Oral microbiome analysis, OralFlor Scan® assesses the oral microbiome, a key ecosystem directly related to the gut-brain axis, cardiovascular system, and of course oral and dental health. Using real-time PCR, OralFlor Scan® provides an accurate and reliable measurement of the microbial species of the oral microbiome.
The oral microbiota exists as a complex biofilm that remains relatively stable, despite environmental changes. However, dysbiosis, which can be caused by infection, antibiotics, injury, dietary changes, and some dangerous habits (e.g., smoking) may disrupt this biofilm community, favoring colonization and invasion of pathogens.
The disturbance in the balance of the oral microbiome to a pathogenic profile, induces host immune responses, chronic inflammation, and ultimately, the development of local and systemic diseases, such as gingivitis, periodontitis, and oral cancer, cardiovascular diseases, and neurodegenerative diseases.
Periodontal disease is a growing public health concern, affecting approximately 750 million individuals worldwide. The burden of this disease is expected to continue to grow as the global population ages. Periodontal disease is preventable and reversible in its early stages; however, it can progress to chronic, irreversible states with significant destruction of the tooth-supporting tissues. The cause of the periodontal disease is multifactorial with modifiable risk factors, including smoking, unhealthy diet (e.g., a western diet with high sugars and saturated fats), poor oral hygiene, hormonal changes, stress, various medications, and poorly managed comorbidities (e.g., type 2 diabetes), while non-modifiable risk factors include age, sex, and genetics. Periodontal disease, when left untreated, can have local and/or systemic consequences, leading to poor oral and systemic health and quality of life. The underlying link of periodontal disease with other chronic systemic diseases likely results from the dissemination of periodontopathogens into the bloodstream, endotoxin release, and the associated imbalanced inflammatory response to periodontopathogens.
Periodontal disease is an inflammatory progressive multi-stage disease of the periodontium (which includes the gingiva, periodontal ligament, alveolar bone, and cementum); this disease is triggered in response to periodontopathogens in the biofilm of the dental plaque on tooth surfaces located near the gingiva. The first stage and mildest form of periodontal disease is known as gingivitis. Gingivitis is a reversible condition, and, if untreated, may progress to periodontitis, which is the advanced stage of periodontal disease. Gingivitis is characterized by redness, swelling, mild irritation and inflammation of the gingival tissue, and mild bleeding on brushing or flossing, while periodontitis is characterized by deep inflammation and loss of alveolar bone and connective tissue between the gingiva and tooth root.
Etiology of periodontal disease
The primary etiology of periodontal disease is an imbalanced subgingival microbiome population developing progressively over time due to an increased relative abundance of periodontal disease-associated bacteria and a corresponding decrease in health-associated bacteria, leading to the disruption of the microbiota–host homeostasis. This gradual phenomenon begins with the early adherence, growth, and colonization of Gram-negative and Gram-positive bacteria on the tooth surface extending sub-gingivally. This provides appropriate conditions for the growth of and colonization by other anaerobic Gram-negative orange and red-complex bacteria. The orange complex consists of Prevotella intermedia, Parvimonas micra, and Fusobacterium nucleatum, while Porphyromonas gingivalis, Tanerella forsythia, and Treponema denticola are components of the red complex. These bacteria are highly pathogenic and have the ability to release bacterial collagenases and other proteases, leading to the stimulation of the pro-inflammatory response and periodontal tissue damage.
In addition to periodontal disease, oral microbiome dysbiosis can lead, through various mechanisms, to the manifestation of systemic diseases.
Chronic gingivitis involving microbes such as Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythensis are risk factors for the development of certain cancers including the pancreas, esophagus, colon, lungs, head, and neck.
Some bacteria such as Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythensis, and Prevotella intermedia can enter the bloodstream and be found in the heart and blood vessels where cholesterol and other lipids form deposits. These microbes can cause inflammation in the arteries, the blockage of which can lead to a heart attack. One goal of treatment is to minimize the levels of these microorganisms as much as possible.
Some bacteria that cause periodontitis such as Porphyromonas gingivalis and some others can also cause arthritis. Inflammation of the gums caused by these microorganisms can lead to chronic inflammation throughout the body and in combination with changes in the immune system of a genetically predisposed person, can lead to chronic pathological conditions such as rheumatoid arthritis.
Recent studies show that poor oral health and high levels of certain microbes in the oral microbiome, such as Porphyromonas gingivalis, increase the risk of developing dementia and Alzheimer's disease.
Obesity, lack of exercise and chronic gum disease from bacteria such as Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythensis cause chronic inflammation. Inflammation can damage the pancreas where insulin is produced, which can lead to diabetes. In addition, diabetes worsens oral health by increasing the concentration of harmful bacteria in the gums.
Bacteria associated with gingivitis, and especially Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythensis, are known to be a risk factor during pregnancy for premature birth, low birth weight, or even a hematogenous infection of the placenta or the newborn. Every pregnant woman should be checked for these harmful bacteria.