Good oral hygiene is an essential part of the basic management of kidney and liver disease. For transplant patients, oral health care is particularly important as these patients are often at increased risk of oral infections and their complications.

The health of the kidneys and liver is closely linked to the well-being of the whole body, and oral health also affects the functioning of these organs. Poor oral health can increase the body's risk of inflammation and reduce overall immunity. This in turn can negatively affect the management of kidney and liver diseases (1).

- Kidney and liver diseases and their treatments are often associated with a weakening of the body's defence mechanisms, which can make any infection dangerous. This is especially true if patients are prescribed immunosuppressive medication, as is always the case after transplantation, says Jukka Meurman, Professor Emeritus, Department of Oral and Maxillofacial Diseases, Helsinki University Hospital.

Inflamed gums provide a direct route for bacteria in the mouth to enter the rest of the body.

- From the mouth and teeth, bacteria can easily enter the bloodstream through gingivitis, periodontitis, caries cavities, and mucosal ulcers. Infections of the mouth are harmful because they result in a low-grade inflammatory condition, at worst involving the whole body, Meurman continues.

Oral infections are particularly harmful for chronically ill people - including diabetics, people with rheumatic and kidney diseases, and patients on immunosuppressive medication, or with defence system disorders. Recent research suggests that dental infections may even increase the risk of cancer (2, 3)

- This is also explained by chronic inflammation, says Meurman.

Preventing the risk of bacteraemia

The risk of bacteraemia is increased in people with long-term conditions. Bacteraemia is an infection caused by bacteria, which occurs when bacteria that have entered the bloodstream trigger the body's defence response against them. In the worst cases, it can trigger damage to one or more organs. This is called sepsis. (4)

Bacteria can enter the bloodstream from inflamed areas of the oral cavity. This can happen during tooth brushing, flossing, or dental procedures. In most cases, bacteraemia is short-lived, and the body can fight it off. However, if a person has a weakened immune system or if bacteraemia recurs frequently, it can cause problems.

- In chronically ill patients, every effort should be made to prevent bacteraemia. Oral health is crucial, as the mouth is the most common source of normal bacterial growth in the body.  Mucous membranes, teeth, and gums must be kept in healthy condition through daily effective oral hygiene maintenance, says Meurman.

Studies have shown that in patients at risk of heart disease, bacteraemia caused by dental procedures is even one of the causes of bacterial endocarditis. Bacterial endocarditis is an infection that affects the endocardium, the inner membrane of the heart, and can be particularly serious in people with compromised immunity. This infection can damage the heart valves and requires immediate treatment (5).

Aiming for an infection-free mouth

At the time of transplantation, the teeth and mouth must be healthy and free of infection.  Oral health also has an impact on recovery from surgery. Meurman points out that transplant patients are at risk of infection for the rest of their lives, so it is essential that they strive to maintain good oral hygiene every day.

- All available methods should be put in place well in advance of any surgery.

Oral infections and the resulting distant infections can be fatal for surgical and chronically ill patients.

- All oral and dental infections should be diagnosed and treated before transplant surgery. This often involves extraction of infected teeth with poor prognosis.  For example, those with deep cavities or deep periodontal pockets need to be removed.

However, radical solutions are not always necessary before surgery. A transplant patient's treatment plan is individual and influenced by the patient's own motivation to maintain good oral health. On the other hand, if the transplant is not planned for many years, more tooth-preserving and restorative treatments are  possible. In this case, tooth extractions can be avoided.

- The basic idea is, of course, that the mouth and teeth should have been always kept in good condition by careful and regular oral hygiene practices, rather than reacting only when there is a need for radical treatments, says Meurman.

Deep gum pockets are nests of bacteria

In addition to health and general well-being, maintaining good oral health also affects the patient's quality of life. A painful mouth, dental problems and other oral health issues can reduce a patient's quality of life and increase stress, which in turn can have a negative impact on health in general and the outcome of treatment for an underlying disease, says Meurman.

Regular dental check-ups and careful oral hygiene practices are an important part of comprehensive health care for people with kidney and liver diseases.

