Oral Colonization by Entamoeba gingivalis and Trichomonas tenax: A PCR-Based Study in Health, Gingivitis, and Periodontitis

Abstract

BackgroundThe etiology of periodontitis remains unclear, as is the place of gingivitis in its pathophysiology. A few studies linked the colonization by oral parasites (Entamoeba gingivalis and Trichomonas tenax) to periodontal disease and its severity. The aim of the current study was to estimate the prevalence of these oral parasites among healthy individuals, and in patients with gingivitis and periodontitis in Jordan.MethodsThe study was conducted during July 2019–December 2019. Samples were composed of saliva and periodontal material including dental plaque sampled with probes. The detection of oral parasites was done using conventional polymerase chain reaction (PCR).ResultsThe total number of study participants was 237: healthy (n=94), gingivitis (n=53) and periodontitis (n=90). The prevalence of E. gingivalis was 88.9% among the periodontitis patients, 84.9% among the gingivitis patients and 47.9% in the healthy group. For T. tenax, the prevalence was 25.6% among the periodontitis patients, 5.7% among the gingivitis patients and 3.2% in the heathy group. Positivity for E. gingivalis was significantly correlated with the presence of periodontal disease compared to the healthy group with odds ratio (OR) of 6.6. Periodontal disease was also correlated with lower monthly income (OR=8.2), lack of dental care (OR=4.8), and history of diabetes mellitus (OR=4.5). Colonization by E. gingivalis was correlated with gingivitis (OR=6.1) compared to the healthy group. Colonization by E. gingivalis and T. tenax were significantly correlated with periodontitis (OR=6.4 for E. gingivalis, and OR=4.7, for T. tenax) compared to the healthy group. T. tenax was only detected among individuals with generalized periodontal disease compared to its total absence among those with localized disease (19.6% vs. 0.0%; p=0.039). The co-infection rate by the two oral parasites was 11.0%.ConclusionsThe higher prevalence of human oral parasites in periodontal disease compared to healthy individuals appears to be more than a mere marker for the disease and might also be associated with disease severity and potential for progression. Thus, the dogmatic view of E. gingivalis and T. tenax as commensals needs to be re-evaluated and their contribution to pathophysiology of periodontal diseases cannot be neglected.

A Loop-Mediated Isothermal Amplification (LAMP) Assay Specific to Trichomonas tenax Is Suitable for Use at Point-of-Care

“…In the periodontitis group, the prevalence of T. tenax among individuals with generalized or localized conditions is 19.6% and 0.0%, respectively ( p = 0.039). Furthermore, the odds ratios with T. tenax infection between periodontitis and healthy groups, and between periodontitis and gingivitis groups are 4.7 (95% CI: 1.0–21.8, p = 0.045) and 7.2 (95% CI: 1.5–33.8, p = 0.013), respectively [ 11 ]. In a study of 92 samples of canine plaque using touchdown PCR and next generation sequencing, the proportion of Trichomonas sp.…”

Functional biomes beyond the bacteriome in the oral ecosystem

“…Electron microscopic studies reveal the presence of Entamoeba gingivalis ( E. gingivalis ) and Trichomonas tenax ( T. tenax ) and free living amoebae in many cases with and without diseases. Its presence is influenced by the host factors showing a mixed composition together with its prominent role along with bacteria and fungi [68] . In patients with genetic diseases, a highest prevalence of E. gingivalis and T. tenax is observed among the age group of 41–50 years portraying its role in the oral microbiome and in inducing diseases upon the alteration of the homeostasis [69] .…”

Entamoeba gingivalis is associated with periodontal conditions in Chinese young patients: A cross-sectional study

“…In recent years, several PCR-based studies showed that E. gingivalis was significantly increased in periodontal pockets of periodontitis. The prevalence in patients with periodontitis and in individuals with periodontal health was 74-88.9% (Zaffino et al, 2019;Bao et al, 2020;Dubar et al, 2020;Yaseen et al, 2021) and 3.3-47.9%, respectively (Bao et al, 2020;Dubar et al, 2020;Yaseen et al, 2021). In a study of the transcriptional activity of periodontal pocket microbiota, E. gingivalis had the second highest abundant rRNA found in periodontitis after human rRNA.…”