Clear aligners are becoming a popular choice for orthodontic patients, offering a more comfortable and convenient experience than traditional metal braces. These custom-fitted plastic brackets fit snugly against teeth almost around the clock and typically last for one to two years.
However, because they cover teeth for an extended period of time, they significantly reduce saliva flushing, which compromises the teeth’s natural defenses against microorganisms.
A recent study from ADA Forsyth further explores the unique impact of clear aligners on the oral microbiome and reveals potential clinical applications. The research team hopes to develop more effective care strategies for orthodontic patients by gaining a deeper understanding of how aligners alter the oral microbiome.
Led by ADA Forsyth faculty member and practicing orthodontist Dr. Tingxi Wu, DDS, Ph.D., the study, funded by the National Institutes of Health (NIH), focuses on the mechanisms by which three specific bacteria contribute to gingival inflammation during clear aligner wear.
While analyzing clinical data from patients wearing clear aligners, Dr. Wu discovered that patients with increased gum inflammation had elevated levels of three bacterial species: Saccharibacteria (TM7), Fusobacterium nucleatum (F. nucleatum), and Clostridium odontolytica (S. odontolytica).
“The abundance of these bacteria in patients wearing clear aligners suggests they may work synergistically to trigger inflammation,” Dr. Wu said. “Understanding how they interact could potentially lead to new approaches to prevent and treat gum disease.”
Saccharibacteria have previously been shown to attach to the surface of Streptococcus odontolyticus, forming a symbiotic relationship. This microbial combination may interact with F. nucleatum, a common bacterium known to trigger periodontitis.
ADA Forsyth’s research team had previously studied the potential role of Saccharibacteria in periodontitis, but had not yet explored the interactions between these three bacterial groups.
This study will help scientists better understand how changes in the oral microbiome during clear aligner wear affect gum health and lay the foundation for developing new strategies to protect gums.
“As we better understand how certain bacteria on the tooth surface interact and cause disease, we can find ways to mitigate their effects,” said Dr. He Xuesong, who collaborated on the study.