Taking care of oral health and working closely with dental professionals is particularly important for patients taking immunosuppressive drugs, which increase the risk of oral infections such as gingivitis and periodontitis. This is because these drugs weaken the immune system's ability to fight bacteria in the mouth.

Immunosuppressive medicines can also cause changes to the mucous membranes, such as mouth ulcers and dryness (xerostomia), which increases the risk of caries.

Periodontal disease – a persistent companion once it breaks out

Signs of periodontal disease include reddened and bleeding gums and bad breath. In people with periodontal disease, the fibres that attach to the tooth are destroyed. A pocket begins to form between the gum and the tooth, which can extend around the entire tooth. Gradually, the inflammation begins to destroy more of the tissues that attach the teeth and eventually spread in the jawbone.

Once established, periodontitis is a tenacious companion that will progress if not treated carefully. Daily oral home care plays an important role in periodontitis and  oral health in general.

- Regular dental check-ups, daily brushing and cleaning of the interdental spaces and maintaining the oral moisture balance are important measures to maintain oral health.

However, traditional oral hygiene methods are not always enough to keep the mouth healthy. For example, flossing or brushing may be difficult due to age, thus leaving the spaces between the teeth uncleaned. On the other hand, even if brushing the teeth is successful, studies have shown that even an effective electric toothbrush only removes about 65% of the harmful bacteria in the mouth. (6)

To tackle this residual plaque, which is invisible to the naked eye, Finnish researchers have developed an antibacterial oral health enhancing device that is based on antibacterial photodynamic therapy. This method effectively eliminates both the bacteria responsible for tooth decay and those contributing to gingivitis. The Finnish Association of Oral Hygienists has endorsed the use of the Lumoral device (7).

- Home-administered antibacterial photodynamic therapy is a new method that helps improve oral health and has been proven to be effective in scientific studies. It does not replace other oral hygiene methods such as tooth brushing and flossing but complements them perfectly. For liver, kidney, and organ transplant patients, if any, use of the new method is highly recommended, says Meurman.

The oral health enhancing device is used in addition to regular brushing. Plaque, which is made up of living bacterial cells, is normally sticky and is difficult to remove completely from the surfaces of the teeth with a brush alone. After using the device, the existing plaque becomes easier to remove by brushing (8).

- Home-administered antibacterial photodynamic therapy is suitable for everyone but is particularly important for those with tooth decay or gingivitis.

Prof Jukka Meurman is an eminent figure in the field of oral infectious diseases. Presently, he holds the title of Professor Emeritus at the University of Helsinki, and serves as the Head Physician at the Department of Oral and Maxillofacial Diseases at Helsinki University Hospital, Finland. His contributions have earned him numerous prestigious honors and accolades.

Sources:

1.       Åberg F, Helenius-Hietala J. Oral Health and Liver Disease: Bidirectional Associations-A Narrative Review. Dent J (Basel). 2022 Jan 21;10(2):16. doi: 10.3390/dj10020016. PMID: 35200242; PMCID: PMC8870998..
2.       Nieminen, M., Listyarifah, D., Hagström, J. et al. Treponema denticola chymotrypsin-like proteinase may contribute to orodigestive carcinogenesis through immunomodulation. Br J Cancer 118, 428–434 (2018). https://doi.org/10.1038/bjc.2017.409
3.       Heikkilä, P., But, A., Sorsa, T. and Haukka, J. (2018), Periodontitis and cancer mortality: Register-based cohort study of 68,273 adults in 10-year follow-up. Int. J. Cancer, 142: 2244-2253. https://doi.org/10.1002/ijc.31254
4.       https://www.epressi.com/tiedotteet/terveys/suun-infektiopesakkeet-voivat-vaarantaa-syopa-tai-leikkauspotilaan-hoidon.html
5.       Poveda-Roda R, Jiménez Y, Carbonell E, Gavaldá C, Margaix-Muñoz MM, Sarrión-Pérez G. Bacteremia originating in the oral cavity. A review. Med Oral Patol Oral Cir Bucal. 2008 Jun 1;13(6):E355-62. PMID: 18521055.
6.       Aggarwal N, Gupta S, Grover R, Sadana G, Bansal K. Plaque removal efficacy of different toothbrushes: a comparative study. Int J Clin Pediatr Dent. 2019;12(5):385-390. doi:10.5005/jp-journals-10005-1669
7.       The Finnish Oral Hygiene Association recommends Lumoral. Finnish Association of Dental Hygienists. September 1, 2022. https://www.suuhygienistiliitto.fi/suomen-suuhygienistiliitto-suosittelee-lumoralia/
8.       Pakarinen, Saila, et al. "Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)—Three-Month Interim Results." Dentistry Journal 10.11 (2022): 206.

