AirPerio | A New Program To Treat Periodontal Gum Disease

BACTERIAL DNA TEST: AN ESSENTIAL NEW DIAGNOSTIC TOOL

Maggie's Testimonial

"I had one severely affected tooth that I am sure I would have lost without the DNA test and treatment combining antibiotics and hygiene."

Since periodontal disease is a bacterial infection, it is very important to know which bacteria are present before treatment begins. Using the Bacterial DNA test, we are able to identify exactly which bacteria are causing the infection. In the majority of cases, the DNA test will reveal that the type of bacteria that are present in the gums can be eliminated without the use of antibiotics (see the BOST section for more details on the treatment). In these cases, it is preferable to avoid antibiotics in order to prevent a drop in the immune system. However, some species of bacteria cannot be permanently eliminated using the treatment alone. Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) are aggressive species of bacteria that fall under this category (see the complete list of periodontal pathogens at the bottom of the page). If the test shows that these bacteria are present, then appropriate antibiotics are added to the treatment in order to produce complete healing.

WHAT IS THE DNA TEST?

Paper Points

Bacterial DNA testing is based on the fact that each strain of bacteria has a specific "fingerprint" of genetic material. This fingerprint can then be analyzed in a laboratory to establish which species of bacteria are present in the infection. Compared to culturing the bacteria, Bacterial DNA testing offers much greater accuracy as well as reduced cost.

HOW IS THE TEST PERFORMED?

Administering the DNA test is a quick, safe, and painless process. Four tiny paper points are placed under the gums for a period of 15 seconds. This is long enough to collect disease causing bacteria from under the gums. These bacteria thrive in the plaque--otherwise known as biofilm--that covers the tooth roots down to the attachment level. Once they are removed, the paper points are packaged and sent to the laboratory where the bacterial DNA will be analyzed to reveal which types of bacteria are present. The test results are then e-mailed back to the dentist in about 10 days.

WHY IS THE DNA TEST NECESSARY?

Bacterial DNA Test Results

Liz's Testimonial

"I have watched my mom Sheila have lots of problems with her gums and implants and the DNA test showed why. I had the test done too and I have most of the same bad bacteria as my mom. I am glad at 19 to get rid of them before they can harm me."

The bacterial DNA test provides a scientifically accurate way of knowing which bacteria are causing the infection. Without the test, there is only one chance out of ten of choosing the right antibiotic combination to fight the bacteria under the gums. When invasive bacteria are inside the tissue in addition to on the roots and the bone, the BOST treatment can't reach them and antibiotics are needed to clear them out. Without the focus given by the test we are more likely producing resistant strains than good treatment results.

Most patients find that it is very reassuring to know whether or not they have aggressive strains of bacteria in their gums. If the Aa and Pg are not present, patients feel relieved immediately. Patients who test positive for the aggressive strains of bacteria, on the other hand, gain a better understanding of why they have had such a difficult time with periodontal problems in the past. They can feel hopeful for the future because they know that they will receive properly targeted antibiotics in addition to effective local treatment.

WHO SHOULD TAKE THE TEST?

Anyone with current periodontal gum disease benefits from a bacterial DNA evaluation. Symptoms of periodontal disease are bleeding gums, loose or shifting teeth, painful chewing, bad breath, gum recession, and bone loss. AirPerio recommends the DNA test as the first step towards successful treatment.

In addition, the test can be used as a preventive measure. People with a history of periodontal disease in their family can be screened and diagnosed early before the bacteria have a chance to cause an infection.

People about to have dental implants should absolutely have the test to make sure that any prior periodontal infection is under control to protect the implants from getting infected. For people who have currently an infected, failing implant the test and AirPerio treatment may be able to save it.

Baby Apolline

The test should also be done prior to orthodontic treatment where force will be put on the bone and oral hygiene will be more difficult. Aerobic hygiene is also important to help prevent common post-orthodontic problems like gum recession as well as gingivitis during treatment.

Periodontal disease has been linked to premature birth and infertility so a bacterial DNA test is a good measure to add before entering the reproductive years so prevention and or treatment can be accomplished. For couples who have been trying to have a child this is a simple factor to test for and rule out. Already two couples have had full term babies after the AirPerio treatment!

HOW DO I GET THE TEST?

There are two methods of obtaining the DNA test.

Through your local dentist.
Click here to send an .

