Inflammation Markers in Gum Fluid Drop After Disinfection, Study Finds

Published 26 September 2026
Reviewed by Dr. Advaitha Anand, BDS MDS (Conservative Dentistry & Endodontics)

Periodontitis is a chronic inflammatory condition caused by interactions between bacterial deposits on teeth (oral biofilms) and the body’s immune defenses. Over time, this ongoing immune response can damage the tissues and bone supporting the teeth. While dentists typically assess gum health using direct physical measurements, biological markers found in the mouth can provide deeper insight into how tissues respond to inflammation and treatment.

A clinical study conducted in Bengaluru, India, evaluated the levels of two specific inflammatory proteins in gum fluid before and after deep gum cleaning. The findings help illuminate how routine disinfection procedures alter the inflammatory environment surrounding teeth.

What the Researchers Investigated

The study was carried out between June 2022 and June 2023 at the Department of Periodontology and Implantology, Sri Rajiv Gandhi College of Dental Sciences & Hospital. The research team enrolled 30 systemically healthy adults, dividing them into two equal groups:

15 individuals with healthy gums who served as controls
15 individuals diagnosed with stage III periodontitis (an advanced form of gum disease)

At the start of the study, researchers documented several standard clinical measurements for each participant:

Plaque Index (PI): A measure of visible bacterial buildup along the gumline.
Gingival Index (GI): A scoring system used to assess the severity of gum inflammation.
Probing Depth (PD): The depth of the space (pocket) between the gum and tooth.
Clinical Attachment Loss (CAL): The extent of supportive tissue detachment around a tooth.
Bleeding on Probing (BOP): Bleeding triggered during gentle gum examination.

The investigators also collected gingival crevicular fluid (GCF)—the minute amount of fluid that naturally seeps from the tissue into the crevice between the tooth and gum. In this fluid, they measured the concentrations of two proteins using enzyme-linked immunosorbent assay (ELISA) testing:

Leucine-rich alpha-2 glycoprotein (LRG): An acute-phase protein produced during inflammatory responses.
Tumour necrosis factor-alpha (TNF-α): A well-known signaling protein involved in body-wide immune and inflammatory reactions.

Measuring the Effects of Disinfection

Patients with stage III periodontitis underwent a full-mouth disinfection procedure using a chlorhexidine protocol to suppress bacterial buildup. After six weeks, the researchers re-evaluated the clinical parameters and collected second samples of gingival crevicular fluid to assess changes.

At baseline, both LRG and TNF-α levels were significantly higher in patients with stage III periodontitis compared to healthy participants. Furthermore, higher levels of these two biomarkers were statistically correlated with poorer scores across the clinical measurements (such as deeper probing depths and greater tissue detachment).

Six weeks after the full-mouth disinfection treatment, the results showed substantial improvements:

Plaque Index, Gingival Index, Probing Depth, and Clinical Attachment Loss were all significantly reduced.
Gingival crevicular fluid levels of both LRG and TNF-α dropped significantly.
Statistical regression analysis confirmed significant associations between the physical periodontal parameters and the fluid biomarker levels throughout the evaluation period.

Limitations to Keep in Mind

While these findings offer useful information on biological changes during gum healing, the study has several clear limitations:

Small study size: The research involved a total of 30 adults (15 with periodontitis and 15 healthy controls), meaning larger trials are required to confirm the findings across wider populations.
Short follow-up period: Patients were monitored for six weeks following treatment; longer studies are needed to evaluate whether these reductions in inflammatory markers persist over many months or years.
Investigational marker status: While TNF-α is well-studied, LRG is an emerging marker in oral health. The authors noted that LRG merits further study before it could serve as a standard diagnostic tool.

What This Means for Patients

For patients managing advanced gum disease, this research demonstrates that professional periodontal cleaning does more than simply remove visible tartar and plaque. It also significantly decreases underlying inflammatory proteins circulating in the fluid around the teeth.

Controlling these biological drivers of inflammation is a central goal in halting tissue breakdown. For individuals diagnosed with periodontitis, participating in structured professional cleaning and maintaining consistent daily oral hygiene remain essential steps in managing the biological inflammation that drives the condition.