Scientists have discovered a significant link between poor oral health and systemic diseases, including specific cancers. This connection is centered around so-called oral dysbiosis, a condition where imbalanced oral bacteria can lead to a range of health issues. It also emphasizes the crucial role of oral hygiene in promoting overall health.

The oral cavity houses more than 700 types of bacteria. While some bacterial species are beneficial for dental and overall health, in some cases, they can play a role in the development of serious systemic illnesses.

Studies show that maintaining a balanced microbial ecosystem in the mouth is crucial for oral health and it has a significant impact on how the body responds to various diseases. Dysbiosis, or an imbalanced oral microbiome, or ecosystem, can lead to various health issues ranging from common dental problems like cavities and gum disease to severe conditions such as heart disease, Alzheimer’s disease, and diabetes. [1, 2]

Recent studies have revealed that oral dysbiosis may even be involved in the development of life-threatening digestive cancers. Digestive cancers include cancers located in the esophagus, stomach, liver, pancreas, colon, and rectum. Their incidence and related mortality are increasing worldwide, with the majority of new cases of digestive cancers (63%) and related deaths (65%) occurring in Asia, followed by Europe and North America. [3].  

Scientists believe that many digestive cancer forms are influenced by various environmental factors that can be potentially changed. These include tobacco smoking, diet, alcohol consumption, and obesity. Some recent evidence also suggests a role of the human oral microbiota in the development of digestive cancers. Fusobacterium nucleatum is one bacteria species found commonly in the mouth, which is a key member of colorectal cancer-associated bacteria. However, many other oral pathogens can play a role in the development of cancer as well. [4,5]

Exposing the oral bacteria-pancreatic cancer link

One study published in the British Journal of Cancer (BJC) reported that Trepenoma denticola (Td), the bacteria responsible for periodontitis, may cause pancreatic cancer [6,7]. Pancreatic cancer is one of the deadliest forms of cancer caused by the abnormal and uncontrolled growth of cells in the pancreas – a large gland that is part of the digestive system. Around half of all new cases are diagnosed in people aged 75 or over. [8]

–  The Treponema bacterium can enter the bloodstream through inflamed gums and spread to other parts of the body. If left untreated and undiagnosed, periodontal disease contributes to the development and spread of cancer and cancer deaths – not only from oral cancer, but especially pancreatic cancer, explains Timo Sorsa, Professor of Oral and Maxillofacial Diseases at the University of Helsinki, findings of the study.

Professor Sorsa points out that Treponema bacterium shares a specific enzyme with some cancer types in the gut. This enzyme is called Treponema denticola chymotrypsin-like proteinase – or dentilisin – and it is usually found in the mouth, where it is known to contribute to severe gum disease (periodontitis). However, this same enzyme has also been observed in malignant and life-threatening tumors. [6,7].

In the oral cavity, dentilisin not only contributes to gum disease but also triggers other enzymes that promote cancer. These enzymes are called matrix metalloproteinases (MMPs), and they break down the material between cells and cell membranes, making it easier for cancer to invade healthy tissue. This connection raises concerns about potential health issues related to dentilisin in the oral cavity, Prof. Sorsa stresses.

The BJC study from 2017 was the first to show that virulence factors from gum disease bacteria could spread from the mouth to other parts of the body and take part in central mechanisms of cancer-related tissue destruction.

