How to Teach Oral Ecology Using Complexity Approach?

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Oral ecology is a recently emerged branch of inquiry that studies the oral world – the ‘world of human mouth’. When applying the approach of com­plexity in teaching oral ecology, we seek to explore the ‘oral world’ in re­lationships with the world of the whole organism existing in unbreakable unity with the social and natural environment in which we live. This is our rational for suggesting an oral ecology-based approach in dental education.

The mouth is ‘the house’ of the oral dynamics and the oral ecology focuses on these dynamics. Complexity theory explains that the oral dynamics cannot be understood only by keeping them locked in the mouth. Through the prism of complexity, dynamical processes in human mouth are seen as nested in dynam­ical processes of the individual’s body, nested in social dynamics, which are nested in the dynamics of nature and the planetary and universal dynamics (Bak, 1996; Gleick, 1987). Therefore, the first thing that needs to be underlined when we teach oral ecology using the approach of complexity science is its inseparable connected­ness with human ecology – a study of the ever-changing, evolving and transform­ing interrelationships and interactions operating at different level of human nature – physical, emotional, mental, spiritual, social, environmental, universal. Human ecology is organically imbedded in the ecology of society (social ecology) (Dimi­trov, 2003) and the ecology of nature and planet (environmental ecology) (Sole and Goodwin, 2000; Bak, 1996). This implies that the understanding of oral ecology is impossible without developing understanding of the essentials of human, social and environmental ecologies. This is a direct consequence of applying the complex­ity approach. One can never grasp the nature of a complex dynamic entity when studying it in isolation from the entities which it relates to – depends on, exercise influence to, and co-evolves with.

If we focus on the micro-world of the human mouth, we can observe more than 400 distinct species of micro-organisms, mainly bacteria. In addition, recent investigations have documented that a number of non-cultivable species might be added, interfering in the balance between oral health and disease (Aas, 2006). Bil­lions of interacting bacteria live on the surface of each tooth, in the crevices of the tongue, on the inner sides of the cheeks, on the gums and the palate. In this humid environment, saliva participates both in positive and negative feedback loops in relation to the whirling bacterial dynamics. The proteins which the saliva contains have positive impact on the growth of the bacteria, as they provide them with nu­trients, while the antibacterial agents in the saliva (lysozyme, immunoglobulins, antifungal and antiviral components) have negative impact impeding their growth. Saliva also contains acid-buffering substances. Bicarbonate ions in the saliva neu­tralize the tooth-decaying acids produced by a variety of acidogenic bacteria and the phosphatic and calcium ions in the saliva act both as buffering and re-mineralizing agents repairing microscopic initial de-mineralized area.

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