The overall goals of the Forsyth Department of Periodontology are two-fold. The first is to determine the microbial and other contributing causes of periodontal diseases and to devise the best methods for controlling them. The second is to understand the nature of and relationships among bacteria that colonize the different surfaces (teeth and soft tissues) of the mouth.
A major focus of research in the Department is the longitudinal clinical and laboratory assessment of the periodontal patient. In the clinic, periodontists, dental hygienists and dental assistants and coordinators recruit, monitor, take samples from and treat patients enrolled in various studies. Microbiologists and research assistants analyze the samples taken from these subjects. Accordingly, most research performed in the Department is translational and bridges the gap between basic science and clinical application.
Periodontal diseases are among the most common infectious diseases affecting mankind. The bacteria that cause these diseases reside in complex biofilm communities, often called dental plaque, that occur at or below the gingival (gum) margin. Some bacterial species in these communities are pathogens that destroy the supporting structures of the teeth—the periodontal ligament, cementum, gingiva and alveolar bone. These bacteria also may disseminate to other parts of the body, increasing the risk for cardiovascular disease, stroke and low–birth-weight babies, and exacerbating diabetes and other metabolic conditions. Therefore, preventing and adequately treating periodontal infections is important for both oral health and systemic health.
Past studies performed in this Department have helped to define the bacterial complex that causes periodontal diseases, the inter-relationships among plaque bacteria and the natural history and progression of periodontal diseases; they have also supported the development of novel treatment methods, including local drug-delivery systems. More recent studies have indicated that specific bacteria in the subgingival plaque exist in complexes or communities. The relationships of these communities to local tissue status, host genetic markers and environmental factors such as cigarette smoking are being carefully defined.
A recent series of Department studies determined the effect of different therapeutic approaches, including scaling and root planing, periodontal surgery, tooth brushing, repeated professional removal of supragingival plaque and the use of systemic antibiotics, on the composition of the bacteria in oral biofilms and on clinical outcomes. These studies have led to a greater understanding of the effects of different periodontal therapies and have identified the periodontal patients who would most benefit from specific therapies or therapeutic combinations.
New studies will employ microarray technologies, along with the well established DNA checkerboard hybridization approach, to determine whether this group of novel species participates in periodontal infections, thus clarifying potential targets for therapy.
The Department is also examining the host response to periodontal infections. When pathogenic bacteria interact with the host immune system, protective molecules are induced to combat the infection and minimize tissue destruction. New high-throughput techniques are being developed to identify a wide range of host response molecules in large numbers of samples, to achieve a clearer understanding of the host-parasite interaction.