DNA/ Bacterial Identification
If Dr. Primm feels it would be important to know what bacteria are present in your mouth he will suggest taking samples of the bacteria from the periodontal pockets for testing. This sampling process is quick and painless. A thin paper probe is placed under the gum line for 10 seconds. In that time, bacteria are collected on the paper probe. When removed from the mouth, the probe is placed into a small container. The container is then sent out to a laboratory where the bacteria can be grown and identified. At the same time, the laboratory can determine what antibiotics might be useful in killing these bacteria.
When the results are sent back to Dr. Primm (usually in about 10 – 14 days) he can determine if taking antibiotics is necessary and which ones would be helpful in treating your condition.
Bacterial DNA test: An essential diagnostic tool
Since periodontal disease is a bacterial infection, it is very important to know which bacteria are present before treatment begins. Using the Bacterial DNA test, we are able to identify exactly which bacteria are causing the infection. In the majority of cases, the DNA test will reveal that the type of bacteria that are present in the gums can be eliminated without the use of antibiotics (see the BOST section for more details on the treatment). In these cases, it is preferable to avoid antibiotics in order to prevent a drop in the immune system. However, some species of bacteria cannot be permanently eliminated using the treatment alone. Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) are aggressive species of bacteria that fall under this category (see the complete list of periodontal pathogens at the bottom of the page). If the test shows that these bacteria are present, then appropriate antibiotics are added to the treatment in order to produce complete healing.
What is the DNA test?
Bacterial DNA testing is based on the fact that each strain of bacteria has a specific “fingerprint” of genetic material. This fingerprint can then be analyzed in a laboratory to establish which species of bacteria are present in the infection. Compared to culturing the bacteria, Bacterial DNA testing offers much greater accuracy as well as reduced cost.
How is the test performed?
Administering the DNA test is a quick, safe, and painless process. Four tiny paper points are placed under the gums for a period of 10 seconds. This is long enough to collect disease causing bacteria from under the gums. These bacteria thrive in the plaque–otherwise known as biofilm–that covers the tooth roots down to the attachment level. Once they are removed, the paper points are packaged and sent to the laboratory where the bacterial DNA will be analyzed to reveal which types of bacteria are present. The test results are then e-mailed back to the dentist in about 10 days.
Why is the DNA test necessary?
The bacterial DNA test provides a scientifically accurate way of knowing which bacteria are causing the infection. Without the test, there is only one chance out of ten of choosing the right antibiotic combination to fight the bacteria under the gums. When invasive bacteria are inside the tissue in addition to on the roots and the bone, non surgical treatment can’t reach them and antibiotics are needed to clear them out. Without the focus given by the test we are more likely producing resistant strains than good treatment results.
Most patients find that it is very reassuring to know whether or not they have aggressive strains of bacteria in their gums. If the Aa and Pg are not present, patients feel relief immediately. Patients who test positive for the aggressive strains of bacteria, on the other hand, gain a better understanding of why they have had such a difficult time with periodontal problems in the past. They can feel hopeful for the future because they know that they will receive properly targeted antibiotics in addition to effective local treatment.
Who should take the test?
Anyone with current periodontal gum disease benefits from a bacterial DNA evaluation. Symptoms of periodontal disease are bleeding gums, loose or shifting teeth, painful chewing, bad breath, gum recession, and bone loss. Dr. Primm recommends the DNA test as the first step towards successful treatment.
In addition, the test can be used as a preventive measure. People with a history of periodontal disease in their family can be screened and diagnosed early before the bacteria have a chance to cause an infection.
People about to have dental implants should absolutely have the test to make sure that any prior periodontal infection is under control to protect the implants from getting infected. For people who currently have an infected, failing implant the test and treatment may be able to save it.
The test should also be done prior to orthodontic treatment where force will be put on the bone and oral hygiene will be more difficult. Aerobic hygiene is also important to help prevent common post-orthodontic problems like gum recession as well as gingivitis during treatment.
How do I get the test?
Schedule to have the test and a thorough exam at the office The Advanced Institute of Oral Health. With over 25 years of experience, our Doctors offer some of the highest quality service in the periodontal field. Call us today!