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Imbalances in the normal bacterial equilibrium within the oral cavity, known as dysbiosis, can arise from an excessive proliferation of disease-associated bacteria or a reduction in health-associated bacteria29,45

Merrin adds

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Other Factors Dehydration appears to be a substantial factor in increasing the risk of acute gout attacks ( Prophylaxis of Acute Gout Flares )( Table 7 - 2 )