Exploring the prevalence of oral trichomonads in patients with periodontitis at a tertiary teaching hospital

Trichomonas tenax is an oral protozoan associated with periodontitis, a chronic inflammatory disease affecting the periodontal tissues. Although globally recognized, its role in oral health remains unclear, and no data exist on its prevalence in Malaysia. This study aimed to determine the incidence of T. tenax in a Malaysian population and assess its association with periodontitis. A total of 30 subjects (15 patients with periodontitis, 15 controls) were recruited at Hospital Universiti Sains Malaysia. Saliva and subgingival dental plaque samples were collected and analyzed using direct microscopy, selective culture, and polymerase chain reaction (PCR) targeting the 18S rRNA gene, with sequencing for confirmation. T. tenax was detected exclusively in the periodontitis group (13.3 %, 2/15). PCR yielded a 776 base-pair amplicon and demonstrated the highest sensitivity, identifying T. tenax in 6.7 % (2/30) of subgingival dental plaque samples and 3.3 % (1/30) of saliva sample. Microscopy and culture showed limited effectiveness, with no positive results from microscopy and only one positive culture from saliva. These findings represent the first confirmed detection of T. tenax in Malaysia and underscores its association with periodontitis. PCR is recommended as the preferred detection method. Further studies are warranted to clarify the pathogenic role of T. tenax and its broader epidemiological significance.