The most fundamental goal of general dentistry is the prevention and treatment of gum disease. Three quarters of the population of the United States, it is estimated, suffer from some level of gum disease, from mild gingivitis to advanced periodontitis. What the majority of these very individuals don’t realize is how serious gum disease is. Left untreated, it is associated with increased risk of heart disease, diabetes, and even cancer.

New research shows that long standing gum disease, periodontitis, is caused by the interaction between several types of oral bacteria. The most abundant of these, Treponema denticola, has a sticky enzyme, called CTLP, on its surface that enables other bacteria to attach to it. The result is the build up of dental plaque and increased risk of gum disease.

In addition to bacteria, plaque contains dead skin cells, bits of food, and saliva. A recent study showed that CTLP attracts proteins, primarily fibrinogens, which are present in the bloodstream. This inhibits the clotting of blood, so that gums bleed more often and more freely. Gradually, cellular destruction of tissues in the mouth occurs, allowing more bacteria to gather.

Here is what makes gum disease so dangerous; these bacteria and proteins that accumulate are actually disguised from the immune system. This allows them to rapidly reproduce and spiral out of control without the body defending itself commonly causing infection that spreads to the heart without the individual ever knowing.

A family dentist can use the amount of Treponema found in a person’s mouth to evaluate that person’s risk of disease. Because higher levels are associated with higher incidence dentists are now able to address and prevent serious infection before it becomes a risk.

Scientists are working on treatments that inactivate the CTLP on Treponema’s surface, and hopefully dental science will have a product that can be provided to those at high risk for developing periodontitis.

For now, this study only suggests a possible approach to reducing plaque formation at the source. An appropriate pharmaceutical material must first be identified, and then fully tested for effectiveness and safety. This will take some time, but it is promising.

Understanding the disease process better will help researchers to think strategically about how to disrupt it. Currently, only about a third of the population seeks routine dental cleanings. Less invasive methods will lead to a new way of thinking about dental care, presumably resulting in more people seeking treatment and a proportional decrease in periodontal disease.

There will never be a substitute for regular dental care, and routine home care of the teeth. The front line of defense against the development of gum disease is our home dental cleaning routine. Good habits make for good results and even better, prevent death. So it is important to talk to your family dentist about preventative treatments.

Dentists are finding exciting new treatments and technologies are being developed at an ever increasing rate. Oral surgery is faster and safer than it has ever been. Tooth extraction has been greatly reduced over the past several years. Now, with the discovery of the Treponema surface molecule and its role in plaque accumulation, preventive care for high risk health problems associated with oral disease can be recognized and treated.