Radiographic and clinical signs of periodontitis and associated bacterial species in a Swedish adolescent population

Periodontitis in adolescents has historically been rare in the Nordic countries but could be expected to increase due to changing demographics. The primary aim was to cross-sectionally examine the presence of radiographic bone loss in adolescents in Västerbotten County, Sweden. The secondary aim was to compare periodontal and microbial parameters, as well as demographic patterns, between controls without bone loss and cases with bone loss.

Adolescents born in 2001 who had a dental examination in 2016 (n = 1656) were screened for proximal bone loss using bitewing radiographs taken during dental examinations (2014-2016). Individuals exhibiting proximal bone loss (>2 mm) were invited to participate in a complete periodontal examination. Subgingival plaque and saliva were also sampled. For each adolescent with bone loss, two healthy individuals as controls were examined. Selected bacterial species in saliva and subgingival plaque were examined by quantitative PCR. The subgingival plaque samples were also analyzed via cultivation technique.

Proximal bone loss was identified in 24 individuals (1.45%) based on the radiographs. Thirteen of these cases were periodontally examined and matched with 26 controls. Most cases were diagnosed with periodontitis (12/13 [92%]), whereas none of the controls had periodontitis. Higher concentrations and higher prevalence of the bacteria Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Filifactor alocis were generally found in the cases.

The results suggest that periodontitis is increasing among adolescents in Sweden because of demographic differences (an increasingly heterogenous population), and emphasize the importance of radiographs for early detection of this disease.