PMPR and Chlorhexidine on Periodontal Disease and Vascular Function

Summary

* Gum inflammation is called gingivitis. Gum disease, known as periodontal disease, is a long-term inflammation of the gums and bone around teeth, leading to tooth loss. Both gingivitis and periodontal disease are also linked to other health problems, including heart disease. Additionally, salivary proteins play a role in maintaining oral health. For example, a protective layer called the salivary pellicle (SP) forms on teeth after tooth brushing and helps defend against harmful bacteria. * Nitrate-reducing bacteria (NRB) are also present in saliva and play a role in oral and cardiovascular health by converting nitrate to nitric oxide (NO). This compound supports blood vessel health and overall cardiovascular function. Therefore, NRB's abundance is linked to lower blood pressure and improved cardiovascular health. * Standard treatments for gum disease include deep cleaning (also called professional mechanical plaque removal, or PMPR), and sometimes chlorhexidine (CHX) mouthwash is used with PMPR to help reduce mouth bacteria. However, while CHX is effective against plaque (a sticky film of bacteria on the tooth surface), it may reduce the activity of "nitrate-reducing" bacteria (NRB), which are important for producing nitric oxide (NO). * This study investigates the impact of deep cleaning (PMPR) with and without Chlorhexidine mouthwash on salivary and SP proteins, as well as blood vessel function, in people who have gum disease. By examining these links, the investigators aim to gain a deeper understanding of how oral care practices may impact overall health, particularly heart health.

Eligibility

Inclusion Criteria:

* Participants must have a minimum of 2 natural teeth in each sextant (at least 12 teeth overall).
* Individuals with clinically diagnosed gingivitis and/or early periodontitis (stage 1 and 2)
* Must not have undergone periodontal maintenance therapy (PMPR) within the last 6 months.
* Must not currently be wearing orthodontic appliances, due to their effect on oral microbiota and plaque composition.
* Must not be using removable orthodontic appliances, as they increase plaque accumulation.
* Must not have taken any antibiotic treatments within the last 3 months.
* Must be able to provide written informed consent.
* Individuals with dental erosion or caries will still be included but matched during the baseline visit.

Exclusion Criteria:

* Individuals under regular medication within one month of the study start date for any medical condition (such as hypertension and/or diabetes)
* Pregnant or breastfeeding individuals.
* Individuals requiring an interpreter or who are non-English speakers.
* Individuals unable to provide written informed consent.
* Individuals participating in another ongoing clinical study (other than observational studies) within 3 months prior to or during this study.
* Individuals who have used mouthwash or tongue scrapers in the last 6 weeks.
* Individuals who consume 20 or more cigarettes per day.
* Individuals who consume more than 5 alcoholic drinks per day.

Conditions6

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