Periodontal Pathogens that can be found using DNA testing

The following 11 oral bacteria are the ones most often implicated in periodontal disease. They are the mostly gram negative, anaerobic varieties. Most often there is cooperation between species that have complementary virulence and resistance factors. These bacteria are capable of opening breaches in the body's barriers and suppressing defense mechanisms, leading to disease and the opening for other pathogens such as viruses and parasites to add their destructive potential.

Actinobacillus actinomycetemcomitans
- A small, gram negative, facutatively anaerobic, non motile rod, not considered part of normal flora but a true infectious agent
- One of the few bacteria in the mouth capable of colonizing the oral mucosa because of attachment mechanism of long arms or fimbriae on the surface
- Can be inhibited from growth in the presence of Streptococcus strains, once established very effective at inhibiting other species including Streptococcus
- Associated with Juvenile localized periodontitis
- Possesses many virulence factors: leucotoxin (kills human neutrophils and monocytes), immunosuppressive factor, bone resorption mediation factor, fibroblast proliferation depression factor, causes release of lysosomal products from damaged immune cells, perturbs adaptive mechanisms, delays antibody sysnthesis, invasive
- Implicated in endocarditis, pericarditis, meningitis, osteomyelitis, pnemonia and sub-cutaneous abscess
- Sensitive to Amoxicillin, Claritromycin and Doxycycline, practically insensitive to Metronidazol
- Transmittable from parent to child
Porphyromonas gingivalis
- A gram negative, non motile small strictly anaerobic rod, has numerous fimbriae for attachment
- Not considered part of normal flora
- Virulence factors: posseses very strong proteolytic enzymes, collagenases, chemical adherence factors ( attaches to erythrocytes and causes agglutination), decomposes immunogloblins, invasive
- Implicated in coronary artery disease
- Transmissible from parent to child and to a lesser degree between partners
- Sensitive to Metronidazol
Bacteriodes forsythus
- A strictly anaerobic, gram negative, fusiform rod
- Associated with refractory periodontitis, considered a major periodontal pathogen, possesses strong proteolytic properties
- Sensitive to metronidazol and Clindamycin but resistant to Doxycycline
Treponema denticola
- An anaerobic, spiral shaped bacteria from the spirochete family, nearly impossible to culture, can support small quantities of oxygen
- Very strongly proteolytic, invasive in cooperation with other bacteria
- Antibiotic sensitivity in vivo is not evident
Prevotella intermedia
- Strict anaerobe, gram negative rod, can ferment complex sugars
- Highly proteolytic
- Sometimes associated with halitosis
- Sensitive to Metronidazol and Clindamycin
Micromonas micros
- Gram positive anaerobic cocci, part of normal flora in small numbers
- No specific virulence factor but is often found in large numbers during periodontal infections
- Sensitive to Clindamycin, but resistant to erythromycin, bacitracin, and amoxicillin contradictory sensitivity to metronidazol but insensitivity dominates
- Known to be involved in many infections outside the mouth; abdominal, peritoneal, cerebral
Fusobacterium nucleatum
- Gram negative rod, anaerobic,
- Unknown virulence factors but their rich adhesine production seems to be important to allow other pathogenic species to proliferate in plaque.
- Sensitive to metronidazol and amoxicillin, insensitive to erythromycin, claritromycin and tetracycline
Campylorbacter rectus
- Gram negative bacillus, not strictly anaerobic
- Little known about resistance or virulence factors
- Contradictory infromation as to antibiotic sensitivity
Eubacterium nodatum
- Gram positive, anaerobic cocco-bacillus
- Present in most periodontal infections but no known specific virulence factors
- Sensitive to metronidazol, clindamycin, vancomycin, cefoxitin
Eikenella corrodens
- Gram negative bacillus that is facultatively anaerobic
- Virulence factors include inflammation reactions, cytotoxic proteins on exterior membrane
- Adhesins, toxic polysaccharides
- Resistant to metronidazol, erythyromycin, clindamycin and tetracycline, sensitive generally to amoxicillin, cefoxitin and moxifloxacin
Capnocytophaga species group
- Gram negative bacilli faultative anaerobes
- Nearly always present in periodontal degeneration, produces tissue degenerating enzymes
- Resistant to clindamycin, metronidazol, sensitive to claritromycin, amoxicillin and ampicillin