Inflammatory Mouth Diseases

In November of 2008, scientific researchers from the Oregon Health & Science University's School of Dentistry reported that many dental patients suffering from two inflammatory oral diseases, irreversible pulpitis, and apical periodontitis, have been found to have had the Epstein-Barr virus. Epstein-Barr is a common pathogen found in more than 90% of the population worldwide. The virus is implicated in an assortment of conditions including nasopharyngeal carcinoma, malignant lymphoma, and infectious mononucleosis. 

Of late, researchers have been performing studies on the relationship between herpes viruses and oral disease, but in the main this research has been centered on periodontitis. Until now, there has been no serious attempt to see how the herpes virus relates to the endodontic patient who is beset by various inflammatory diseases. The OHSU team decided to analyze whether human cytomegalovirus (HCMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV-1), and Varicella zoster virus (VZV) might be present in their endodontic patients.

Bone Loss

The study included 82 endodontic patients, some with irreversible pulpitis and apical periodontitis, and used 19 healthy patients as the control group. The researchers wanted to discover if the herpes virus could be implicated in various clinical symptoms, for instance, acute pain, and bone loss.

Through the use of several methods of analysis, the OHSU found the DNA and RNA of the Epstein-Barr virus in the endodontic patients in significant percentages: 43.9% had the DNA, and 25.6% had the RNA of the virus as compared to the healthy group, none of whom had these markers. On the other hand, Human cytomegalovirus DNA and RNA could be found in significant measures in the endodontic patients, 15.9% and 29.3% respectively, and in the healthy group, 42.1% and 10.5% respectively. As for the Herpes simplex virus DNA, this was found in a small percentage of the endodontic patients, 13.4%, and there was only one patient who had markers for Varicella zoster virus.

Effective Treatments

An earlier study had looked at herpes viruses in relation to apical periodontitis, but, "this is the first time irreversible pulpitis has been analyzed for the presence of herpes viruses and associated with Epstein-Barr virus," commented Curt Machida, Ph.D., OHSU professor of integrative biosciences and lead author of the study. "The incidence of irreversible pulpitis and apical periodontitis, caused by bacteria and possibly the latent herpes virus, is painful and can greatly impair the body's natural immune system. Studies such as ours could someday lead to more effective treatments of inflammatory diseases of the mouth."