Periodontal herpesvirus morbidity and treatment

Abstract

Four billion individuals worldwide have a history of periodontitis, with the poorest people in society most affected. Periodontitis can lead to unsightly drifting of teeth and tooth loss that may interfere with the wellbeing of daily living and has also been linked to at least 57 medical diseases and disabilities. The etiology of severe periodontitis includes active herpesviruses, specific bacterial pathogens, and destructive immune responses, but herpesviruses seem to be the major pathogenic determinant. Periodontal herpesviruses that disseminate via the systemic circulation to nonoral sites may represent a major link between periodontitis and systemic diseases. Current treatment of periodontitis focuses almost exclusively on bacterial biofilm and will require revision. Periodontal therapy that targets both herpesviruses and bacterial pathogens can provide long‐term clinical improvement and potentially reduces the risk of systemic diseases. Molecular diagnostic tests for periodontal pathogens may enable early microbial identification and preemptive therapy. This review details an efficient and reliable anti‐infective treatment of severe periodontitis that can be carried out in minimal time with minimal cost.

Herpesvirus‐bacteria synergistic interaction in periodontitis

“…Severe periodontitis is estimated to affect 8.9% of US adults and 11% of the global population . Traditional (mechanical) periodontal therapy and follow‐up supportive care can reduce gingival inflammation and restore partly damaged gingival tissue, but may not arrest ongoing loss of periodontal attachment . Differences in periodontitis progressivity and response to treatment are related to the composition of the periodontal microbiome and to levels of protective and destructive immune reactions to the infectious agents.…”

“…Periodontal herpesvirus infections in immunocompetent individuals are conceptually readily prevented and cured. Effective control of gingivitis restricts herpesviruses imbedded in inflammatory cells from entering the periodontium, and a number of basic periodontal therapies combined with systemic antiviral chemotherapy can resolve established periodontal herpesvirus infections . Maintaining a healthy periodontium depends on proper self‐care, but current methods of oral hygiene require considerable patient commitment, and are often inadequately implemented .…”

“…A focus solely on bacterial biofilms tends to oversimplify the pathogenesis and management of periodontitis, and a template for a low-cost, high-performance periodontal treatment that includes herpesviruses was described recently. 4 Periodontal herpesvirus infections in immunocompetent individuals are conceptually readily prevented and cured. Effective control of gingivitis restricts herpesviruses imbedded in inflammatory cells from entering the periodontium, and a number of basic periodontal therapies combined with systemic antiviral chemotherapy can resolve established periodontal herpesvirus infections.…”

“…Effective control of gingivitis restricts herpesviruses imbedded in inflammatory cells from entering the periodontium, and a number of basic periodontal therapies combined with systemic antiviral chemotherapy can resolve established periodontal herpesvirus infections. 4 Maintaining a healthy periodontium depends on proper self-care, but current methods of oral hygiene require considerable patient commitment, and are often inadequately implemented. 23 Oral rinsing twice-weekly with 0.25% sodium hypochlorite (dilute household bleach) can markedly improve the subgingival microbiota and the periodontal status, even in unscaled deep pockets, 24 and constitutes a valuable adjunct to traditional patient self-care.…”

Herpesvirus: relación con la enfermedad periodontal e implicaciones orales

“…Se han identificado más de 100 tipos diferentes de Herpesvirus pertenecientes a la familia Herpesviridae, de los cuales sólo ocho tipos son capaces de infectar a humanos y se agrupan en tres subfamilias: Alfa, Beta y Gammaherpesvirinae (Tabla 1). 2…”