Epithelial surfaces are the most important route of entry of microbial path
ogens. The interaction between bacteria and epithelial cells is now recogni
zed to be a process in which the epithelial cells are active participants.
This epithelial response is especially important in the oral cavity in whic
h there is continual exposure to bacteria, fungi, and viruses. Humans have
many mechanisms that are responsible for keeping the balance between health
and disease in this complex environment. These include the natural defense
s of saliva and the host innate immune responses, as well as the ability to
generate antibodies via acquired immune responses. This brief review will
focus on a recently recognized group of antimicrobial peptides, the defensi
ns, and mainly on the beta -defensins that are expressed by epithelial cell
s. These peptides are part of the innate immune system; they have broad spe
ctrum antibacterial and antifungal activity and they have properties that m
ay serve to link innate immunity with the acquired immune system. Their rol
e in oral health and susceptibility to disease is only now beginning to be
appreciated, and many interesting questions remain to be explored.