title: The vaginal microflora in relation to gingivitis.
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 >or= 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 higher counts 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 vaginal samples (> 1.0 x 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).
  
  
  CONCLUSIONS
  Higher vaginal bacterial counts can be found in women with BV and gingivitis in comparison to women with BV but not gingivitis. P. bivia and P. disiens may be of specific significance in a relationship between vaginal and gingival infections.
authors.affiliation: Department of Periodontology, Div of Oral Microbiology, University of Berne, Berne, Switzerland. rutger.persson@zmk.unibe.ch
authors.forename: Rutger
authors.initials: R
authors.lastname: Persson
authors.forename: Jane
authors.initials: J
authors.lastname: Hitti
authors.forename: Rita
authors.initials: R
authors.lastname: Verhelst
authors.forename: Mario
authors.initials: M
authors.lastname: Vaneechoutte
authors.forename: Rigmor
authors.initials: R
authors.lastname: Persson
authors.forename: Regula
authors.initials: R
authors.lastname: Hirschi
authors.forename: Marianne
authors.initials: M
authors.lastname: Weibel
authors.forename: Marilynn
authors.initials: M
authors.lastname: Rothen
authors.forename: Marleen
authors.initials: M
authors.lastname: Temmerman
authors.forename: Kathleen
authors.initials: K
authors.lastname: Paul
authors.forename: David
authors.initials: D
authors.lastname: Eschenbach
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005891:Gingivitis / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000150:complications*; D055815:Young Adult