# Cross Talk between Synthetic Food Colors (Azo Dyes), Oral Flora, and Cardiovascular Disorders
## 2 Food Colors, Oral Flora and Cardiovascular Disorders
### Oral Flora and Periodontal Disease
#### 2.3.3 Role of Oral Flora in Periodontal Disease  
Oral flora has a major part in human health status and the human microbial community because it helps the human body against the invasion of an undesirable stimulation outside. An imbalance of microbial flora causes whole body and oral systematic diseases. There are different microbiomes present in the oral cavity, forming a bacterial community structure. Almost 1100 different types of taxa are recorded in the human oral flora [41]. About 20-50% of the world population are affected by periodontitis disease, which is caused by the three bacterial species _P. gingivalis_, _T. denticola_, and _T. forythia_, and Gram-negative bacteria commonly involved in periodontitis disease are also nominated as a red complex group [42]. Recent studies revealed that _P. gingivalis_ majorly contributed to causing periodontal disease because the bacterial species produces certain virulence factors and some extracellular proteases, such as gingipain, fimbria, and lipopolysaccharide, etc., which results in damaging the periodontal tissue. In the literature, there is almost six major phyla present in the human oral cavity, such as _Firmicutes, Proteobacteria_, _Bacteroides_, _Actinobacteria_, _Spirochuates_, and _Fusobacteria_, which contain about 96% of the taxa, as shown in Table 1. \begin{table}
\begin{tabular}{c c c c c} \hline \hline  & & **Human Oral Flora** & & \\ \hline \multirow{4}{*}{**Phyla**} & \multirow{2}{*}{**Class**} & **Order** & **Family** & **Genera** \\ \cline{3-5}  & & Clostridia & Clostridales & Lachnospiracyaceae & _Catonella_ \\  & & Clostridia & Clostridiales & Eubacteria & _Eubacterium_ \\  & & Clostridia & Clostridiales & PeptopStreptococcus & _Filifactor_ \\  & & Bacilli & Bacillus & staphylococcaceae & _Gemella_ \\  & & Bacilli & Lactobacillus & Carnobacteriaceae & _Granulicatella_ \\
**Firmicutes** & & Bacilli & Lactobacillus & Streptococcuscccaceae & _Streptococcus_ \\  & & Negativicutes & Vellionellales & Veillonellaceae & _Vellionella_ \\  & & Negativicutes & Selenomonadales & veillonellaceae & _Dialister_ \\  & & Negativicutes & Selenomonadales & Selenomonadaceae & _Selenomonas_ \\  & & Negativicutes & Selenomonadales & Veillonellaceae & _Megasphera_ \\  & & Tissierellia & Tissierelliales & Peptopinbilaceae & _Parcimonas_ \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Five different Phyla of oral flora that contribute to the formation of different periodontal disorders in the human body [41; 43; 44]. The consumption of processed foods in daily life, such as sugar products, meat products, and carbonated and soft drinks containing synthetic food colorants contaminants, could pose a health risk [45]. These colors contain different azo dyes, which are acidic in nature. In dental health, these dyes cause a staining effect, which produces dental plaque. Dental plaque is commonly caused after the consumption of products that contain synthetic food colors (azo dyes), higher concentrations of citric acids and phosphoric rates, amino acids, and sodium concentration (especially sodium chloride). In addition to the six major phyla in Table 1, the remaining phyla contain _Chlamydia_, _Chloroflexi_, _SR1_, _Euryarchaeota_, _Synergistetes_, _Tenericutes_, and _TM7_, which makes up about 4% of taxa. All the bacterial phyla contribute to different and major oral disorders, such as periodontal disease, which is caused by releasing different chemicals and toxins. It causes gum disease by weakening the gum tissues [46]. Streptococcus mutans in the mouth thrives on sugar and produces acids, which eat the enamel [47; 48], as shown in Figure 2. The basic principle of enamel is to protect the teeth from painful chemicals and temperature; it is the hard-protected layer that coats the crown (part of teeth). When the plaque is not treated in time, it is converted into tartar, which is considered to be the hardest layer (accumulated with different bacterial species). In addition to these bacterial species (_P. gingivalis_, _T. denticola_, _T. forysthia_, and _Strep.