We all know that a healthy immune system is essential for overall health. With a strong immune system, your body can fight off sickness and illnesses before symptoms arise, keeping you healthy and strong. While it’s important to have a healthy immune system, have you ever thought about what it would mean to have a healthy periodontal immune system? A system that would fight off periodontal pathogens before damage is done to the periodontium? A new study suggests this could be a possibility. As a dental hygienist, the idea that there could be a way to actually strengthen the immune response to periodontal disease is incredibly interesting.
A study conducted in May 2018, aimed to test if the presence of a commensal flora would strengthen and mature the periodontal immune response to pathogens. What exactly is a commensal flora? Similar to a healthy flora in gut health, a commensal flora is the presence of unharmful microorganisms in the mouth. Researchers hypothesized the presence of the commensal flora would aid in the immune response to Porphyromonas gingivalis. P. gingivalis contains the periodontal pathogen lipopolysaccharide or LPS, and they wanted to test if LPS would be decreased with the presence of commensal flora.
The study, conducted by researches at Okayama University in Japan, was published in the Journal Of Periodontology earlier this year.1 At the beginning of the study, researchers established four different groups of mice for this experiment. The first group was a baseline group of mice, which was not exposed to P. gingivalis. The other three other groups contained either mice that had been evaluated to be completely “bacteria free,” or mice who had the commensal flora in their mouths.
P. gingivalis was applied to the mice in the palatal gingival sulcus, and the levels of bacteria associated with periodontal disease, LPS, was measured at 3, 24, and 72 hours after the initial application. Researchers measured the levels of cells indicative of an immune response, such as neutrophils, CD4+, and CD8+ T cells, in periodontal tissue. After three hours of the application of P. gingivalis, the mice that had commensal flora in their mouths showed significantly higher amounts of CD4+, showing their immune responses to be stronger than the mice without the commensal flora.
Although this study suggests the presence of a commensal flora does increase immune response towards periodontal disease, it does have limitations. The effect of repeated application of P.gingivalis was not tested, as well as the longterm effect of the immune response towards the periodontal health of the mice with commensal flora. Additionally, researchers only monitored certain cell types that were characteristic of an immune system response. However, this study does state there is research showing the presence of certain healthy microorganisms in the mouth could have a positive effect on fighting periodontal pathogens, which could initiate or progress periodontal disease.
Although there is more research needed on this subject, as hygienists, we should continue to follow this topic, and stay up to date on future studies to see how this could affect our hygiene treatment plans for patients who have periodontal disease.
Fukuhara D, Irie K, Uchida Y, et al. Impact of commensal flora on periodontal immune response to lipopolysaccharide. Journal of Periodontology. 2018;89(10):1213-1220. doi:10.1002/jper.17-0567. https://onlinelibrary.wiley.com/doi/abs/10.1002/JPER.17-0567