A team of researchers from the University of Washington conducted a thorough study to reveal new details about how gingivitis, that is gum inflammation affects the overall health of an individual. They classified taking a deep look at how various individuals respond to the bacterial-laden plaque accumulation of the teeth’ surfaces. Plaque is a sticky, yellowish-white film that firmly adheres to teeth’ surface and is a house for disease-causing bacteria. The research paper, which the National Academy of Sciences published, elaborates on why some people might have an exaggerated response to plaque accumulation leading to teeth loss and even more serious oral complications.

Bacterial laden plaque buildup, if left untreated, leads to gum inflammation-causing gingivitis. Gingivitis, if left unchecked, can lead to a destructive gum disease known as periodontitis. Periodontitis leads to chronic inflammation of the oral tissues, damages the soft tissues and even destroys the teeth supporting bone. This can lead to loose teeth and, ultimately, teeth loss. Apart from this, chronic inflammation also affects your overall health and can have severe consequences leading to heart diseases, diabetes, arthritis, bowel disease and even cancer.

Scientists involved with the research also have identified a range of different inflammatory responses of plaque accumulation in the mouth. When bacteria continue to grow on the teeth surfaces, it generates an inflammatory response to reduce the buildup and fight the infection. Earlier, there were only two prominent oral inflammation phenotypes: strong/High and low clinical response. However, the team has now introduced a third phenotype – Slow. The slow phenotype of oral inflammation shows a delayed but strong inflammatory response to bacterial buildup.

The study shows for the first time that individuals with a low clinical response still demonstrated a low inflammatory response to various inflammatory signs. The study distinctively shows a new pattern of the inflammatory response to bacterial accumulation that has not been previously reported.

The study’s co-author explains how they found a particular group of people with a slower plaque accumulation and a distinct microbiome. The authors also explained how understanding various gum inflammation will contribute to better diagnosis and help identify people with an elevated risk of periodontitis. In addition, it is also assumed that this variation of gum inflammatory conditions may also relate to the susceptibility of an individual to other infective infections and chronic inflammatory conditions such as inflammatory bowel disease.

Moreover, the scientists also have found a rather extraordinary protective response by the body, which is triggered by plaque accumulation. This response can save the oral tissues and bone during inflammation from further destruction. This mechanism seems familiar in all inflammatory phenotypes, namely, low, high, and slow. The body takes the help of primary fighting white blood cells called neutrophils for this. Neutrophils are a type of white blood cells that behave like front line fighters; they patrol and also regulate bacterial growth to maintain homeostasis, a stable state of the body.

In such a case, plaque is not an enemy. A moderate amount of plaque is seen to support normal oral tissue and bodily function. Some studies carried out in mice also have shown that plaque provides a proper pathway for the migration of neutrophils from the bloodstream, through the gum tissue and finally into the crevice between teeth and gums.

A healthy homeostasis means everything in the body is under the right control as neutrophils promote the body’s resistance and gum tissues to bacterial colonisation. This generates a low-level protective response that helps the body fight against unhealthy bacteria and resists infection. In addition, neutrophils ensure proper control of the microbiome for the normal and healthy development of oral tissues and bone. This also goes on to show why dentists have always stressed upon the importance of maintaining good oral health and practising proper oral hygiene.

STUDY SOURCE: Materials provided by University of Washington School of Dentistry

Journal Reference: Shatha Bamashmous, Georgios A. Kotsakis, Kristopher A. Kerns, Brian G. Leroux, Camille Zenobia, Dandan Chen, Harsh M. Trivedi, Jeffrey S. McLean, Richard P. Darveau. Human variation in gingival inflammationProceedings of the National Academy of Sciences, 2021; 118 (27): e2012578118 DOI: 10.1073/pnas.2012578118

DISCLAIMER: The advice offered is intended to be informational only and generic in nature. It is in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.