Our Current System Is Inadequate
Currently, gum disease is classified into two categories: chronic and aggressive, depending on how much damage there seems to be. Unfortunately, there is a great deal of overlap between the two categories, and it’s hard to tell when someone has developed a truly aggressive case of gum disease.
With poor classification, people with aggressive gum disease are often treated as if they have the chronic kind which is not much of a threat. They may then suffer tooth loss and other consequences of gum disease. On the other hand, people with chronic gum disease may be subjected to treatments that have significant cost in money, time, discomfort, and risk.
Finding a better classification system may help dentists give the appropriate response to gum disease.
Classification by Genetics
Researchers from the College of Dental Medicine at Columbia University Medical Center were inspired by the way doctors are beginning to classify cancers based on genetic markers. They took gum tissue from 120 patients, age 11 to 76 who had previously been classified as having either chronic or aggressive gum disease.
They found that patients belonged to two different clusters based on their genetic profile. They also found that patients in one of the clusters had more serious gum disease than those in the other. The serious gum disease cluster contained more men than women, and had higher levels of infection, confirming characteristics already associated with more serious gum disease.
These two clusters cut across the diagnosis made using the other classification system.
Although this system shows promise, the researchers responsible for it are unhappy with its limitations. Although they note that it would serve as a good way to separate out people who are likely to suffer aggressive gum disease before it manifests, they are unhappy that the system depends on genetic testing, which requires a tissue sample and a time-consuming genetic profile. They hope to transform the test into a more straightforward chemical test that could be conducted quickly and conveniently at a dentist’s office.
When that occurs, we may see a truly innovative approach to treating gum disease that can predict the best treatments before the disease even fully manifests itself.