A Review on the Role of Entamoeba gingivalis and Trichomonas tenax in Periodontal Disease
Adenike O. Oladokun *
Department of Medical Laboratory Science, Bowen University, Iwo, Osun State, Nigeria.
Olanrewaju I. Opeodu
Department of Periodontology and Community Dentistry, University of Ibadan/University College Hospital, Ibadan, Nigeria.
Ahmed O. Lawal
Department of Oral Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Mofolusho O. Falade
Biology Program, Transylvania University, Lexington, Kentucky, USA.
*Author to whom correspondence should be addressed.
Abstract
Periodontal disease results from localised inflammation of the periodontium due to its exposure to plaque. This review assessed the role of Entamoeba gingivalis and Trichomonas tenax in the aetiology of periodontal disease. Periodontal disease results from localised inflammation of the periodontium due to plaque accumulation, and if left untreated, can lead to loss of teeth. Although dental plaque is composed mainly of bacteria, protozoan parasites have been found in plaque and implicated in periodontal disease. The protozoan parasites are E. gingivalis and T. tenax. E. gingivalis is an amoeba associated with poor oral hygiene, while T. tenax is a pyriform flagellate that lives in the tartar around the teeth, cavities of carious teeth, necrotic mucosal cells in the gingival margins of gums and pus pockets in tonsillar follicles. These parasites are transmitted by close contact, saliva, droplet spray and kissing or use of contaminated dishes, cups, spoons and forks, as well as drinking water. Age, gender, smoking, socio-economic status, dental condition, gingival pathology and diabetes mellitus have been reported to predispose to periodontitis and influence the presence of the parasite in the oral cavity. Genetic variability and stress are also some of the factors that determine the transition of the periodontium at some gingival sites from healthy to inflamed. Researchers have observed that the prevalence and severity of periodontitis are higher in developing countries than in developed countries. The prevalence of T. tenax worldwide ranges from 4 to 53%, with high prevalence in patients with chronic periodontitis. Microscopic examination of wet preparation is one of the quickest diagnostic methods for T. tenax, while E. gingivalis can be diagnosed by staining with the Trichrome vitelli stain. Culture method can also be used, but the polymerase chain reaction is a very sensitive and specific method for detecting the presence of these parasites in dental plaque. With good oral hygiene, regular scaling and polishing and use of antiparasitic drugs, periodontal disease caused by these parasites can be prevented and periodontal health restored.
Keywords: Entamoeba gingivalis, parasite, periodontitis, periodontal disease, Trichomonas tenax