What is the influence of tonsillectomy on the level of periodontal pathogens on the tongue dorsum and in periodontal pockets

Abstract

BackgroundFor periodontal treatment, the full mouth disinfection approach suggests disinfection of oral soft tissues, such as tongue and tonsils concomitant to scaling and root planning since patients might benefit from treatment of these oral niches either. Periodontopathogenes in tonsillar tissue support this hypothesis. This prospective controlled clinical study investigated the change in the oral flora of patients who underwent tonsillectomy. Pockets were tested for eleven bacterial species before and six weeks after the surgical intervention.MethodsFifty generally healthy adults were included in this study. The test group consisted of 25 patients with tonsillectomy. The control group included 25 patients with otorhinolarynologic surgery without involvement of the oral cavity. Clinical parameters such as probing pocket depth, bleeding-on-probing index and plaque index were registered the evening before surgery. Also bacterial samples from the gingival sulcus and dorsum linguae were taken, and an additional sample from the removed tonsils in the test group. Six weeks after the intervention microbial samples of pockets and tongue were taken again. Data were tested for significant differences using Wilcoxon rank and Whitney-u-test.ResultsNo relevant intra- or intergroup differences were found for the change of the eleven investigated species.ConclusionBased on the results of the present study, tonsillectomy does not seem to have an immediate relevant effect on the bacterial flora of tongue or periodontium. This study design was approved by the ethical committee of Zurich (KEK-ZH-Nr.2013–0419).Trial registrationThe trial was retrospectively registered in the German Clinical Trials Register (DRK00014077) on February 20, 2018.

Analysis of Chronic Periodontitis in Tonsillectomy Patients: A Longitudinal Follow-Up Study Using a National Health Screening Cohort

“…Similarly, these anaerobic bacteria were found in tonsils with recurrent inflammation [25]. The present study was designed based on the anatomic nearness and bacterial similarity indicated in previous studies, suggesting the possibility of an association between the palatine tonsil area and periodontitis [18,22,[24][25][26].…”

“…A previous study reported that the microorganisms in the tongue area were altered following tonsillectomy [26]. The study showed that Tannerella forsythia and Porphyromonas gingivalis levels decreased in samples taken from the tongue after tonsillectomy [26]. This result could be explained by how anatomically close the tongue and tonsils are, and the fact that saliva is exchanged between them while speaking and swallowing.…”

“…Tonsillectomy, including removal of the biofilm, has a positive effect on the intraoral areas such as the gingiva and tongue. A previous study reported that the microorganisms in the tongue area were altered following tonsillectomy [26]. The study showed that Tannerella forsythia and Porphyromonas gingivalis levels decreased in samples taken from the tongue after tonsillectomy [26].…”

“…This result could be explained by how anatomically close the tongue and tonsils are, and the fact that saliva is exchanged between them while speaking and swallowing. On the contrary, the same study reported that lesser changes occurred in other bacteria levels in the periodontal pocket following tonsillectomy [26]. They suggested that, with regards to the tonsillar area, the periodontal pocket would be more distant and difficult to access than the tongue area.…”

Tonsillectomy as a risk factor of periodontitis: A population‐based cohort study

“…Regarding the effect of tonsillectomy on infections in the oral cavity, for which periodontitis has been considered as a consequence of oral dysbiosis, parallel to the imbalance of anti‐microbial immunity and microbiota in the gastrointestinal tract, 9 a previous longitudinal cohort study reported that tonsillectomy had no effect on periodontal status and bacterial flora 32 over a 6‐week observational period in patients aged above 18 years. This agreed with part of our findings that the association between tonsillectomy and periodontitis was not significant in adults during a short‐period of follow‐up.…”