The Clues Within
IDing biomarkers for periodontal disease could lead to better prevention.

Illustration: Jenna Talbott
In As You Like It, Shakespeare paints a gloomy picture of old age: “sans teeth, sans taste, sans everything.” While dental medicine has vastly improved since then, periodontal disease is still widespread and is now the primary cause of tooth loss. Recent research suggests that disruption, or dysbiosis, among the hundreds of organisms found in the mouth leads to periodontitis, but there is no current consensus as to how these organisms interact to promote or prevent disease.
Some patients respond quickly to initial preventive treatments such as cleaning, while others who receive the same treatment develop severe disease, said Yoon Kang, D08, assistant professor in the department of comprehensive care. There is no “gold standard” to identify who is most vulnerable or who will benefit from various treatments. Further, most insurance plans won’t cover periodontal treatment unless the patient has clear clinical evidence of irreversible damage.
“As a general dentist, what I want is something to identify those patients more prone to this dental condition so I can apply a treatment to prevent permanent damage,” said Kang.
Kang and Kyongbum Lee, chair and professor of chemical and biological engineering at the School of Engineering, are tackling that challenge through a seed grant from Tufts Collaborates, which jumpstarts interdisciplinary and cross-institutional research efforts. Kang and Lee will study the metabolites (chemicals produced by microbes as they digest food) collected from the saliva of adults with varying gum health, both before and after prophylactic cleaning. The goal is to create a metabolic profile and then identify biomarkers to predict individual susceptibility to periodontal disease. That knowledge could lead to better protocols for disease prevention.
Kang will direct clinical evaluation of subjects and collection of samples. Lee, a metabolic engineering specialist whose work has focused on metabolites in the gut, will oversee analysis of the samples. Thanks to advanced analytical techniques and the ease and noninvasiveness of collection, saliva is increasingly used in medical diagnostics.
For Kang, who earned a Ph.D. in biomedical engineering before his D.M.D., the driving force behind bench science is helping patients. “What I like to tell students is you, the clinician, know the ins and outs of how to treat patients,” he said. “If something needs to be improved, you are the one to do that, first and foremost. Improved patient results should be the motivation for research. Once you have that clear set goal, you have a much better chance of having research results actually translated.”