Work

Periodontitis: a host‐mediated disruption of microbial homeostasis. Unlearning learned concepts

Year: 2013

Type: review

Abstract: New concepts evolve when existing ones fail to address known factors adequately or are invalidated by new evidence. For decades periodontitis has been considered to be caused by specific bacteria or groups of bacteria and, accordingly, treatment protocols have largely been based on anti-infective therapies. However, close inspection of current data leads one to question whether these bacteria are the cause or the result of periodontitis. Good evidence is emerging to suggest that it is indeed the host response to oral bacteria that leads to the tissue changes noted in gingivitis. These changes lead to an altered subgingival environment that favors the emergence of 'periodontal pathogens' and the subsequent development of periodontitis if the genetic and external environmental conditions are favorable for disease development. Thus, it seems that it is indeed the initial early host-inflammatory and immune responses occurring during the development of gingivitis, and not specific bacteria or their so-called virulence factors, which determine whether periodontitis develops and progresses. In this review we consider these concepts and their potential to change the way in which we view and manage the inflammatory periodontal diseases.

Source: Periodontology 2000

DOI: 10.1111/j.1600-0757.2012.00450.x

Authors: P. Mark Bartold, Thomas E. Van Dyke

Language: English

Topic: Oral microbiology and periodontitis research

Subfield: Periodontics

Field: Dentistry

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funders: U.S. Public Health Service, National Health and Medical Research Council, National Institute of Dental and Craniofacial Research