Viruses and Periodontal Diseases

Could your chronic periodontal disease involve viruses?

Periodontal diseases can involve bacteria and/or viruses initiating chronic inflammation and ensuing tissue and bone destruction.  Patients with history of herpes simplex virus (HSV) or Epstein Barr virus (EBV) are especially high risk for the presence of these putative pathogens. We do not currently have oral salivary  DNA tests to either confirm or refute the presence of viruses in the risk factor assessment of active periodontitis, but blood tests can be performed for the presence of antibodies.  To date the only way to combat oral viruses is to have definitive periodontal treatment to eliminate periodontal pockets and utilize a diluted bleach solution at home (1/20 bleach with water).

Biology and Pathogenesis of Cytomegalovirus in Periodontal Disease:

Periodontol 2000. 2014 Feb;64(1):40-56. doi: 10.1111/j.1600-0757.2012.00448.x.
Biology and pathogenesis of cytomegalovirus in periodontal disease.
Contreras A, Botero JE, Slots J.

Human periodontitis is associated with a wide range of bacteria and viruses and with complex innate and adaptive immune responses. Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, Treponema denticola, cytomegalovirus and other herpesviruses are major suspected pathogens of periodontitis, and a combined herpesvirus-bacterial periodontal infection can potentially explain major clinical features of the disease. Cytomegalovirus infects periodontal macrophages and T-cells and elicits a release of interleukin-1β and tumor necrosis factor-α. These proinflammatory cytokines play an important role in the host defense against the virus, but they also have the potential to induce alveolar bone resorption and loss of periodontal ligament. Gingival fibroblasts infected with cytomegalovirus also exhibit diminished collagen production and release of an increased level of matrix metalloproteinases.  This article reviews innate and adaptive immunity to cytomegalovirus and suggests that immune responses towards cytomegalovirus can play roles in controlling, as well as in exacerbating, destructive periodontal disease.