Dentistry is not a one size fits all type of medicine. Dentistry is a very personalized treatment for our dental health. This includes treatment and management of periodontal disease. DNA testing is all the craze with companies like 23andMe. But did you know you can use DNA testing for oral diseases as well? The company is called OralDNA and they have developed three separate testing methods. These include early warning and detection for periodontal disease, personalized treatment for periodontal disease, and checking if you have increased risk of developing HPV related oral cancers.
OralDNA Approach To Periodontal Disease
-OralDNA MyPerioPath testing. Oral DNA MyPerioPath is a diagnostic tool for the detection of the type of oral pathogens present in your mouth that can cause periodontal disease. By using this test your dentist can create a personalized care to deal with the pathogens causing the issues in your mouth. There is also evidence that knowing what oral pathogens are present can also determine a patients increased risk of developing Diabetes, cardiovascular disease, alzheimer’s disease, possible stroke, and if pregnant, risk of birth complications. Clinical studies are increasingly linking oral bacteria with systemic disease. For example, inflammation is a major factor in both periodontal disease and heart disease. recent studies have found that a high dose of a common cholesterol medication (atorvastatin) can prevent inflammation from both periodontal inflammation as well as cardiovascular inflammation. Statin family of medicines have other side effects as well not always that good. But this adds to the education that there is a connection between periodontal disease and heart disease.
The Oral DNA MyPerioPath test can determine if the following pathogens are present and in what levels:
- (Aa) Aggregatibacter actinomycetemcomitans
- (Pg) Porphyromonas gingivalis
- (Tf) Tannerella forsythia
- (Td) Treponema denticola
- (En) Eubacterium nodatum
- (Fn) Fusobacterium nucleatum/periodonticum
- (Pi) Prevotella intermedia
- (Cr) Campylobacter rectus
- (Pm) Peptostreptococcus (Micromonas) micros
- (Ec) Eikenella corrodens
- (Cs) Capnocytophaga species (gingavalis, ochracea, sputigena)
The Oral DNA MyPerioPath testing should be done on an annual basis. Once at start of periodontal disease treatment and then one at end of first year to track progress of personalized treatment and if any changes need to be made to improve periodontal disease state. Oral DNA MyPerioPath is a valuable tool that can allow you and your dentist to measure success and track progress for a more personalized periodontal disease therapy.
–Oral DNA MyPerioPath combined With MyPerioID. The Oral DNA MyPerioID test assesses a persons inherited genetic risk to developing periodontal disease as well as other systemic diseases as mentioned above. Combining the 2 tests can give greater control to personalized periodontal disease care and give a fuller picture to you and your dentist. Can also help determine which patients are at increased risk for more severe periodontal disease infections due to an exaggerated immunity response.
–Oral DNA OraRisk HPV Test. This test can determine if there is increased risk for HPV related oral cancer. Human papillomavirus (HPV) is one of the most common virus groups in the world (and is linked to the HPV virus in the mouth). Specific types of oral HPV are now considered to be separate and serious risk factors for developing oral cancers. Early detection and identification of the presence or absence of oral HPV is important, as early oral HPV infections do not typically cause any clinical signs or symptoms.
-Oral DNA OraRisk HPV Complete Genotyping Test. This HPV test gives data to your dentist or doctor to establish if there is increased risk for oral cancer and have the ability to make proper referral for further treatment. Oral DNA OraRisk HPV complete genotyping has the ability to identify a total of 51 different types of oral HPV.
Oral Pathogens Associated With Periodontal Disease
Periodontal researchers have uncovered more than 350 different species of microorganisms that are present in a normal, healthy person’s mouth. Fewer than 5% of these species are linked to periodontal disease. It has also proven that these bacteria that cause periodontal disease, can be shared with your partner or loved ones.
Generally healthy and disease causing bacteria are usually placed into two distinct bacteria categories:
–Gram positive aerobic bacteria. These are harmless or helpful bacteria in the mouth.
–Gram negative anaerobic bacteria. These are the bacteria known to be related to periodontal disease. When periodontal disease develops, the bacterial balance in the mouth shifts over to gram negative anaerobic bacteria. Inflammation and injury cannot develop without these bacteria flourishing in the mouth.
Common bacteria involved in periodontal disease include:
–Actinobacillus actinomycetemcomitans (Ag) and Porphyromonas gingivalis (Pg). These two bacteria appear to be particularly likely to cause aggressive periodontal disease. Both P. gingivalis and A. actinomycetemcomitans, along with multiple deep pockets in the gum, show increased resistance to standard dental treatments for periodontal disease. The presence of P. gingivalis may even have 2x the risk for serious periodontal disease. P. gingivalis produces enzymes, such as one called arginine-specific cysteine proteinase, that has been linked to a disruption of the immune system and lead to subsequent periodontal connective tissue destruction.
–Bacteroides forsythus is also strongly linked to periodontal disease.
Other bacteria associated with periodontal disease are Treponema denticola, T. socranskii, and P. intermedia. These bacteria, together with P. gingivalis, are frequently present at the same sites, and are associated with deep periodontal pockets.
Some bacteria are related just to gingivitis, but not development of plaque. They include various streptococcal species.
As you can see there are a variety of bacteria that are linked to periodontal disease. The MyPerioPath testing can isolate the bacteria causing the issues for you. Your dentist can use antibiotic therapy and rinses to personalize care for your particular case.
How does OralDNA testing help to individualize periodontal disease treatment?
The ability to know the bacteria that is causing the issue allows treatment to target that bacteria. Periodontal disease treatment can include the following:
–Scaling And Root Planing (S&RP). Also called a “deep” cleaning. The initial goal of any periodontal disease treatment must be the removal of plaque and tartar buildup that is causing irritation and inflammation development. The scaling and root planing procedure is done with this in mind as well as to allow for healing and reattachment of gingival fibers to the tooth. This healing can hopefully reduce size of periodontal pocketing (normal about 3mm).
–Antibitoics Application. This can include administering this via a pill orally or placed into local areas that need help. Arestin is an antibiotic that can be placed directly into a periodontal pocket and give local therapy. This is important as it reaches places your dentist cannot but it also does not have the side effects of a systemic pill. The use of antibiotics will help control the overgrowth of the “bad” bacteria that is flourishing due to periodontal disease.
-Dental Hygiene Instructions. This is a staple of any periodontal disease treatment. This disease will be an ongoing problem that needs maintenance to stave it off. This includes proper brushing, flossing, and rinsing. Your dentist may even prescribe a prescription oral rinse to control bacteria or even Periogen. Periogen is an oral rinse that has been shown to help dissolve tartar between visits to the dentist. By lowering amount of tartar in the mouth you are hopefully also lowering the irritatation and inflammatory response.
Periodontal Disease Treatment With Oral DNA Testing Conclusion
DNA testing has been a great tool in many facets of society. It can also be one for dentistry thanks to OralDNA. There is an increased cost for this type of testing but it comes with great benefits in controlling a disease that can be difficult to manage. Any advantage will save you time and discomfort over time during treatment as well as possible tooth loss and systemic health maintenance. Periodontal disease linked to heart disease (as well as other diseases) should be motivation enough to get this under control. See your dentist at the first signs of periodontal disease and get your health back on track.