrestrially derived aquatic HS containing large numbers of phenol groups than by other species, and this caused more benzene oxidation to occur in the presence of terrestrially derived aquatic HS than in the presence of other species. Larger amounts of sulfate radicals were scavenged by soil-derived HS than other types of HS because soil-derived HS were composed of larger molecules than other types of HS. The fluorescence regional integration volume for HS reacted with persulfate linearly correlated with persulfate consumption. Decreases in the fluorescence regional integration value could be used to predict persulfate activation through electron transfer from HS to persulfate if the electron-donating capacity cannot be determined. Persulfate activation by HS is expected to be stoichiometrically more advantageous than conventional persulfate-Fe2+ processes when treating an aquifer containing large amounts of electron-rich HS.

Post-Treatment of Tannic Acid for Thermally Stable PEDOT:PSS Film.

As a poly (3,4-ethylenedioxythiophene) doped with poly (styrene sulfonate), PEDOT:PSS is well known for its conductive polymer in a field of organic electronics. PEDOT:PSS can be widely operated as electronics under low temperature conditions; however, the layer can be easily damaged by high temperature conditions, while in fabrication or in the operation of electronics. Therefore, enhancing the thermal stability of PEDOT:PSS can be a novel strategy for both fabrication and operating varieties. Herein, PEDOT:PSS is the surface-treated with tannic acid to increase the thermal stability. A large number of phenols in tannic acid not only provide UV absorption ability, but also thermal stability. Therefore, tannic-treated PEDOT:PSS film sustained 150 °C for 96 h because of its initial conductivity. Moreover, surface properties and its bonding nature was further examined to show that the tannic acid does not damage the electrical and film properties. The method can be widely used in the field of organic electronics, especially because of its high stability and the high performance of the devices.

Complete Genome Sequence of Lactiplantibacillus plantarum Strain DM083 Isolated from Human Tongue Coating.

We isolated Lactiplantibacillus plantarum DM083 from the human tongue coating to establish a strain library for oral probiotics. It has a single circular 3,197,299 bp chromosome with a guanine-cytosine (GC) content of 44.6% without plasmids. Importantly, the genome is devoid of the antimicrobial resistance gene, satisfying the minimum safety requirement for probiotics.

Leaky Gum: The Revisited Origin of Systemic Diseases.

The oral cavity is the gateway for microorganisms into your body where they disseminate not only to the directly connected respiratory and digestive tracts but also to the many remote organs. Oral microbiota, travelling to the end of the intestine and circulating in our bodies through blood vessels, not only affect a gut microbiome profile but also lead to many systemic diseases. By gathering information accumulated from the era of focal infection theory to the age of revolution in microbiome research, we propose a pivotal role of "leaky gum", as an analogy of "leaky gut", to underscore the importance of the oral cavity in systemic health. The oral cavity has unique structures, the gingival sulcus (GS) and the junctional epithelium (JE) below the GS, which are rarely found anywhere else in our body. The JE is attached to the tooth enamel and cementum by hemidesmosome (HD), which is structurally weaker than desmosome and is, thus, vulnerable to microbial infiltration. In the GS, microbial biofilms can build up for life, unlike the biofilms on the skin and intestinal mucosa that fall off by the natural process. Thus, we emphasize that the GS and the JE are the weakest leaky point for microbes to invade the human body, making the leaky gum just as important as, or even more important than, the leaky gut.