Trichomonas tenax | |
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Parasite taken from the biofilm of a patient with chronic active periodontitis. Phase-contrast microscope, 1000× magnification, salivary smear | |
Scientific classification | |
Domain: | Eukaryota |
Phylum: | Metamonada |
Subphylum: | Trichozoa |
(unranked): | Parabasalia |
Order: | Trichomonadida |
Family: | Trichomonadidae |
Genus: | Trichomonas |
Species: | T. tenax |
Binomial name | |
Trichomonas tenax | |
Trichomonas tenax, or oral trichomonas, is a species of Trichomonas commonly found in the oral cavity of humans. Routine hygiene is generally not sufficient to eliminate the parasite, hence its Latin name, meaning "tenacious". The parasite is frequently encountered in periodontal infections, affecting more than 50% of the population in some areas, but it is usually considered insignificant. T. tenax is generally not found on the gums of healthy patients. [2] It is known to play a pathogenic role in necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis, worsening preexisting periodontal disease. [3] [ page needed ] This parasite is also implicated in some chronic lung diseases; in such cases, removal of the parasite is sufficient to allow recovery (Mussaev 1976).
Of the three species in the genus Trichomonas, T. tenax is the smallest, measuring only 5-14 µm long and 6-9 µm wide; specimens can be identified by their long axostyles and tails, 4 anterior flagella, and by the recurrent flagellum that raises an undulating membrane which is two thirds the length of the body. This undulating membrane may appear like small legs. It may occasionally appear larger, allowing it to be confused with Trichomonas vaginalis due to similar morphology. In such cases, the presence of an oral or vaginal parasite should be confirmed, due to the ease with which the parasite can be transmitted through direct contact of mucous membranes.
T. tenax trophozoites survive in the body as mouth scavengers that feed primarily on local microorganisms located between the teeth, tonsillar crypts, pyorrheal pockets, and the gingival margin around the gums. T. tenax trophozoites multiply by longitudinal binary fission. These trophozoites are unable to survive the digestive process.
T. tenax is a commensal of the human oral cavity, found particularly in the patients with poor oral hygiene and advanced periodontal disease. Transmission is through saliva, droplet spray, and kissing or use of contaminated dishes or drinking water. [4]
T. tenax alone is not known to cause any symptoms. There are merely implications that this parasite may worsen preexisting periodontal disease and in rare cases has been reported to cause bronchopulmonary infections, mainly in patients with underlying cancers or other lung diseases. [4] The organism is believed to enter the respiratory tract by aspiration from the oropharynx.
In infected hosts, the parasite can typically be found among dental calculus, as well as within the tonsillar crypts, which will often become purulent during the course of infection. T. tenax may also be involved in the degradation of periodontal tissue through the secretion of substances such as alkaline phosphatases and the fibronectin cathepsine. [5] T. tenax is classified as a parasite due to the manner in which it causes damage to host tissues; its behavior when in contact with target cells is similar to the closely related and likewise parasitic T. vaginalis. [6] It has no cysts and is only transmitted directly in its vegetative form.
The specimen of choice for diagnosing Trichomonas tenax trophozoite is mouth scrapings. Microscopic examination of tonsillar crypts and pyorrheal pockets of patients with T. tenax infections often yields the typical trophozoites. Tartar between the teeth and the gingival margin of the gums are the primary areas of the mouth that may also potentially harbor this organism. T. tenax may also be cultured onto appropriate media.
Regardless of patient's demographic characteristics, it seems that oral hygiene instructions in combination with scaling and root planning can help with controlling excessive colonization of parasites, particularly E. gingivalis and T. tenax and their probable opportunistic infestation. [7] T. tenax can easily be detected through the use of phase-contrast microscopy. Biofilm harvested from infested areas of the periodontal pockets can be mounted onto a slide; T. tenax, if present, will be clearly visible. The preparation must use the patient's saliva as the medium, as the use of plain water or saline as hypotonic solutions could cause the cells to lyse.
The etymology of the name Trichomonas tenax is from a combination of Greek: trichos (tiny hair) + monas (simple creature), and Latin: tenere (to keep, to stick to). [8]
During the early 1900s, prisoners at the San Quentin prison in California were subject to advanced periodontal disease at a rate of almost 90%, owing at least in part to a high rate of infection by T. tenax. [9] In the Journal of the American Dental Association , it was speculated that this high rate of transmission was attributable to the crowding and poor diets faced by inmates. Age was also an important factor in this population [9] and intense inflammation was observed.
Owing to the morphological similarity between T. tenax and other trichomonad spp., examination of a greater number of organisms is necessary to establish a reliable diagnosis than is easily obtained from the patient's mouth. In vitro,T. tenax reproduced better in LES medium, pH value between 5.80 and 7.00 with cultivation temperature of 35 °C than other media with pH 5.40 and cultivation temperature of 37 °C. [10] Normal, healthy human saliva is slightly alkaline at pH 7.40. Whitening products have a mean pH of 8.22 with a range (5.09-11.13). Whitening toothpastes have a mean pH of 6.83 with a range (4.22-8.35). Mouthwashes also vary greatly in pH from pH 4.40 to 6.80. Mouth rinsing after an acidic challenge increased salivary pH. The tested mouthwashes raised pH higher than water. Mouthwashes with a neutralizing effect can potentially reduce tooth erosion from acid exposure. [11] Essentially the human mouth is an optimum habitat for this organism and any pH level alteration needed to stunt the reproductive rate significantly would require a duration of time that would cause greater damage to the tooth enamel than to T. tenax. Regular oral hygiene and dental visits to remove dental plaque is currently the best solution to deal with this protozoan.
