Running head: [SHORTENED TITLE UP TO 50 CHARACTERS] 1

The role of genetics in the development and treatment of dental

diseases

College student at Faculty of Medicine and Biology Sciences

Abstract:

Dental diseases such as tooth decay and periodontal disease are common

oral health conditions affecting individuals of all ages. While environmental

factors such as diet and oral hygiene practices have been known to contribute to

the development of dental diseases, the role of genetics in these conditions has also

been increasingly recognized. Recent advances in genetic research have identified

several genetic variants associated with the susceptibility to dental diseases, which

has important implications for understanding the underlying mechanisms of

disease development and for the development of personalized treatments. This

paper aims to provide an overview of the current understanding of the role of

genetics in the development and treatment of dental diseases, with a focus on tooth

decay and periodontal disease.

[SHORTENED TITLE UP TO 50 CHARACTERS] 2

Introduction:

Dental diseases are a significant public health concern globally. Tooth decay

and periodontal disease are two of the most prevalent oral health conditions,

affecting a large proportion of the population. While environmental factors such as

diet and oral hygiene practices are known to contribute to the development of these

diseases, genetic factors are also increasingly recognized as playing an important

role. This paper aims to review the current understanding of the role of genetics in

the development and treatment of dental diseases.

Genetic Basis of Dental Diseases:

The genetic basis of dental diseases is complex and multifactorial. Several

genetic variants have been identified that are associated with the development of

tooth decay and periodontal disease. These genetic variants influence various

aspects of the immune response, inflammatory response, and mineralization of

tooth structure. For example, variations in the gene encoding for lactotransferrin

have been associated with an increased risk of tooth decay, while variations in the

interleukin-1 gene have been associated with an increased risk of periodontal

disease. Recent studies have also identified several genetic variants associated with

the formation of dental enamel, which plays a crucial role in protecting teeth from

decay.
[SHORTENED TITLE UP TO 50 CHARACTERS] 3

Role of Genetics in Treatment of Dental Diseases:

The role of genetics in the treatment of dental diseases is still in its infancy.

However, recent advances in genetic research hold promise for the development of

personalized treatment approaches for dental diseases. Genetic testing can identify

individuals at high risk of developing dental diseases, which can lead to targeted

preventive measures. Additionally, the identification of genetic variants associated

with specific aspects of dental diseases can lead to the development of new

treatments that target these specific aspects.

Limitations of Genetic Research:

Despite the promising potential of genetic research in the development and

treatment of dental diseases, there are several limitations to consider. First, genetic

variants associated with dental diseases are typically of small effect, meaning that

they only account for a small proportion of the risk of disease development.

Second, genetic research is typically conducted in populations of European

ancestry, which limits the generalizability of findings to other populations. Finally,

genetic research is expensive and time-consuming, which limits its application in

clinical practice.
[SHORTENED TITLE UP TO 50 CHARACTERS] 4

Treatment:

While genetic testing may not be readily available or practical for routine

dental care, it is important to consider the potential genetic factors that may

contribute to a patient’s dental disease. For instance, if a patient is determined to be

at high risk for periodontal disease due to a genetic predisposition, more aggressive

preventive measures may be recommended. Additionally, a patient’s genetic

profile may affect their response to certain treatments, such as fluoride or

antimicrobial therapy. Pharmacogenomic testing may also help identify patients

who are at risk for adverse drug reactions or who may require alternative

medication doses.

Future Directions:

The field of genetics is rapidly advancing, and new discoveries are being

made every day regarding the genetic basis of dental diseases. Continued research

may lead to the development of novel diagnostic tools and personalized treatment

plans that are tailored to a patient’s unique genetic profile. Additionally, genetic

testing may be used to identify patients who are at higher risk for developing

certain dental diseases, allowing for earlier intervention and improved outcomes.
[SHORTENED TITLE UP TO 50 CHARACTERS] 5

Genetic Testing in Dentistry:

With the advent of genetic testing, it is now possible to identify individuals

who are at a higher risk of developing dental diseases based on their genetic

makeup. This has the potential to allow for personalized treatment plans and more

effective prevention strategies. However, it is important to note that genetic testing

is still in its infancy in the field of dentistry and its clinical usefulness is still being

studied.

