A study conducted by the University of Campinas (UNICAMP) has found that adults can transmit the bacteria that cause periodontitis to their children, and even remain in the mouth when the children undergo various treatments.
Periodontitis, which is preceded by gingivitis, is a bacterially caused inflammation of the periodontium, the tissue supporting the teeth. It is characterised by swollen and bleeding gums and halitosis, and can result in loss of teeth in severe cases.
Should the microorganisms responsible for the disease enter the bloodstream, they may trigger other kinds of inflammation in the body. The disease can be treated by cleaning the pockets around the teeth by a dentist or dental hygienist and administration of anti-inflammatory drugs or antibiotics.
“The parents’ oral microbiome is a determinant of the subgingival microbial colonization of their children,” the article’s wrote in their conclusion, adding that “dysbiotic microbiota acquired by children of periodontitis patients at an early age are resilient to shift and the community structure is maintained even after controlling the hygiene status”.
According to the first author of the article, dental surgeon Mabelle de Freitas Monteiro, she and her group have been researching periodontitis for ten years, and have observed both parents with the disease and their children, and noted the impact on their health.
“If the findings are applied to day-to-day dental practice, the study can be said to help design more direct approaches. Knowing that periodontal disease may affect the patient’s family is an incentive to use preventive treatment, seek early diagnosis and mitigate complications,” said Monteiro, who was supported by FAPESP via two projects.
The principal investigator for both of these projects was Renato Corrêa Viana Casarin, a professor at UNICAMP’s Piracicaba Dental School (FOP), who is the last author of the article .
In Prof Casarin’s view, parents’s care of their children’s dental hygiene should start when they are still infants.
“This pioneering study compares parents with and without periodontitis,” said Prof Casarin. “In children of the former, we found subgingival bacterial colonization at a very early age. However, ‘inheriting’ the problem doesn’t mean a child is fated to develop the disease in adulthood. Hence the importance of keeping an eye open for the smallest signs and seeking specialized help.”
According to the latest national dental epidemiological survey from 2010, 18% of children aged 12 had never been to the dentist and 11.7% had experienced bleeding of the gums. Of those in the 15-19 age group, 13.6% had never visited a dental clinic. The planned 2020 survey was postponed due to COVID. According to the São Paulo State Department of Health’s latest oral health survey in 2019 revealed that 50.5% of adults aged 35-44 complained of toothache, bleeding gums and periodontitis.
In the FOP-UNICAMP study led by Casarin and Monteiro, the team colleclected samples of subgingival biofilm and plaque from 18 adults with a history of generalised aggressive (grade C) periodontitis, their children aged 6-12, and 18 orally healthy adults.
As well as a clinical analysis, the samples were also subjected to a microbiological analysis and genetic sequencing by Ohio State University researchers.
“Children of periodontitis parents were preferentially colonized by Filifactor alocis, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Streptococcus parasanguinis, Fusobacterium nucleatum and several species belonging to the genus Selenomonas even in the absence of periodontitis,” the article states. “These pathogens also emerged as robust discriminators of the microbial signatures of children of parents with periodontitis.”
Prof Casarin told Agência FAPESP that even with bacterial plaque control and vigorous brushing, children of people with the disease still had the bacteria in their mouths, whereas the effects of dental hygiene and prophylaxis were more significant in the children of healthy subjects.
“Because the parents had periodontitis, their children assumed this community with disease characteristics. They carried the bacterial information into their adult lives,” he said, adding that the analysis of bacterial colonisation indicated the transmission was more likely from the mother. The research group’s next step is working with pregnant women to prevent bacterial colonisation of their children’s mouths.
“We’ll treat the mothers during pregnancy, before the babies are born, and try to find out if it’s possible to prevent bacterial colonization from occurring,” Casarin said, adding that studies with patients will only go ahead when the pandemic is under control.
Journal information: Monteiro, M. F., et al. (2021) Parents with periodontitis impact the subgingival colonization of their offspring. Scientific Reports. doi.org/10.1038/s41598-020-80372-4.