According to recent research published in the Journal of Dental Research, a new classification system for gum disease based on its genetic signature may help dentists diagnose it earlier and begin treatment. Currently, gum disease is diagnosed by its clinical signs and symptoms but classifying and diagnosing gum disease by its genetic signature would allow for an earlier diagnosis and personalized treatment before the worst symptoms of the disease form.
Current Classification System
Under the current system, gum disease may be classified as “chronic” or “aggressive” depending on the amount of swelling and bone loss but lead researcher Panos N. Papapanou, professor and chair of oral and diagnostic sciences at the College of Dental Medicine at Columbia University Medical Center New York, NY, sees a flaw in this system, “. . . . there is much overlap between the two classes. Many patients with severe symptoms can be effectively treated, while others with seemingly less severe infection may continue to lose support around their teeth even after therapy.”
He explains that the problem is that it is difficult to tell if the gum disease is aggressive until after the severe damage has been done. In search of a new method to classify gum disease, the researchers were inspired by the way markers in the genetic signatures of tumors are being used to classify and appropriately treat individual patients with cancer. They performed a genome-wide analysis of gum tissue samples from 120 male and female patients between the ages of 11 and 76 that have been diagnosed with chronic or aggressive gum disease.
Proposed Classification System
The researchers discovered that the genetic signatures found in the samples placed each patient into one of two clusters. They also discovered that these two clusters differed from the two classes of the current classification system and that one of the clusters, cluster 2, showed more severe symptoms of the disease than cluster 1. There were also more cluster 2 patients with infections from other known oral pathogens and overall, more male patients fell into cluster 2, providing further proof that men are more likely than women to contract severe gum disease.
Professor Papapanou believes that these results could provide a basis for a new classification system based on the genetic signatures of gum diseases which could help dentists diagnose severe gum disease before showing the clinical symptoms. He explains, “If a patient is found to be highly susceptible to severe periodontitis, we would be justified in using aggressive therapies, even though that person may have subclinical disease. Now, we wait years to make this determination, and by then, significant damage to the tooth-supporting structures may have occurred.”
The next step in Professor Papapanou’s research is to conduct a study with a group of patients using this classification system based on genetic signatures to determine how well it can predict the severity of the disease.
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