T. tenax has been found in the mouths of a small proportion of dogs, cats and horses, [12] but other animals are expected to have their own species of Trichomonas . [13]
Mouthwash, mouth rinse, oral rinse, or mouth bath is a liquid which is held in the mouth passively or swirled around the mouth by contraction of the perioral muscles and/or movement of the head, and may be gargled, where the head is tilted back and the liquid bubbled at the back of the mouth.
Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main cause of tooth loss for adults worldwide. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Halitosis may also occur.
Necrotizing gingivitis (NG) is a common, non-contagious infection of the gums with sudden onset. The main features are painful, bleeding gums, and ulceration of inter-dental papillae. This disease, along with necrotizing periodontitis (NP) and necrotizing stomatitis, is classified as a necrotizing periodontal disease, one of the three general types of gum disease caused by inflammation of the gums (periodontitis).
Trichomonas vaginalis is an anaerobic, flagellated protozoan parasite and the causative agent of a sexually transmitted disease called trichomoniasis. It is the most common pathogenic protozoan that infects humans in industrialized countries. Infection rates in men and women are similar but women are usually symptomatic, while infections in men are usually asymptomatic. Transmission usually occurs via direct, skin-to-skin contact with an infected individual, most often through vaginal intercourse. The WHO has estimated that 160 million cases of infection are acquired annually worldwide. The estimates for North America alone are between 5 and 8 million new infections each year, with an estimated rate of asymptomatic cases as high as 50%. Usually treatment consists of metronidazole and tinidazole.
Bad breath, also known as halitosis, is a symptom in which a noticeably unpleasant breath odour is present. It can result in anxiety among those affected. It is also associated with depression and symptoms of obsessive compulsive disorder.
Trichomonas is a genus of anaerobic excavate parasites of vertebrates. It was first discovered by Alfred François Donné in 1836 when he found these parasites in the pus of a patient suffering from vaginitis, an inflammation of the vagina. Donné named the genus from its morphological characteristics. The prefix tricho- originates from the Ancient Greek word θρίξ (thrix) meaning hair, describing Trichomonas’s flagella. The suffix -monas, describes its similarity to unicellular organisms from the genus Monas.
Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.
Dental plaque is a biofilm of microorganisms that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. It is commonly found between the teeth, on the front of teeth, behind teeth, on chewing surfaces, along the gumline (supragingival), or below the gumline cervical margins (subgingival). Dental plaque is also known as microbial plaque, oral biofilm, dental biofilm, dental plaque biofilm or bacterial plaque biofilm. Bacterial plaque is one of the major causes for dental decay and gum disease.
Tooth brushing is the act of scrubbing teeth with a toothbrush equipped with toothpaste. Interdental cleaning can be useful with tooth brushing, and together these two activities are the primary means of cleaning teeth, one of the main aspects of oral hygiene. The recommended amount of time for tooth brushing is two minutes.
Scaling and root planing, also known as conventional periodontal therapy, non-surgical periodontal therapy or deep cleaning, is a procedure involving removal of dental plaque and calculus and then smoothing, or planing, of the (exposed) surfaces of the roots, removing cementum or dentine that is impregnated with calculus, toxins, or microorganisms, the agents that cause inflammation. It is a part of non-surgical periodontal therapy. This helps to establish a periodontium that is in remission of periodontal disease. Periodontal scalers and periodontal curettes are some of the tools involved.
Oral microbiology is the study of the microorganisms (microbiota) of the oral cavity and their interactions between oral microorganisms or with the host. The environment present in the human mouth is suited to the growth of characteristic microorganisms found there. It provides a source of water and nutrients, as well as a moderate temperature. Resident microbes of the mouth adhere to the teeth and gums to resist mechanical flushing from the mouth to stomach where acid-sensitive microbes are destroyed by hydrochloric acid.
Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.
Entamoeba gingivalis is an opportunistic Amoebozoa and is the first amoeba in humans to be described.
Gingivitis is a non-destructive disease that causes inflammation of the gums; ulitis is an alternative term. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that are attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.
Biotene is an over-the-counter dental hygiene product currently marketed GSK plc. It comes in a number of forms, including toothpaste, mouthwash and gel.
Trichomonas gallinae is a cosmopolitan parasite of birds including finches, pigeons, doves, turkeys, chickens, parrots, raptors. The condition in birds of prey is called frounce. It is believed to be an ancient pathogen causing frounce-like symptoms in theropod dinosaurs. The same condition in pigeons is commonly called canker.
Dientamoeba fragilis is a species of single-celled excavates found in the gastrointestinal tract of some humans, pigs and gorillas. It causes gastrointestinal upset in some people, but not in others. It is an important cause of travellers diarrhoea, chronic diarrhoea, fatigue and, in children, failure to thrive. Despite this, its role as a "commensal, pathobiont, or pathogen" is still debated. D. fragilis is one of the smaller parasites that are able to live in the human intestine. Dientamoeba fragilis cells are able to survive and move in fresh feces but are sensitive to aerobic environments. They dissociate when in contact or placed in saline, tap water or distilled water.
Plaque hypotheses are theories to explain the role of plaque bacteria in dental caries and in periodontitis. They rely heavily on the postulates of Koch and on the work of Louis Pasteur (1822–1895). Changing perceptions have altered treatment models.
Prenatal dental care is the care of the oral cavity during fetal development. The woman’s body is subject to hormonal changes leading to several physical changes in the oral cavity during pregnancy. Some of these changes may cause tooth decay, erosion and periodontal health changes.
Dimasuay KG, Rivera WL (April 2014). "First report of Trichomonas tenax infections in the Philippines". Parasitology International. 63 (2): 400–2. doi:10.1016/j.parint.2013.12.015. PMID 24406842.