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.
In research published in last month’s Applied and Environmental Microbiology, an international team of researchers and clinicians charted the microbial ecology of the mouth at all stages of this progression, in nearly 1,000 women in Malawi where oral infections are very common.
The investigators used high-throughput sequencing of the 16S ribosomal RNA (16S rRNA) gene to take the census of the oral microbiomes—the combined genetic material of oral microorganisms. When they analysed this, they found that a small number of bacteria were associated with periodontitis, but not gingivitis.
“Our findings confirm that periodontitis cannot be considered simply an advanced stage of gingivitis, even when only considering supragingival plaque,” said author Liam Shaw, a PhD student at University College London, UK.
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 co-author Ulla Harjunmaa, 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, added Harjunmaa, noting that this research may in future lead to an inexpensive and rapid point-of-care test, based on distinguishing the microbiomes associated with both conditions.
“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,” said Shaw.