Katherine Overmyer Katherine Overmyer

Open wide: Detecting links between what’s in your mouth and illness

Using tiny specks of dental plaque, scientists at the Morgridge Institute for Research for the first time compiled a sophisticated analysis that opens the door to using the trove of micro-organisms in your mouth as an indicator of other health issues.

The research – conducted in collaboration with the Marshfield Clinic Research Institute – has the potential to help break down barriers between dentists and physicians and help patients by diagnosing diseases outside of the mouth earlier while reducing the cost of their disease management.

Researchers used multiomics – an integrated approach to viewing multiple levels of biology – to analyze dental plaque from nearly 100 Marshfield Clinic patients.

“The research uses oral health as a gateway to look at other systemic diseases,” says Katherine Overmyer, a Morgridge scientist working with Joshua Coon, Morgridge investigator and a professor of biomolecular chemistry at UW–Madison. “We’re looking at thousands to hundreds of thousands of organisms that occupy that biome and integrating that into how that affects the host.”

The interdisciplinary research confirmed previous findings that the dental plaques of patients with diabetes and pre-diabetes – who show a much higher incidence of periodontal disease – are clearly different from those of healthy individuals. But it went further, measuring in vast detail what happens in the complex and changing biome of the human mouth.

“What Katie’s been able to do is put together a very big – perhaps the biggest – catalog of what compounds are there, how they’re changing, how they correlate with which microbes are there and how that fits on top of bigger health issues like diabetes,” Coon says. “It was a first-of-its-kind study in the mouth.”

The research, published in the journal Molecular & Cellular Proteomics, could also be consequential since oral health has also been linked to many systemic conditions such as heart and respiratory disease, complications with pregnancy and Alzheimer’s disease.

“Understanding more of these associations and these chemicals that are being produced by microbes and which ones are associated with good health outcomes versus poor outcomes is vital.”

Katherine Overmyer

Overmyer and her colleagues used multiomics – in this case metabolomics, lipidomics and proteomics – to perform the analysis. The technique uses mass spectrometry to weigh molecules from the samples to identify what they are. The team also used DNA sequencing.

The multiomics technique examines not only the microbes in the mouth, but the chemicals and proteins they produce.

“Understanding more of these associations and these chemicals that are being produced by microbes and which ones are associated with good health outcomes versus poor outcomes is vital,” Overmyer says.

Sanjay Shukla, one of the study’s collaborators at Marshfield Clinic, says that multiomics provided an abundance of novel information that suggests a larger study.

“Now we can look at not only specific microbial molecules, but how those molecules interact with each other and the host to understand chronic diseases,” says Shukla, who directs the clinic’s Center for Precision Medicine Research. “You have to go beyond DNA-based identification. That’s where you find out how they function and how they act.”

Of multiomics, Shukla adds: “This is the future if you want to study the connection between microbiomes and health and disease.”

Previous research suggested a strong link between Type 2 diabetes and periodontal disease, but the connection between patients with periodontal disease and diabetes is less certain.

“I was hoping to find a common signature molecule between the Type 2 diabetes patients and the periodontal disease patients, but that data is not clear yet; hopefully a larger study will help clarify that,” he adds.

Amit Acharya, formerly of the Marshfield Clinic, was one of Overmyer’s colleagues and believes that the study reinforces the need for dentists and physicians – who are often siloed in their practices – to work more as a team, since oral health can be an early-warning system for other conditions.

“When a patient comes in for an oral cleaning, why don’t we scoop samples of this plaque and send it off for some testing?” he asked. “Let’s develop a panel that can be more understandable to the clinicians, like a blood panel.”

Acharya says the research is a “great indication of diagnostics which could be developed to help diagnose diabetes fairly early with a visit to a dental center and making sure that physicians know.”

That early detection could also have significant economic effects, says Acharya, who is chief research officer and system vice president at Advocate Aurora Health.

“If you can maintain overall health by some preventative oral health care, the burden to the health system – whether it be the insurance, or the patients, or healthcare delivery – makes for a win-win for everybody,” Acharya says.