Since then, supplementary research has supported the study’s findings.  One report released in the International Journal of Cancer – also by Prof. Sorsa’s team – examined registry data for over 10 years on over 68,000 adults in Finland who had made a primary dental healthcare visit. This revealed that periodontitis was associated with a 33% increased risk for overall cancer mortality. The mortality risk associated with gum disease among individuals with pancreatic cancer was far higher, with a more than twofold increased risk, the study shows [7].

From fast diagnosis to a quick onset of treatment 

The links revealed so far between oral bacteria and cancer developments have inspired Prof. Sorsa’s team to search ways to help prevent cancerous developments. One potential solution is to detect gum infections in their initial stages through early diagnosis. By quickly identifying gum disease with a chair-side aMMP-8 rapid test, researchers believe that we might be able to prevent certain cancers because it allows for faster treatment of the underlying issue: gum inflammation. The test makes invisible visible, points out Prof. Sorsa. [9,10]

– Out of all MMP enzymes, especially active MMP-8 enzyme has been found to be elevated in patients suffering from gum disease leading to periodontal connective tissue destruction, Prof. Sorsa explains his team’s findings.

Periodontitis, or severe gingivitis, is a common disease that is estimated to affect as many as half of the global population – often without any symptoms at all. Early detection of these diseases is important because it allows for intervention and treatment before irreversible damage occurs. Traditional methods like check-ups and X-rays might, however, miss early signs of these diseases since they often show symptoms in later stages. Using biomarkers like aMMP-8, clinicians can spot subtle inflammation and tissue damage, allowing them to start treatment before the disease becomes visible.

–The aMMP-8 rapid test can measure and assess active periodontal adhesive tissue loss and the risk of its progression within five minutes in the dental chair non-invasively. The test complements the diagnosis, follow-up, and maintenance treatment of periodontitis and peri-implantitis, explains Prof. Sorsa. 

Advanced approaches for treating oral diseases

Periodontal and peri-implant diseases are conditions that affect the supporting structures of teeth and dental implants and can lead to tooth loss if left untreated. Gum infections can develop for various reasons. One key factor is the buildup of bacterial plaque, also known as biofilm, on the surfaces of teeth due to inadequate oral hygiene. [9]  

When discussing new treatment options and prevention of periodontitis, Prof. Sorsa emphasizes modern antibacterial methods for better oral hygiene and efficient plaque removal in periodontitis treatment and prevention. Also, research reveals that antibacterial photodynamic therapy (aPDT) is a promising approach to treat bacterial infections – even ones that do not respond well to antibiotics [12].

Lumoral treatment is the first aPDT treatment device designed for home use. It has been developed by Finnish scientists as a drug-free alternative for treating and preventing severe gum disease.

– Poor oral health is linked to over 200 chronic diseases. Lumoral is a product that enhances oral hygiene when used regularly at home, and research suggests that it can also enhance the effectiveness of professional dental care. What's more, it may reduce the need for conventional medications like antibiotics and chlorhexidine in the treatment of gum disease, according to Tommi Pätilä, a cardiac and organ transplant surgeon at the New Children's Hospital in Helsinki.

– Based on a light-activated antibacterial effect, Lumoral slows down plaque formation and significantly reduces the burden of harmful bacteria in the mouth, Pätilä explains further.

The product is suitable for patients of all ages, but it is particularly recommended for those with a history of problems with common oral diseases, tooth decay, and gum disease [9].

The crucial role of oral hygiene in cancer care

Brushing and flossing on a regular basis is key to maintaining a healthy mouth by removing dental plaque from the surfaces of teeth and interdental spaces. However, it is not always enough. Good oral hygiene requires adequate motor and mental skills. On the other hand, even when brushing teeth perfectly, studies show that even the most effective electric toothbrush only removes about 65% of harmful oral bacteria from the mouth [13].

– The key to overall well-being is good oral hygiene. For cancer patients, this is all the more important because they must maintain a high-calorie diet in order to fight the disease, notes Prof.  Dr. Tuomas Waltimo from the University of Basel.

