Abstract
BackgroundWest Virginia has the worst oral health in the United States, but the reasons for this are unclear. This pilot study explored the etiology of this disparity using culture-independent analyses to identify bacterial species associated with oral disease.MethodsBacteria in subgingival plaque samples from twelve participants in two independent West Virginia dental-related studies were characterized using 16S rRNA gene sequencing and Human Oral Microbe Identification Microarray (HOMIM) analysis. Unifrac analysis was used to characterize phylogenetic differences between bacterial communities obtained from plaque of participants with low or high oral disease, which was further evaluated using clustering and Principal Coordinate Analysis.ResultsStatistically different bacterial signatures (P < 0.001) were identified in subgingival plaque of individuals with low or high oral disease in West Virginia based on 16S rRNA gene sequencing. Low disease contained a high frequency of Veillonella and Streptococcus, with a moderate number of Capnocytophaga. High disease exhibited substantially increased bacterial diversity and included a large proportion of Clostridiales cluster bacteria (Selenomonas, Eubacterium, Dialister). Phylogenetic trees constructed using 16S rRNA gene sequencing revealed that Clostridiales were repeated colonizers in plaque associated with high oral disease, providing evidence that the oral environment is somehow influencing the bacterial signature linked to disease.ConclusionsCulture-independent analyses identified an atypical bacterial signature associated with high oral disease in West Virginians and provided evidence that the oral environment influenced this signature. Both findings provide insight into the etiology of the oral disparity in West Virginia.
Highlights
West Virginia has the worst oral health in the United States, but the reasons for this are unclear
Identification of bacterial populations in subgingival plaque that differentiate individuals with high or low oral disease in West Virginia Previous studies found bacterial species in the ‘red complex’ to be strongly linked to periodontal disease [25]. To examine if these same bacteria were associated with oral disease in West Virginia, we used 16S rRNA gene sequencing to characterize bacteria in subgingival plaque of COHRA participants diagnosed as having low or high oral disease based on periodontal examinations (Table 1, bordered by dashed lines)
Subsequent evaluation of sequence data using the Human Oral Microbiome Database (HOMD) BLAST server [26] yielded nearly identical results, except for a few changes caused by reclassification of Clostridiales type strains, which affected some assignments to Eubacterium and Lachnospiraceae
Summary
West Virginia has the worst oral health in the United States, but the reasons for this are unclear This pilot study explored the etiology of this disparity using culture-independent analyses to identify bacterial species associated with oral disease. West Virginians have the worst oral health in the nation, with almost twice the national average (48.2%) of adults aged 65 or more having all their natural teeth extracted [1]. These statistics become more alarming knowing that infections of the oral cavity have been associated with chronic diseases, such as diabetes, cardiovascular disease and atherosclerosis [2,3,4]. As it is recognized that only about 60% of the species in oral biofilms are cultivable [10], the use of culture-independent analyses has led to a new level of understanding of oral associated microbes [11]
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