Inoculating against Periodontitis

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Michael Sultan looks at vaccinating against gum disease

According to a recent news article, a vaccination to fight against gum disease may soon be a reality, after scientists based at the University of Melbourne received a $14 million investment [1]. While a vaccine has been in the works for a long time, this is a huge step towards this becoming a viable treatment for people in the future.

But what would a vaccination against periodontal bacteria mean for patients in the UK? Despite the best efforts of dental professionals rates of gum disease remain high across the nation. According to recent statistics it seems that as many as 90% of the population will suffer from gum disease at some time [2].

While in most cases this will be minor and easily reversible, it is still a first step towards more serious forms of the disease such as periodontitis. Although there seem to be no solid statistics regarding the number of people in the UK who suffer from periodontitis, the British Society of Periodontology believes that around 10% of the population are susceptible to the disease, meaning millions are at constant risk [3].

Periodontitis remains one of the most difficult diseases to deal with in modern dentistry. Sufferers are likely to experience bone loss, loose teeth and possibly even lost teeth as a result of bacterial build up. What’s worse is that the bacteria responsible for the condition are all naturally present in the mouth, though they only become dangerous when they multiply at hugely advanced rates.

We must explore what a vaccination would mean for people who are more susceptible to the disease. If, like other vaccinations, it offers a completely effective barrier against chronic periodontitis, it could very well transform the general standard of oral health in the modern era, and hugely benefit hundreds of thousands of people. The only thing to consider then would be the logistics – how the vaccine can be delivered.

Would it, like the MMR shot, be given to school-age children to protect them in the future, or would it only be offered to people who are considered more at risk from periodontitis? At the moment we still cannot predict how this vaccine is going to shape dental care going forwards.

How does the vaccine work?

The science behind this new vaccine is pretty unique. Unlike other vaccines which form a resistance by exciting antibodies through introducing a weak strain of the disease into the recipient, the periodontitis vaccine works by targeting specific enzymes produced by Porphyromonas Gingivalis, one of the strains of bacterium responsible for periodontal diseases.

It would effectively neutralise the destructive effects of the bacteria, preventing them from causing damage to bone and soft tissue. These bacteria have been identified as ‘keystone pathogens’ because they have the potential to disrupt the microbiome in the mouth and enhance the conditions necessary for periodontal disease to occur [4].

By neutralising the detrimental effects of this bacterium, we would no longer have to rely on extensive cleaning regimes and the prescription of antibiotic courses to tackle periodontitis. Thanks to the vaccine it might become impossible for the disease to manifest, or if it does, it will be far less severe.

Will the UK accept a vaccine?

One problem standing in the way of this new vaccine is how it will be received. The very word ‘vaccine’ has become troubling for many, and demonised by others. The anti-vaxx movement is in full swing, which has already led to the re-emergence of diseases that had been all but wiped out; and you can guarantee that people will approach this new treatment with a heavy dose of scepticism.

This means that even if the vaccine is entirely effective, there will be those who refuse to have it or prevent their children from receiving it – depending on the proposed age group implemented for the vaccine. The result may mean that periodontitis will remain a problem that we dental professionals will still have to battle against in the future, especially if the anti-vaxx movement continues to gain traction.

On face value, the creation of a vaccine to ward off periodontal disease is an amazing breakthrough with the capacity to completely transform dental care in the future. However, until the vaccine is launched (it is estimated to become available in 2022) and we know more about who will be eligible to receive it – balanced against the general public’s response to a new vaccine – we can’t yet relagate periodontitis to a threat we can ignore.

Author

Michael Sultan is the founder and Principal of EndoCare, a leading endodontic specialist practice and referral centre. For more information, visit www.endocare.co.uk. He is interested in all aspects of healthcare and is a regular contributor to Dental Review.

References:

1] Anthill. University of Melbourne spin-out attracts $14m investment for vaccine to treat gum disease that affects 30% adults. Link: Click HERE. [Last accessed October 19].

2] BUPA. Gum Disease. Link: https://www.bupa.co.uk/dental/dental-care/treatments/gum-disease [Last accessed October 19].

3] British Society of Periodontology. Periodontal Disease and Treatment. Link: https://www.bsperio.org.uk/patients/periodiseaseandtreatment.html [Last accessed October 19].

4] Science Daily. World-First Therapeutic Dental Vaccine. Link: https://www.sciencedaily.com/releases/2016/12/161205113748.htm [Last accessed October 19].