Prof. Waltimo also acts as a private dentist at a clinic that offers dental services to patients with special dental needs, for example patients undergoing cancer treatments. He reminds that cancer treatments often bring along side-effects that can require special attention. Mucositis, as one example, can lead to generalised infection and even be life-threatening.

Mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract. It can occur anywhere along the gastrointestinal (GI) tract, but oral mucositis refers to the inflammation and ulceration that occurs specifically in the mouth. Maintaining good oral hygiene habits is a prerequisite for treating oral mucositis. Lumoral supports regular mechanical dental hygiene, helps achieve gum health, and prevents inflammation when regular dental hygiene is insufficient. 

– Good oral hygiene is of paramount importance also in the management of oral mucositis. Initial findings suggest Lumoral treatment might help prevent and potentially treat oral mucositis, but this hypothesis requires further scientific research to confirm. We are, therefore, starting a new PhD study examining the topic at the University of Helsinki, Prof. Waltimo says.

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November is Stomach Cancer Awareness Month, and the goals of stomach cancer awareness primarily include: Raising public awareness and supporting educational efforts about stomach cancer, including risk factors, prevention, and early detection.

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References:

1.   Maier, T. Oral Microbiome in Health and Disease: Maintaining a Healthy, Balanced Ecosystem and Reversing Dysbiosis. Microorganisms 2023, 11, 1453. https://doi.org/10.3390/microorganisms11061453
2.   Silva DNdA, Casarin M, Monajemzadeh S, Bezerra BdB, Lux R and Pirih FQ (2022) The Microbiome in Periodontitis and Diabetes. Front. Oral. Health 3:859209. doi: 10.3389/froh.2022.859209
3.     https://dceg.cancer.gov/news-events/news/2020/global-burden-gastro
4.   Pignatelli, P.; Nuccio, F.; Piattelli, A.; Curia, M.C. The Role of Fusobacterium nucleatum in Oral and Colorectal Carcinogenesis. Microorganisms 2023, 11, 2358. https://doi.org/10.3390/microorganisms11092358
5.   Reitano E, de'Angelis N, Gavriilidis P, Gaiani F, Memeo R, Inchingolo R, Bianchi G, de'Angelis GL, Carra MC. Oral Bacterial Microbiota in Digestive Cancer Patients: A Systematic Review. Microorganisms. 2021 Dec 14;9(12):2585. doi: 10.3390/microorganisms9122585. PMID: 34946186; PMCID: PMC8707512.
6.   Nieminen, M., Listyarifah, D., Hagström, J. et al. Treponema denticola chymotrypsin-like proteinase may contribute to orodigestive carcinogenesis through immunomodulation. Br J Cancer 118, 428–434 (2018). https://doi.org/10.1038/bjc.2017.409
7.   Heikkilä, P., But, A., Sorsa, T. and Haukka, J. (2018), Periodontitis and cancer mortality: Register-based cohort study of 68,273 adults in 10-year follow-up. Int. J. Cancer, 142: 2244-2253. https://doi.org/10.1002/ijc.31254
8.     https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/pancreatic-cancer/
9.   Pakarinen, S.; Saarela, R.K.T.; Välimaa, H.; Heikkinen, A.M.; Kankuri, E.; Noponen, M.; Alapulli, H.; Tervahartiala, T.; Räisänen, I.T.; Sorsa, T.; Pätilä, T. Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)—Three-Month Interim Results. Dent. J. 2022, 10, 206. http://hdl.handle.net/10138/350606
10. Sorsa T, Gursoy UK, Nwhator S, Hernandez M, Tervahartiala T, Leppilahti J, Gursoy M, Könönen E, Emingil G, Pussinen PJ, Mäntylä P. Analysis of matrix metalloproteinases, especially MMP-8, in gingival creviclular fluid, mouthrinse and saliva for monitoring periodontal diseases. Periodontol 2000. 2016 Feb;70(1):142-63. doi: 10.1111/prd.12101. PMID: 26662488.
11. Sorsa T, Nwhator SO, Sakellari D, Grigoriadis A, Umeizudike KA, Brandt E, Keskin M, Tervahartiala T, Pärnänen P, Gupta S, Mohindra R, Bostanci N, Buduneli N, Räisänen IT. aMMP-8 Oral Fluid PoC Test in Relation to Oral and Systemic Diseases. Front Oral Health. 2022 Jun 10;3:897115. doi: 10.3389/froh.2022.897115. PMID: 35757444; PMCID: PMC9226345.
12. Liu Y, Qin R, Zaat SAJ, Breukink E, Heger M. Antibacterial photodynamic therapy: overview of a promising approach to fight antibiotic-resistant bacterial infections. J Clin Transl Res. 2015 Dec 1;1(3):140-167. PMID: 30873451; PMCID: PMC6410618.
13. 1 Neha Aggarwal, Sunil Gupta, Rashu Grover, Gunmeen Sadana, and Karan Bansal; Plaque Removal Efficacy of Different Toothbrushes: A Comparative Study, Int J Clin Pediatr Dent. 2019 Sep-Oct; 12(5): 385–390.  doi: 10.5005/jp-journals-10005-1669

