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Less pain for patients, more money saved by dental health services, researchers investigate

2017-11-10

The ability to identify individuals who run the risk of developing periodontitis would save the dental care system money, and patients would avoid a lot of unnecessary suffering, conclude Malmö University researchers. 

In a recently completed research project, Professor Gunnel Svensäter and her research team have taken the first step in mapping potential biomarkers.

Severe periodontal disease affects more than 700 million people worldwide. It is currently difficult to identify exactly who will develop this very serious condition. Gunnel Svensäter is heading a research study, funded by Region Skåne and the Knowledge Foundation, which represents the first step towards pinpointing bacteria, molecules and metabolites in biofilms under the gums, and which could be the driving force behind the degradation of alveolar bone – the bone tissue around the teeth. 

Shifting the focus of research

Previous research in this field has focused mainly on special bacterial genotypes – the names of the bacteria and their DNA set. A whole range of bacteria have been discovered that are definitely related to the development of periodontitis, although their presence is only part of the story. This study has instead focused on special phenotypes. These tell us which genes the bacteria use and thus which features they display in a particular situation.

Gunnel Svensater“Our working hypothesis is that proteolytic phenotypes – bacteria that form proteases in order to be able use protein as a source of nutrition – are the driving force in the destructive process that results in the loss of dentin,” said Gunnel Svensäter.

According to Gunnel Svensäter, overexpression of a specific phenotype could increase the risk of bone destruction around the teeth. “I don’t believe that the genotype itself can explain the disease. We must detect and draw attention to the disease-inducing phenotype,” she said. 

More than 700 different species of bacteria could exist in the mouth. Every person has around 600 species and this raises the question of what happens when several species of bacteria live in close proximity in a protein-rich environment – under the gums for example. In their pursuit of the ‘culprit’, the research team has conducted a series of experimental studies. 

Finding the 'culprit'

They succeeded in isolating two suspected genotypes, proteolytic phenotypes, and two proteins. By investigating a group of 25 patients with a low risk of developing periodontitis and an equal number with a high risk of developing periodontitis, they are now looking to see if these potential biomarkers occur more frequently in the latter group. The hope is to be able to ascertain more closely which combination of biomarkers has a key role to play. In that case, clinical tools can be produced for the next step, where researchers intend to follow hundreds of individuals over several years as part of a prospective study to validate the biomarkers.

“By examining whether certain individuals develop bone destruction, we can validate a certain marker. If we manage to find it, we can design treatment strategies directed at that particular phenotype,” Gunnel Svensäter explained.

The research team hope that this will have huge benefits in the future.

“Dentists would have a tool at their disposal for making much more accurate assessments of the risk of developing periodontitis than is currently the case. This would mean the dental care system could declare more people healthy and not everyone who is potentially at risk would be regarded as being ill. This would allow more focused, preventative measures to be implemented as and when necessary.”

Text: Magnus Jando

Last updated by Adrian Grist