Sindy Cornelia Nelwan, - and Ricardo Adrian Nugraha, - and Anang Endaryanto, - and Frisma Dewi, - and Prawati Nuraini, - and Udijanto Tedjosasongko, - and Daniel Haryono Utomo, - (2019) Effect of scaling and root planing on level of immunoglobulin E and immunoglobulin G4 in children with gingivitis and house-dust mite allergy: A pilot randomised controlled trial. Singapore Dental Journal, 39 (1). pp. 21-31. ISSN 2214-6075

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Abstract

Background and Objective: There is a pressing need for developing innovative strategies to prevent allergic diseases among children. As house-dust mite (HDM) allergy is often seen in children with gingivitis, strategies should be derived from a conceptual framework of allergen elimination and pathogen eradication; one such strategy is dental scaling and root planing (SRP) to remove dental plaque and periodontal pathogens. The study aimed to evaluate the beneficial effects of comprehensive 6-months dental SRP to reduce the level of immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) in children with gingivitis and HDM allergy. IgE and IgG4, whose production is controlled mainly by Th-2 cells and B cells, are proven biomarkers for atopic inflammatory responses. Methods: The present study conducted a non-blinded randomised controlled trial with superiority design. A total of 10 subjects (age range 6–16 years) with gingivitis and positive skin-prick test to HDM from Pediatric Allergy Outpatient Clinic, Dr. Soetomo General Hospital were enrolled in the present study. Of the 10 subjects, only five received dental SRP. We further evaluated total serum IgE and IgG4 level before and 6 months after treatment. Results and Discussion: Subjects in the standard treatment group showed a slight decrease in the IgE level (p=0.019) but no change in the IgG4 level (p=0.839), while subjects in the intervention group showed a significant decrease in IgE (p<0.001) and IgG4 levels (p=0.001). Conclusion: The study results suggest that 6-month comprehensive dental scaling combined with root planing may help to reduce IgE and IgG4 levels in children with gingivitis and HDM allergy. Furthermore, untreated or undertreated gingivitis is often associated with worsening allergic manifestation and thus should be avoided.

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