Exploring the Relationship Between Oral Pathogens and Gingival Health in Adults with Gingivitis and Mild Periodontitis: An Observational Cross-sectional Study

Gingivitis, characterized by inflammation of the gingiva, is prevalent globally and can progress to more severe periodontal diseases if untreated. Dysbiosis, an imbalance in the oral microbiota, plays a critical role in the progression of gingivitis. This study investigates the relationship between ten pathogenic bacteria and clinical indices (Plaque Index, Gingival Index, Bleeding on Probing, and Probing Pocket Depth) used in the diagnosis and assessment of gingivitis in adults under the hypothesis that specific oral pathogens correlate with these indices. A cross-sectional study was conducted on 130 adults diagnosed with gingivitis or mild periodontitis at Myongji Hospital, South Korea. Supragingival plaque samples were collected and analyzed using PowerCheck™ Periodontitis Pathogens Multiplex Real-time PCR to identify the prevalence of ten periodontitis-related pathogens. Statistical analyses, including multiple linear regression, were performed to determine associations between bacterial prevalence and clinical indices, adjusting for age and sex. Significant associations were found between several periodontal pathogens and clinical indices. Fusobacterium nucleatum exhibited a strong correlation with Plaque Index (P-value=5.61×10-5) and Gingival Index (P-value=4.02×10-4), suggesting its relevance in the inflammatory profile of gingivitis and mild periodontitis. Other pathogens also demonstrated varying degrees of association with the clinical indices. The study highlights the value of integrating bacterial analysis with conventional diagnostic approaches for comprehensive assessment and management of gingivitis. The findings suggest that Fusobacterium nucleatum may contribute to early inflammatory processes in gingival health, potentially informing targeted therapeutic strategies in periodontal care.