<p>The potential role of <i>Fusobacterium nucleatum</i>, bacterium that is a major and regular inhabitant of the oral cavity, in the progression of oral cancer through various mechanisms, including adhesion, immune perturbation, and its potential associations with different signalling pathways. Scientists have already demonstrated that infection with bacteria can cause them to adhere to oral epithelial cells, leading to their invasion of host tissues, as shown through in vitro, preclinical, and clinical studies. Furthermore, <i>Fusobacterium nucleatum</i> alters the tumour microenvironment, inciting inflammation, and shifts in the immune system to enhance tumour growth. It also modifies important signaling pathways (e.g. Wnt/ β-catenin pathways), which are associated with cell proliferation and survival, characteristics of cancer progression. The study provides a clear demonstration of these processes and discusses implications for the bacteria in terms of medical diagnosis and therapies for patients. Studies involving <i>Fusobacterium nucleatum</i> offer an important window into potential therapeutic targeting of immune responses and pathways in the context of oral cancer. This research builds upon <i>Fusobacterium nucleatum</i>, identified as a therapeutic target, and provides several case examples of how precision medicine may be applied to oral cancer treatment.</p> Graphical abstract <p></p>