World Heart Day, launched by the World Heart Federation (WHF), is celebrated each year on the 29th of September. The global event aims to raise awareness and encourage action for heart health.

Cardiovascular disease (CVD) is the leading cause of death in the Western world. The most common cardiovascular diseases are coronary heart disease, heart failure, and cerebrovascular disorders. More than 20.5 million people die from these diseases each year. Cardiovascular diseases affect the heart and blood vessels, leading to severe and possibly even fatal complications. However, the WHF estimates that 80% of premature deaths from the disease are preventable (1).

– By making small changes to our lifestyles, we can better manage our heart health and beat cardiovascular disease, the WHF encourages.

Such changes include actions that help improve oral health. Good oral hygiene is more than just a beautiful smile. It is essential to look after your teeth and mouth because even seemingly harmless oral conditions can put you at risk of serious diseases.

Oral pathogens are not limited to the mouth

Tommi Pätilä, a cardiac and transplant surgeon at the New Children’s Hospital (HUS), stresses that a healthy heart requires a healthy mouth and thorough daily oral hygiene. Oral biofilm bacteria are the cause of 95 percent of dental diseases.

– Simple measures such as regular brushing and cleaning of the interdental spaces and regular dental check-ups can help prevent the onset of gum disease and, at the same time, minimise the risk of bacteria or their structures in the mouth entering the bloodstream and spreading to the rest of the body, says Pätilä.

Even chewing food can spread bacteria or parts of bacteria that cause oral infections to the rest of the body through infected gums. This results in a persistent inflammatory condition within the body, which may subsequently give rise to serious health conditions, including cardiovascular disease, Pätilä notes. 

– On the other hand, sudden problems occur when live bacteria infect the heart valves, Pätilä continues.

In 2016, Pätilä operated on a severe bacterial heart valve infection and was motivated to make a difference in oral health. 

– It turned out that the cause of the patient’s severe heart infection was bacteria from the mouth. At that point, I knew something had to be done to combat the residual plaque that causes disease and plagues in peoples’ mouths despite brushing and flossing.

Pätilä is one of three Finnish researchers who have developed the antibacterial Lumoral method. Lumoral is a patented medical device that treats and prevents oral diseases at home. The Lumoral treatment can remove 99.99% of plaque bacteria from the tooth surface (2).

Prevention and early diagnosis pays off

– In contrast to commonly held beliefs, a toothbrush is only capable of eliminating approximately 60% of oral biofilm. It's no surprise then that cavities and gingivitis stand as the most prevalent diseases worldwide. If we want to improve oral health outcomes, we need to tackle the plaque left behind by tooth brushing, says Timo Sorsa, Professor of Oral and Maxillofacial Diseases at the University of Helsinki.

In Finland, it is estimated that up to two out of three people over 30 suffer from periodontitis. This common gum disease can lead to tooth loss if left untreated – but it is also linked to severe heart events. According to a study, individuals with periodontal disease are 30% more likely to experience a first heart attack compared to their healthy counterparts of the same age (3).

According to another study published in the Journal of Periodontology, people with periodontal disease were almost twice as likely to develop coronary artery disease (CAD) than those with healthy gums (4). 

