Rare form of gum disease afflicts African-American adolescents - Dr. Colin Richman

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Rare form of gum disease afflicts African-American adolescents

March 6, 2015

By: Dr. Colin Richman

Oral biologist Daniel H. Fine and his team at Rutgers School of Dental Medicine have tracked more than 2,500 Newark children since 2007 to chart the progression of a rare form of gum disease that afflicts African-American adolescents.

The disease, called “localized aggressive periodontitis,” which has a genetic basis, affects 2 percent of African-America children ages 11 to 17.

A $3.2 million grant from the National Institutes of Health (NIH) will help Fine and his team pinpoint biological markers in saliva that can predict whether bone loss will occur from the disease and which teeth it will affect before there are symptoms.

Because the disease, which has a high rate of prevalence in children of African descent, only attacks central incisors and molars, it can result in disfiguring tooth loss and difficulty eating among a demographic that often has limited access to dental care.

“This is a health disparity issue that has an impact on members of the African-American community that can ill afford to lose teeth and suffer the consequences from either a psychological or sociological vantage point,” says Fine, who is chair of the dental school’s oral biology department and associate dean for research in the Graduate School of Biomedical Sciences.

The dental school provides treatment for study subjects who develop the disease so that infection and tooth loss can be prevented. Fine’s research on early diagnosis of the disease, which affects 70,000 children in this country, can pave the way for early interventions.

Fine’s work also has broader implications. It sheds light on the biological basis for other forms of periodontitis, a disease which affects nearly half of Americans over age 30. In its more advanced stages, periodontal disease can cause the gum to pull away from the teeth, resulting in bone and tooth loss. The condition is more common among those living below the poverty level, striking 65 percent of that population.

“If we focus on these children, it gives us an opportunity to dissect the factors that lead to bone loss and help save their teeth,” says Fine.

In previous studies of the same group, including past research funded by the NIH, Fine’s team found that a cluster of three microbes found together can help diagnose the disease with 98 percent accuracy six to nine months before signs are apparent. The new NIH study focuses entirely on early detection of potential bone loss.

According to Fine, the findings are a valuable jumping off point for related discoveries. His research on oral bacteria could eventually increase the understanding of mucosal infections throughout the gastrointestinal tract. “Bacteria of oral origin have been implicated in GI diseases,” says Fine. “Recently an organism found in periodontal disease has been implicated as a cause of gastric cancer.”

During previous studies of local aggressive periodontitis, Fine’s team uncovered something unexpected: a way to potentially eliminate cavities. They found that children with localized aggressive periodontitis had a much lower rate of dental caries, or cavities, than others. That’s because they produce a higher volume of a lactoferrin, an abundant salivary protein. The variant kills bacteria that causes cavities, but has no effect on the periodontal disease.

In several previous studies findings led Fine and his researchers to create a synthetic peptide that has the same cavity-fighting effect. They have also developed patents to improve diagnosis and treatment of cavities and periodontal disease, which affect more than 70 percent of the population.

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