Quantifying red complex bacteria, oral hygiene condition, and inflammation status in elderly: A pilot study

Saudi Dent J. 2023 Feb;35(2):185-190. doi: 10.1016/j.sdentj.2022.12.010. Epub 2022 Dec 28.

Abstract

Introduction: Periodontitis is an inflammation of the periodontal apparatus leads to destruction of connective tissue attachment and tooth loss. Red complex bacteria may contribute to disease initiation. Bacterial infection in periodontitis leads to a low-grade chronic infection and inflammation in distant organs. Notably, aging can affect the immune response.

Objectives: The aim of this study was to analyze the effect of aging on oral hygiene and inflammation condition. Moreover, to evaluate the correlation between the oral hygiene condition and red complex bacterial load in subgingival plaque.

Materials and methods: In this cross-sectional study, we examined 20 adult and 20 elderly subjects with periodontitis. Clinical parameters included Oral Hygiene Index Simplified (OHI-S) and Papillary Bleeding Index (PBI) were recorded. Subgingival plaque was collected from the tooth with a probing depth of 5-7 mm and analyzed with a reverse transcription polymerase chain reaction (RT-PCR) for red complex bacteria quantification. Statistical analysis was performed, respectively.

Results: Both groups had poor oral hygiene conditions, reflected by high OHI-S and PBI. The quantity of red complex bacteria (P. gingivalis, T. denticola, T. forsythia) in the elderly group was significantly higher in comparison to the adult group. There was significant strong linear relationship between OHI-S and red complex bacteria (r < 1, p < 0.05). Only P. gingivalis bacteria with PBI values had a strong linear relationship and statistically significant. (r < 1, p < 0.05). P. gingivalis load was significantly higher than T. denticola and T. forsythia load, and it correlated with poor oral hygiene in the adult and elderly groups and with PBI in the elderly group.

Conclusions: Aging affects to the red complex bacterial load and oral hygiene condition, but not the inflammation. These findings contribute to the development of novel treatment strategies focusing on bacterial aspect for periodontitis in the elderly.

Keywords: Aging; Ct, cycle threshold; OHI-S, Oral Hygiene Index Simplified; Oral hygiene; P. gingivalis, Porphyromonas gingivalis; PBI, Papillary Bleeding Index; PCR, polymerase chain reaction; Periodontitis; RT-PCR, reverse transcription PCR; Red complex bacteria; T. denticola, Treponema denticola; T. forsythia, Tannerella forsythia; qRT-PCR, quantitative RT-PCR.