“In 1980, a then-National Institute of Dental Research grantee and colleagues reported in the New England Journal of Medicine about a five-year-old boy with an unusual history of chronic skin and ear infections. Their case study provided the scientific lead for what now is known in the medical literature as leukocyte adhesion deficiency type I (LAD-I), a rare primary immunodeficiency driven by a subtle-but-stymieing inherited change to prominent immune cells called neutrophils that impair their ability to fight off skin and mucosal infections, including in the mouth.

Four decades later, a new set of NIDCR scientists and grantees and their colleagues have made another major LAD-I discovery. This time, they explain why children with the condition are predisposed to an extremely aggressive, early-onset form of periodontitis that has puzzled patients, parents, and practitioners.

The scientists show that the problem is not as long suspected a case of bacteria opportunistically exploiting a hole in the immune system to infect cells in the subgingival space, the fluid-filled pocket between the tooth and gum. Bacteria, in fact, were only minimally present in gingival tissue.”

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