Gingivitis ranks as one of the most common health problems in the U.S., with over 50 percent of the adult population suffering from some degree of gum disease. At the early stages of gingivitis – an early form of gum disease – most people don’t even notice their gums slowly turning a darker red, especially if they don’t regularly visit their Edmond family dentist. Unfortunately, without the proper care and attention, the disease progresses and can cause bleeding, chronic bad breath, gum inflammation, and eventually periodontitis, a more advanced form of gum disease and the leading cause of permanent tooth loss in adults.
Bacterial growth, commonly referred to as plaque, ranks as the primary cause of gum disease. While several types of oral bacteria can pose a threat to our oral health, some types pose a greater risk than others. One particularly troublesome strain of bacteria is known as Porphyromonas gingivalis. A mouth that features a high percent of this type of bacteria has a higher risk for periodontitis.
Understanding the Causes of Gum Disease
For decades, researchers have attempted to determine what makes this type of bacteria so problematic for our oral health. Studies from the 90s found that the bacteria had the ability to invade our gum cells. This led to the possibility for the bleeding and cell death that causes gum recession.
While this discovery provided some insight, it marked only the beginning of what researchers would uncover. When any chronic infection develops, the immune system invariably plays a role. In 2001, researchers finally found what impact this type of bacteria had on the body’s immune system. The presence of the bacteria caused a type of cellular inflammation in gum tissue. Some research indicated that just the physical components of the bacterial cells was enough to cause the inflammation. However, this data only showed short-term effects of the oral bacteria, allowing the long-term cause of gum disease to remain hidden.
Now, researchers believe they may have uncovered what’s ultimately responsible for the development of gum disease. An international group of researchers used a combined mixture of human and microbial cell cultures to identify a specific protein they named Gingipain as the cause of long-term inflammation linked to gum disease. The results of this research suggest the bacteria causes the most trouble when inactive.
The initial experiments behind this research were fairly standard. Immune cell cultures were infected by the bacteria in hopes that the cellular markers for inflammation would materialize. Indeed, not only did the cell react to the presence of the bacteria, but when Gingipain was active, very little inflammation actually occurred. Conversely, when the enzyme remained dormant, the inflammation really took off.
This unexpected twist led researchers to believe that there may be more than just a simple infection going on in the body. To answer that question, researchers had to conduct a different type of experiment. Researchers needed to analyze the infected cells after adding them to an artificial immune system to determine what effect the enzyme had on a systematic level.
When researchers examined the impact the infection had on the immune system, they were surprised to discover the inactive form of the enzyme has the sores effect. In this study, inflammation was actually increased and sustained. This indicated that a lack of enzyme activity was actually making the situation worse.
While these results seemed to make little sense initially, researchers were able to identify an explanation. They examined the different proteins involved in inflammation hoping to find one that might interact with the enzyme. The most likely candidate was a molecule known as interleukin six (IL-6). If researchers were right, blocking this molecule might stop the inflammation causing gum disease regardless of how active the enzyme.
The Potential for Future Breakthroughs
Researchers were proven correct, when they blocked IL-6, inflammation decreased in all cases. Researchers had finally identified the right suspect in the periodontitis mystery. But perhaps even more important, the results of their research have shown that the trouble wasn’t being caused by some type of previously unknown biological entity, but by a factor previously known to be linked with long-term inflammation.
Having identified the role IL-6 plays in oral inflammation, researchers suggest the potential to slow and possibly stop the progression of gingivitis may not be too far into the future. A drug already exists that would effectively achieve this goal, but currently it is only approved to treat another IL-6 based condition, rheumatoid arthritis. Regardless, the fact that a drug exists that has already been approved for use by the FDA suggests a new version designed to treat gum disease may only be a few years away vs. decades.
As we continue to wait for the medication to catch up with the research, the best way reduce your risk of gingivitis is to ensure your teeth and gums remain healthy. This means brushing at least twice a day, flossing daily, and scheduling regular exams and cleanings with your Edmond family dentist. While research may eventually help us find long-term solutions for gum disease, a little prevention in the short-term will go a long way towards ensuring you enjoy a lifetime of healthy teeth and gums.