A trip to the dentist can be a nerve-wracking event. We're helpless as these oral professionals examine our mouths looking for a variety of troubles. Cavities and gum disease are the usual suspects and have the most immediate impact in the form of fillings, surgeries and tooth extraction. But many more troubles could arise from having an unhealthy mouth leaving us even more prone to disease.
One of the conditions associated with poor oral health is known periodontitis. It's inflammation of the ligament and bone supporting our teeth. But while the obvious symptoms are local, other unseen troubles may be happening inside the body. The ailment has been linked to a variety of chronic diseases including diabetes, rheumatoid arthritis, osteoporosis and cardiovascular diseases, to name a few. It should come as no surprise oral health professionals want to stop periodontitis as quickly as possible.
For years, researchers have been trying to figure out what contributes to this ailment. For well over a century, the most common suspects have been bacteria. By the 1970s, the detrimental role of some microorganisms was confirmed. According to the research, a variety of pathogenic bacterial species contributed to the decline of oral health. If they were not stopped, the consequences could be dire.
This discovery led to the development of a variety of therapeutic options, but the most effective happened to be antibiotics. The intent was to target specific types of bacteria and ensure they were killed off. While this had short-term value, they could never quite resolve the condition. Other natural options such as herbal extracts were also examined. Yet again, while they can help the body resist these harmful bacteria, they could not eliminate them.
The trouble lies not in the bacteria themselves, but how they form communities, better known as biofilms in the mouth. When a single bacterium finds a home, it can quickly reproduce and colonize the area. As the numbers grow, so does the production of sticky substances designed to protect the individuals and bring in other species. Over time, this can form into a polymicrobial city with a variety of different traits and defences. With the right mix of bacteria communicating back and forth, antibiotics, herbal remedies and other therapies can be fought off leaving the person little choice but to continue suffering.
But last week, an international team of researchers suggested they may have the answer to resolve periodontitis in the future. They published a study providing the evidence they believed was necessary to support a rather new medical technique. Formally, it's called bacteriotherapy, but in the public, it's more commonly known as microbial transplantation.
The premise of using bacteria to combat bacteria isn't new. It's currently being used in another area of the body -- the gut -- to fight off a variety of single and polymicrobial troubles. It has shown promise to combat the potentially lethal Clostridium difficile and also has helped to resolve other gastrointestinal disorders, particularly in children.
For the authours of the study, the concept of transplantation appeared to be transferrable to the mouth. Thankfully, though, the actual bacteria to be used would not be fecal, but rather oral. In essence, oral microbes would be taken from healthy individuals and transplanted into those suffering with periodontitis. However, to be sure this could be possible they had to determine whether there was a noticeable difference in the microbial population of the two groups.
To accomplish this, they examined the oral bacteria of 16 individuals. Twelve suffered from one of the following conditions: severe periodontitis, caries, or edentulism. The final four had optimal oral health. Bacteria were taken from above and under the gum line, as well as from the inner cheek. The samples were then taken back to the lab and examined. If the authors were right, they would find noticeable differences in the population and also possibly a collection of good bacteria for possible transplant.
As expected, there were significant differences in the bacterial population between the groups. In those suffering, there were a few of the long-known usual suspects such as Porphyromonas gingivalis and Treponema denticola, but their contribution was minimal. Instead, the three conditions appeared to be due to a combination of bacterial species working together to cause trouble.
The results allowed the authors to conclude the conditions appeared to be associated with a form of oral dysbiosis in which a lack of proper diversity and friendly bacteria allowed pathogens to enter the environment and take hold. To the group, this was no different than what is seen in the gut and provided the evidence needed to support transplantation and move towards more studies in the lab and hopefully in clinical trials.
Obviously, it will still be years before anyone actually attempts oral microbial transplantation. The promise may be there but the practice is still far in the future. In the meantime, keep up the brushing, flossing, mouthwash, and those regular visits to the dentist. Until we can use bacteria to prevent disease, these options are the best ways to maintain oral health.
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