Periodoncia

BMC Infectious Diseases
Research article

BioMed Central

Open Access

The vaginal microflora in relation to gingivitis
Rutger Persson*1,2,3, Jane Hitti4, Rita Verhelst5, Mario Vaneechoutte5, Rigmor Persson1,3, Regula Hirschi1, Marianne Weibel1, Marilynn Rothen6, Marleen Temmerman7, Kathleen Paul4 and David Eschenbach4
Address: 1Department of Periodontology, Div of Oral Microbiology,University of Berne, Berne, Switzerland, 2Department of Periodontics, University of Washington, Seattle, WA, USA, 3Department of Oral Medicine, University of Washington, Seattle, WA, USA, 4Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, USA, 5Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium, 6Regional Clinical DentalResearch Center (RCDRC), University of Washington, Seattle, WA, USA and 7Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium Email: Rutger Persson* - rutger.persson@zmk.unibe.ch; Jane Hitti - jhitti@u.washington.edu; Rita Verhelst - rita.verhelst@UGent.be; Mario Vaneechoutte - mario.vaneechoutte@UGent.be; Rigmor Persson -rigmor.persson@zmk.unibe.ch; Regula Hirschi - regula.hirschi@zmk.unibe.ch; Marianne Weibel - marianne.weibel@zmk.unibe.ch; Marilynn Rothen - rothen@u.washington.edu; Marleen Temmerman - kpaul@u.washington.edu; Kathleen Paul - marleen.temmerman@Ugent.be; David Eschenbach - eschen@u.washington.edu * Corresponding author

Published: 22 January 2009 BMC Infectious Diseases 2009, 9:6 doi:10.1186/1471-2334-9-6Received: 27 April 2008 Accepted: 22 January 2009

This article is available from: http://www.biomedcentral.com/1471-2334/9/6 © 2009 Persson et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium,provided the original work is properly cited.

Abstract
Background: Gingivitis has been linked to adverse pregnancy outcome (APO). Bacterial vaginosis (BV) has been associated with APO. We assessed if bacterial counts in BV is associated with gingivitis suggesting a systemic infectious susceptibilty. Methods: Vaginal samples were collected from 180 women (mean age 29.4 years, SD ± 6.8, range:18 to 46), and at least six months after delivery, and assessed by semi-quantitative DNA-DNA checkerboard hybridization assay (74 bacterial species). BV was defined by Gram stain (Nugent criteria). Gingivitis was defined as bleeding on probing at ≥ 20% of tooth sites. Results: A Nugent score of 0–3 (normal vaginal microflora) was found in 83 women (46.1%), and a score of > 7 (BV) in 49 women(27.2%). Gingivitis was diagnosed in 114 women (63.3%). Women with a diagnosis of BV were more likely to have gingivitis (p = 0.01). Independent of gingival conditions, vaginal bacterial counts were higher (p < 0.001) for 38/74 species in BV+ in comparison to BV- women. Counts of four lactobacilli species were higher in BV- women (p < 0.001). Independent of BV diagnosis, women with gingivitis had highercounts of Prevotella bivia (p < 0.001), and Prevotella disiens (p < 0.001). P. bivia, P. disiens, M. curtisii and M. mulieris (all at the p < 0.01 level) were found at higher levels in the BV+/G+ group than in the BV+/G- group. The sum of bacterial load (74 species) was higher in the BV+/G+ group than in the BV+/G- group (p < 0.05). The highest odds ratio for the presence of bacteria in vaginalsamples (> 1.0 × 104 cells) and a diagnosis of gingivitis was 3.9 for P. bivia (95% CI 1.5–5.7, p < 0.001) and 3.6 for P. disiens (95%CI: 1.8–7.5, p < 0.001), and a diagnosis of BV for P. bivia (odds ratio: 5.3, 95%CI: 2.6 to 10.4, p < 0.001) and P. disiens (odds ratio: 4.4, 95% CI: 2.2 to 8.8, p < 0.001). Conclusion: Higher vaginal bacterial counts can be found in women with BV and gingivitis in...