Non-surgical periodontal therapy and the oral microbiome in elderly periodontitis
Aims: Periodontitis among frail nursing home residents is increasing as more older adults retain their natural dentition. Evidence on the impact of periodontal therapy on their oral microbiota is limited. We assessed the effect of pragmatic, outreach-based, non-surgical periodontal therapy on the periodontal microbiome of institutionalized older adults. Materials and Methods: Thirty-six residents (mean age 85±6 years) with periodontitis were randomized to immediate non-surgical periodontal therapy (combined supra- and subgingival debridement; mean duration 14.3±5.2 min) or a three-month waiting-list control. Supragingival and subgingival plaque samples were collected at baseline and three months. Bacterial 16S rRNA sequencing and mixed-effects modeling were used to assess alpha/beta diversity, dysbiosis index, and differential abundance between groups over time. Results: At three months, the intervention group showed significant clinical improvements (probing pocket depth, bleeding on probing) and a reduction in dysbiosis (ß = -1.97, p = 0.0008) versus controls. Beta-diversity analysis confirmed distinct microbial shifts (R² = 0.0075, p = 0.025), with decreases in Treponema and Fretibacterium and increases in Lactobacillus and Actinomyces. Conclusions: A short, single-session, outreach-based, non-surgical periodontal therapy partially restored microbial homeostasis and improved periodontal health in frail, institutionalized older adults—supporting its feasibility and biological efficacy in domiciliary settings.
Aims: Periodontitis among frail nursing home residents is increasing as more older adults retain their natural dentition. Evidence on the impact of periodontal therapy on their oral microbiota is limited. We assessed the effect of pragmatic, outreach-based, non-surgical periodontal therapy on the periodontal microbiome of institutionalized older adults. Materials and Methods: Thirty-six residents (mean age 85±6 years) with periodontitis were randomized to immediate non-surgical periodontal therapy (combined supra- and subgingival debridement; mean duration 14.3±5.2 min) or a three-month waiting-list control. Supragingival and subgingival plaque samples were collected at baseline and three months. Bacterial 16S rRNA sequencing and mixed-effects modeling were used to assess alpha/beta diversity, dysbiosis index, and differential abundance between groups over time. Results: At three months, the intervention group showed significant clinical improvements (probing pocket depth, bleeding on probing) and a reduction in dysbiosis (ß = -1.97, p = 0.0008) versus controls. Beta-diversity analysis confirmed distinct microbial shifts (R² = 0.0075, p = 0.025), with decreases in Treponema and Fretibacterium and increases in Lactobacillus and Actinomyces. Conclusions: A short, single-session, outreach-based, non-surgical periodontal therapy partially restored microbial homeostasis and improved periodontal health in frail, institutionalized older adults—supporting its feasibility and biological efficacy in domiciliary settings.
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