Association of oral spirochetes from periodontally healthy sites with development of gingivitis.

The purpose of this investigation was to determine whether the presence of selected disease-associated bacteria in health-associated plaque correlated with future gingivitis. Sites of periodontal health were identified in 65 adults. Six months later (recall 1) plaque was collected from sites that remained in periodontal health, and 5 species of specific bacteria and pathogen-related oral spirochetes were detected using monoclonal antibodies in a microscopic assay. Members of the spirochete morphogroup were also identified by phase contrast microscopy. The relationship between site-specific detection of bacteria at recall 1 and development of gingivitis at recall 2 or 3 was evaluated by means of logistic regression using generalized estimating equations, from which odds ratios (OR) were estimated. Significance was conservatively defined as OR > 2.0 and P < 0.05. We found that 488 of 1,424 healthy sites developed gingivitis over the 12-month interval between recall 1 and 3. Only the spirochete morphogroup (OR =2.04; P=0.002) was significantly associated with the transition from health to gingivitis. The association of Treponema socranskii with future gingivitis was higher than expected (OR=2.27), but the relationship was not statistically significant (P=0.163). Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, and pathogen-related oral spirochetes did not correlate well with gingivitis (OR < 2.0). Health-associated plaque from 5 sites contained Treponema denticola, and all 5 sites progressed to gingivitis. An OR could not be calculated because T. denticola was not detected in health-associated plaque from stable healthy sites. These findings indicated that the presence of T. denticola and unidentified spirochetes in health-associated plaque was associated with increased susceptibility to gingival inflammation. Future studies assessing a larger panel of dental plaque microorganisms, with shorter intervals between baseline and follow-up assessment, are necessary to more fully evaluate the association between detection of specific organisms at healthy sites and risk for gingivitis.