Dental News - Interview: “50 per cent of our population is susceptible to periodontal disease”

Kasper Mussche, DTI

Fri. 22. June 2018

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During a unique breakfast briefing on Friday morning, Unilever’s Zendium showcased a remarkable set of data demonstrating how daily use of Zendium toothpaste improves gingival health by balancing the oral microbiome. The results are perfectly aligned with the evolving view of the pathology of periodontal disease that puts microbial balance, rather than microbial elimination, at its heart. Dental Tribune International sat down with speaker Prof. Nicola West, head of restorative dentistry and the Clinical Trials Unit at the Bristol Dental School in the UK. An expert in clinical research on the efficacy of oral hygiene products, she was the ideal conversation partner for an update on the topic.

What is the oral microbiome, and what is its significance for oral health?
The oral microbiome is the structure of the bacteria on the teeth and oral mucosa, with its proteins and natural enzymes. Ideally, the bacteria in our oral microbiome are naturally in a state of balance, that way maintaining oral health and protecting us from developing disease. The vast majority of periodontal diseases are initiated by an accumulation of biofilm on the hard surfaces of the mouth: the teeth or implants. If the biofilm is not disrupted on a regular basis by self-directed oral hygiene, it becomes dysbiotic, and we get the emergence of pathogenic strains, leading to gingivitis and, in susceptible individuals, periodontitis.

What are some of the dangers to a healthy microbiome?
A poor sleeping pattern or unhealthy lifestyle choices such as smoking. Pregnancy is a risk factor too, owing to the hormonal changes happening in the body, and the fact that there are hormone receptors in the mouth. Lastly, a healthy diet is very important. We should be eating and drinking more natural products instead of the processed forms we eat a lot of the time, like honey in the Mediterranean diet, to give just one example. It is important to get the physical effect of our nutrition in the mouth instead of just swallowing it and getting the systemic reaction afterwards. Honey is actually a marvellous natural ingredient containing a lot of natural protective agents, so much so that I actually have started keeping my own bees!

You also mentioned stress as a possible risk factor. Could you explain why that is?
We know that there are stress pathways linked to the mouth. When it comes to periodontal disease, people either are or are not naturally susceptible to it. If one is susceptible, stress is one of the contributing genetic and epigenetic risk factors. All in all, 50 per cent of our population is susceptible to periodontal disease—which is a huge number. When we look after patients, we can definitely see a difference in stability in the periodontal condition between people who are stressed and those who are not. In people who do not cope well with stress, one can actually see changes in saliva production, sleeping pattern, pocket formation and so on.

Lastly, how has EuroPerio been for you so far?
I think it is a fantastic event. It is buzzing, isn’t it? It is busier than the last one we had in London, and I just think this is the place to be. For me, it is an opportunity to network and exchange ideas with all the experts on periodontics from all around the world. It is very friendly and well organised, and the programme is just amazing.

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