Gum Disease: More Than Just Bad Bacteria

Apr 27, 2016, by Dr. Becky Coats

We have made great strides in understanding gum disease, but it remains a somewhat mysterious condition. It’s hard to understand just how gum disease can be so damaging to our bodies and how it can trigger such a strongly negative response from our immune system, costing us thousands of dollars a year at the doctor’s office as well as the dentist. It’s also hard to understand why some people seem to develop mild gum disease, known as gingivitis, and never get any worse, while other people will suddenly develop serious progressive periodontitis.

But now a new theory of gum disease may help us answer some of these questions and develop better treatments.

The Current Model of Gum Disease

In the model of gum disease we’ve been working with, bacteria fit into certain categories. There are symbiotic bacteria, which live in our mouths as elsewhere in our body, causing no harm. In some cases, they are called “probiotics” because they are actually helpful, and may even save our dental implants from infection. Bad bacteria are those that can infect and damage our gums and teeth, leading to gingivitis and cavities. But then there are very bad bacteria, which aggressively infect our gums and other tissues. These bacteria can cause receding gums, damage our bones, attack our teeth, and even spread to other tissues like the sinuses and even the heart and the brain.

In this model, although we recognize some genetic susceptibility factors, the severity of your gum disease is pretty much determined by which types of bacteria you have and how many of them there are. The emphasis is on controlling the overall population of bacteria and targeting infecting bacteria where they live.

Polymicrobial Synergy and Dysbiosis (PSD)

The model of gum disease that some people are developing is known as polymicrobial synergy and dysbiosis (PSD). In this model, it’s not as important what types of bacteria you have, it’s more important how these organisms are working together in your mouth. All these bacteria are, to some extent, opportunistic and are always looking for ways to promote themselves at the expense of other bacteria, and you.

In this model, bad bacteria aren’t just bad because they infect your tissues. Instead, they’re bad because they have the ability to act as keystone organisms that change the dynamic in your mouth. When these bacteria get in place, they can rally not only their own species, but other bacteria, including so-called “good” bacteria, as well to attack your body. Our own cells can even turn traitor. You don’t need to have a lot of these keystone bacteria to develop serious gum disease–they can use the numbers of other bacteria to damage you.

In this model, it’s the interactions between bacteria and your body that matter, and that’s where we have to organize our prevention and treatment efforts.

At Grapevine Dental Care, we are already moving in this direction, utilizing genetic testing to tell us when you have some of these dangerous keystone bacteria so we know how best to protect your oral health.

If you would like to learn more about new directions in oral health, please call (817) 481-6888 for an appointment with a Grapevine dentist at Grapevine Dental Care.