Periodontal disease in mothers indicates risk in their children

Parents with periodontitis impact the subgingival colonization of their offspring

Early acquisition of a pathogenic microbiota and the presence of dysbiosis in childhood is associated with susceptibility to and the familial aggregation of periodontitis. This longitudinal interventional case-control study aimed to evaluate the impact of parental periodontal disease on the acquisition of oral pathogens in their offspring. Subgingival plaque and clinical periodontal metrics were collected from 18 parents with a history of generalized aggressive periodontitis and their children (6-12 years of age), and 18 periodontally healthy parents and their parents at baseline and following professional oral prophylaxis. 16S rRNA amplicon sequencing revealed that parents were the primary source of the child's microbiome, affecting their microbial acquisition and diversity. Children of periodontitis parents were preferentially colonized by Filifactor alocis, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Streptococcus parasanguinis, Fusobacterium nucleatum and several species belonging to the genus Selenomonas even in the absence of periodontitis, and these species controlled inter-bacterial interactions. These pathogens also emerged as robust discriminators of the microbial signatures of children of parents with periodontitis. Plaque control did not modulate this pathogenic pattern, attesting to the microbiome's resistance to change once it has been established. This study highlights the critical role played by parental disease in microbial colonization patterns in their offspring and the early acquisition of periodontitis-related species and underscores the need for greater surveillance and preventive measures in families of periodontitis patients.

Triclosan toothpaste as an adjunct therapy to plaque control in children from periodontitis families: a crossover clinical trial

OBJECTIVES

Studies have demonstrated that children from aggressive periodontitis (AgP) parents presented precocious alterations in their periodontal condition, and the use of chemical agents in association to plaque control could be useful to control these alterations. This study aimed to evaluate the effect of Triclosan toothpaste to modulate the clinical and subgingival condition in children from AgP parents.

METHODS

Fifteen children from AgP parents and 15 from periodontally healthy parents were included in this crossover placebo study. Children were randomly allocated into triclosan or placebo therapy, using selected toothpaste for 45 days. After 15 days of wash-out, groups were crossed, changing the used toothpaste. Clinical examination and saliva, crevicular gingival fluid (GCF), and subgingival biofilm collection were performed at baseline and 45 days of each phase. GCF cytokines' levels were analyzed by Luminex/MAGpix platform and subgingival and salivary periodontal pathogens' levels by qPCR.

RESULTS

At baseline, AgP group presented higher plaque index (PI), gingival index (GI), and bleeding on probing (BoP), higher Aggregatibacter actinomycetemcomitans (Aa) abundance in saliva and subgingival biofilm, and lower levels of INF-ɣ, IL-4, and IL-17 in GCF. Placebo therapy only reduced PI in both groups. Triclosan toothpaste reduced PI and GI in both groups. Triclosan promoted reduction of BoP and probing depth (PD), Aa salivary, and IL-1β levels in AgP group. In health group, triclosan reduced INF-ɣ and IL-4 concentration.

CONCLUSION

Triclosan toothpaste demonstrated to be more effective than placebo toothpaste to control the periodontal condition in children from AgP parents, by reducing the BoP, PD, salivary Aa, and IL-1β.

CLINICAL RELEVANCE

Triclosan toothpaste can improve oral conditions in higher-risk population for AgP.

TRIAL REGISTRATION

This study was registered at ClinicalTrials.gov with the identifier NCT03642353.

Effect of family characteristics on periodontal diseases in children and adolescents-A systematic review

AIM

To synthesize the literature on the influence of family/parents characteristics on periodontal diseases in children and adolescents.

METHODS

An electronic search for relevant literature published between 2007 and 2017 was undertaken in PubMed, Embase, Cinahl and Cochrane databases; the search was updated in April 2018. Two reviewers independently reviewed the abstracts of these; of which, 43 articles were reviewed in full.

RESULTS

Of the 746 retrieved titles, 649 remained after removing duplicates. Thirty articles met the inclusion criteria, and 13 were excluded. Also, two were included from the updated search. Data from the reviewed articles indicate that all three indicators of parent's socioeconomic status (income, education and occupation) are significantly associated with periodontal diseases in children. Better periodontal status was observed in children of parents with higher SES than those whose parents were of lower SES. Although the association between parent's smoking practices, level of periodontal diseases and children's periodontal status was explored only in few studies, findings indicate that children exposed to passive smoking and having parents with periodontal diseases are more likely to present with periodontal diseases as well.

CONCLUSIONS

Most of the studies considered socioeconomic factors and had not attempted to explore the impact of parental psychosocial variables on periodontal diseases in children. The literature indicates that these variables significantly influence health practices, including oral hygiene practices, which could ultimately affect periodontal health. More studies are required to explore the association of these variables with periodontal outcomes in children.

The influence of mothers' oral health behaviour and perception thereof on the dental health of their children

Objective

The study aims to investigate how mothers' oral health behaviour and perception thereof influence the dental health in their children.

Methods

A total of 556 Vietnamese mother-child pairs participated in the current study. Mothers self-reported their oral status and oral health behaviour and perception. Dental caries of the children were examined using the index of decayed, missing, and filled teeth. The Dental Anxiety Scale instrument was used to assess the dental anxiety level in mothers and children.

Results

Among mothers, 41.3% had gingival bleeding, 40% perceived their dentition and gingival status to be at a good level, 68% brushed their teeth more than twice a day, and 17% had never visited a dentist. Mothers' oral health behaviour and their perception thereof were positively correlated with their frequency of dental visits (r = (0.105-0.221), p < 0.001) and negatively correlated with dental anxiety (r = (- 0.149- - 0.105), p < 0.05).Caries-free children were positively correlated with mothers having more than 20 teeth (r = 0.085, p < 0.05). Positive correlations between mothers and children were found in terms of frequency of fresh fruits consumption (r = 0.090, p < 0.05), drinking sweet beverages (r = 0.072, p < 0.05), and dental anxiety (r = 0.183, p < 0.001).

Conclusions

Maternal oral health was significantly associated with dental health of their children. Not only did maternal dental anxiety influence oral health of mothers but it was also a concomitant factor in the development of children's dental anxiety. The education programme on mothers' oral health-related knowledge can be a target for improvement of the oral health of mothers and children.

Papillon-lefevre syndrome

BACKGROUND

Papillon-Lefevre syndrome is a rare autosomal recessive disorder caused by cathepsin C gene mutation leading to the deficiency of cathepsin C enzymatic activity. The disease is characterized by palmoplantar hyperkeratosis, loss of deciduous and permanent teeth and increased susceptibility to infections. Onset of palmoplantar hyperkeratosis and periodontopathy is most commonly before the age of 4 years.

MAIN OBSERVATIONS

A 15 year old boy with a history of frequent infections presented with hyperkeratosis of palms and soles, which worsened during winter season. Examination of the oral cavity revealed missing mandibular central incisors and left lateral incisors. Most remaining permanent teeth were mobile. Fibrosis and scarring of gingival and labial mucosa restricted opening of the mouth.

CONCLUSION

Early diagnosis of Papillon-Lefevre syndrome may help preserve the teeth. We present a case of a late diagnosis of this syndrome.