Dr. Krape Cosmetic & Specialized Dentistry of North Palm Beach Florida, understands the seriousness of oral neglect. Over many years he has observed the long term ill-effects of poor oral hygiene and what it can do to the entire body when it comes to much more serious and life threatening concerns.
Gingivitis is one of the most common signs that eventually leads to a much more serious concern of Periodontitis. Note what the following article and study published by: Applied and Environmental Microbiology on August 12th reveals below.
Investigators chart microbial ecology of gingivitis, periodontitis
Gingivitis, a common and mild form of gum disease can progress to periodontitis, a more serious infection that damages the soft tissue of the gums and sometimes even destroys the bone supporting the teeth. An international team of researchers and clinicians has charted the microbial ecology of the mouth at all stages of this progression, in nearly 1,000 women in Malawi. This work is laying a foundation of knowledge that could lead to better oral health. The research is published in Applied and Environmental Microbiology, a journal of the American Society for Microbiology.
The investigators used high-throughput sequencing of the 16S ribosomal RNA (rRNA) gene to take the census of the oral microbiomes. Among much else, they found that a small number of species were associated with periodontitis, but not gingivitis, including members of the genera, Prevotella, Treponema, and Selemonas. “Our findings confirm that periodontitis cannot be considered simply an advanced stage of gingivitis, even when only considering supragingival plaque,” said first author Liam Shaw, a PhD student at University College London, United Kingdom.
Periodontitis is diagnosed by measuring the depth of the pockets in the gums next to the teeth. “But diagnosing periodontitis visually is impossible and it doesn’t usually give any symptoms until it has developed so far that teeth become mobile, which is very late for any treatment,” said coauthor Ulla Harjunmaa, a dentist with a master’s degree in international Health, who is a PhD student at the Center for Child Health Research, University of Tampere and Tampere University Hospital, Finland.
Diagnosis requires specially trained dental professionals and expensive equipment, which are seldom available in developing countries, said Harjunmaa. But among other things, in the future, this research may lead to an inexpensive and rapid point-of-care test, based on distinguishing the two conditions’ microbiomes. “The research made it possible to tell which differences in bacteria were linked specifically to the deepening of dental pockets – which causes loss of teeth – rather than just to bleeding gums,” explained Shaw.
“We’re not the first to do this sort of research into periodontal disease, but our study is the largest to be done in such a setting,” said Shaw. “There is a great need to find new solutions to prevent these problems everywhere, but especially in this kind of setting.” He added that oral infections are very common in Malawi, since there is little awareness about oral health and prevention, and little treatment available.
Some of the techniques used in the research may have wide applications, said Shaw. “Where diseases can have multiple severities and clinical features that are also found in non-disease (like bleeding gums in periodontitis), this kind of modeling will be increasingly important in microbiome research.”
Periodontal disease is a major public health problem associated with oral bacteria. In developed nations, approximately half of adults are thought to have moderate periodontal disease, with another 7-15 percent having advanced disease, according to the Centers for Disease Control and Prevention. Additionally, periodontal disease is thought to be a risk factor for cardiovascular disease, diabetes, and other chronic health conditions. Treating gum disease could reduce healthcare costs, as well as hospitalizations, according to a study published in the August, 2014 American Journal of Preventive Medicine.
“The best way to prevent periodontal disesases is by proper tooth brushing twice a day combined with flossing once a day,” said Harjunmaa. For smokers, quitting is also critically important to prevention, she said.
Article: Distinguishing the Signals of Gingivitis and Periodontitis in Supragingival Plaque: A Cross-Sectional Cohort Study in Malawi, Liam Shaw, Ulla Harjunmaa, Ronan Doyle, Simeon Mulewa, Davie Charlie, Ken Maleta, Robin Callard, A. Sarah Walker, Francois Balloux, Per Ashorn and Nigel Klein, Applied and Environmental Microbiology, doi: 10.1128/AEM.01756-16, published online 12 August 2016.
Distinguishing the Signals of Gingivitis and Periodontitis in Supragingival Plaque: A Cross-Sectional Cohort Study in Malawi
Periodontal disease ranges from gingival inflammation (gingivitis) to the inflammation and loss of tooth-supporting tissues (periodontitis). The bacterial composition of supragingival plaque across a range of periodontal severities has not previously been explored with high-throughput sequencing. Furthermore, quantitative modelling of bacterial abundances in supragingival plaque as a function of both gingivitis and periodontitis has not previously been attempted.
We assessed a cross-sectional cohort of 962 Malawian women for periodontal disease and used 16S rRNA gene amplicon sequencing (V5-V7 region) to characterise the bacterial composition of supragingival plaque samples. Associations between bacterial relative abundances and gingivitis/periodontitis were investigated by using negative binomial models, adjusting for epidemiological factors. We also examined bacterial co-occurrence networks to assess community structure.
The main differences in supragingival plaque composition were associated more with gingivitis than periodontitis, including higher bacterial diversity and greater abundance of particular species. However, even after controlling for gingivitis, the presence of subgingival periodontitis was associated with an altered supragingival plaque. A small number of species were associated with periodontitis but not gingivitis, including members ofPrevotella, Treponema, and Selemonas, supporting a more complex disease model than linear progression following on from gingivitis. Co-occurrence networks of periodontitis-associated taxa clustered according to periodontitis across all gingivitis severities. Species including Filifactor alocis and Fusobacterium nucleatum were central to this network, supporting their role in co-aggregation of periodontal biofilms during disease progression.
Our findings confirm that periodontitis cannot be considered simply an advanced stage of gingivitis, even when only considering supragingival plaque.
IMPORTANCE. Periodontal disease is a major public health problem associated with oral bacteria. While earlier studies focused on a small number of ‘periodontal pathogens’, it is now accepted that the whole bacterial community may be important. However, previous high-throughput marker gene sequencing studies of supragingival plaque have largely focused on high-income populations with good oral hygiene without including a range of periodontal disease severities. Our study includes a large number of low-income participants with poor oral hygiene and a wide range of severities. We are able to quantitatively model bacterial abundances as a function of both gingivitis and periodontitis, which has not previously been attempted. A signal associated with periodontitis remains after controlling for gingivitis severity, supporting the concept that even when only considering supragingival plaque, periodontitis is not simply an advanced stage of gingivitis. This suggests the future possibility of diagnosing periodontitis based on bacterial occurrences in supragingival plaque.