Meanwhile, a 2020 European Journal of Preventive Cardiology report found that poor oral health was associated with an increased risk of cardiovascular disease, particularly among those with gum disease (5).

Professor Sorsa stresses that periodontal disease prevention is vital to maintaining a patient’s oral and overall health.

– Untreated periodontitis leads to low-grade inflammation that affects the whole body, contributing to conditions like cardiovascular disease, diabetes, Alzheimer's disease, and potentially even cancer.

Periodontitis revealed in minutes

According to Professor Sorsa, in the long term, the prevention and rapid diagnosis of periodontal disease benefit the patient, public health, and the economy. This is also possible with the new modern diagnostic and treatment methods available that are revolutionising the whole field of dentistry.

Professor Sorsa’s extensive research career has long focused on developing an immunological rapid test for active matrix metalloproteinase-8 (aMMP-8). The quick test can detect whether a person’s gum tissue is undergoing periodontal breakdown before it is visually apparent. 

The test can be performed by a healthcare professional or the consumer independently at home – similar to the COVID-19 antigen test or the traditional rapid pregnancy test (6).

–The aMMP-8 rapid test can measure and assess active periodontal adhesive tissue loss and the risk of its progression within five minutes in the dental chair non-invasively, i.e. without disturbing the tissue under examination. The test complements the diagnosis, follow-up, and maintenance treatment of periodontitis and peri-implantitis, says Professor Sorsa.

When discussing new treatment methods and prevention of periodontitis, he highlights Lumoral therapy. He calls Lumoral a drug-free alternative for treating and preventing severe gum disease. 

– Lumoral enhances the effect of the toothbrush, and studies show that it also significantly improves the results of professional oral care. At the same time, the device can potentially reduce the need to use drugs traditionally used to treat gum disease, such as antibiotics and chlorhexidine.

Based on photodynamic therapy, a light-activated antibacterial effect, Lumoral slows down plaque formation and significantly reduces the burden of harmful bacteria in the mouth. The product’s user profile is suitable for all ages, but it is particularly recommended for those with a history of problems with common oral diseases, tooth decay, and gum disease (2).

References:

1. https://world-heart-federation.org/news/deaths-from-cardiovascular-disease-surged-60-globally-over-the-last-30-years-report/
2. Pakarinen, S., Saarela, R. K. T., Välimaa, H., Heikkinen, A. M., Kankuri, E., Noponen, M., Alapulli, H., Tervahartiala, T., Räisänen, I. T., Sorsa, T., & Pätilä, T. (2022). Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP) Three-Month Interim Results. Dentistry Journal, 10(11), [206]. https://doi.org/10.3390/dj10110206
3. Rydén L, Buhlin K, Ekstrand E, de Faire U, Gustafsson A, Holmer J, Kjellström B, Lindahl B, Norhammar A, Nygren Å, Näsman P, Rathnayake N, Svenungsson E, Klinge B: Periodontitis Increases the Risk of a First Myocardial Infarction. A Report From the PAROKRANK Study. 13.1.2016 Circulation. 2016;133:576–583 https://doi.org/10.1161/CIRCULATIONAHA.115.020324
4. Nesarhoseini V, Khosravi M. Periodontitis as a risk factor in non-diabetic patients with coronary artery disease. ARYA Atheroscler. 2010 Fall;6(3):106-11. PMID: 22577425; PMCID: PMC3347825.
5. Pirkko J Pussinen, Eija Könönen, Oral health: A modifiable risk factor for cardiovascular diseases or a confounded association?, European Journal of Preventive Cardiology, Volume 23, Issue 8, 1 May 2016, Pages 834–838, https://doi.org/10.1177/2047487316636506
6. Sorsa, T., Lähteenmäki, H., Pärnänen, P., Tervahartiala, T., Mäkitie, A. Pätilä, T. &   Räisänen, I. T., (2022). Aktiivisen MMP-8:n vieritestaus ja pikadiagnostiikka, Suomen Hammaslääkärilehti 2022; 14: 26–33.