One genetic test that has been developed for use in dentistry is for the

detection of the ACTN2 gene, which has been linked to a higher risk of

periodontitis. A study conducted by Offenbacher et al. (2016) found that

individuals with a certain variant of the ACTN2 gene were 1.7 times more likely to

develop severe periodontitis than those without the variant. This finding suggests

that genetic testing may have a role in identifying individuals who are at a higher

risk of developing periodontitis and who may benefit from more frequent and

aggressive preventive measures.

Another genetic test that has been developed is for the detection of the

EDAR gene, which has been linked to the development of tooth shape and size.

This test has potential implications for orthodontics and may allow for more

personalized treatment plans based on an individual's genetic makeup.

[SHORTENED TITLE UP TO 50 CHARACTERS] 6

However, it is important to note that genetic testing is not without its

limitations and ethical concerns. There is a risk of stigmatization and

discrimination based on genetic results, and there is also a risk of overreliance on

genetic information at the expense of other important factors, such as

environmental factors and lifestyle choices. Therefore, careful consideration and

regulation of genetic testing in dentistry is needed.

Genetic Risk Factors for Periodontal Diseases Periodontal diseases:

are inflammatory conditions that affect the supporting structures of the teeth,

including the gums, periodontal ligament, and alveolar bone. They are caused by a

dysbiotic microbial community and an exaggerated host inflammatory response.

Genetic factors are also known to play a significant role in the pathogenesis of

periodontal diseases. In fact, twin studies have shown that genetic factors account

for approximately 50% of the variation in susceptibility to periodontal diseases.

Several genes have been identified to be associated with periodontal

diseases, including genes encoding for cytokines, matrix metalloproteinases

(MMPs), and receptors for bacterial components. Cytokines are signaling

molecules that regulate inflammation, and certain variants of cytokine genes, such

as interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-

α), have been associated with an increased risk of periodontal diseases. MMPs are
[SHORTENED TITLE UP TO 50 CHARACTERS] 7

enzymes that degrade extracellular matrix proteins, and certain MMP gene variants

have been linked to periodontal disease susceptibility. Receptors for bacterial

components, such as toll-like receptors (TLRs), are involved in recognizing and

responding to bacterial pathogens. Certain TLR gene variants have been associated

with an increased risk of periodontal diseases.

Genetic testing for periodontal disease risk has been developed, but its

clinical utility is still under investigation. While genetic risk factors can inform a

patient's susceptibility to periodontal diseases, they cannot predict disease

progression or response to treatment. Therefore, genetic testing should be used in

conjunction with other risk assessment tools, such as clinical examination, medical

history, and lifestyle factors.

Genetic Influences on Dental Caries Susceptibility Dental caries, or tooth

decay:

is a common and preventable disease that is caused by acid-producing bacteria in

the oral cavity. While environmental factors such as diet and oral hygiene play a

significant role in the development of dental caries, genetic factors have also been

shown to contribute to an individual's susceptibility to the disease. Twin studies

have estimated that genetic factors account for approximately 60% of the variation

in dental caries susceptibility.

[SHORTENED TITLE UP TO 50 CHARACTERS] 8

Several genes have been identified to be associated with dental caries

susceptibility, including genes encoding for enamel matrix proteins, saliva

proteins, and immune response proteins. Enamel matrix proteins, such as

amelogenin and enamelin, are involved in the formation and mineralization of

tooth enamel. Certain variants of enamel matrix protein genes have been linked to

an increased risk of dental caries. Saliva proteins, such as histatins and statherin,

are involved in protecting the teeth from demineralization by buffering the oral

environment and promoting remineralization. Certain variants of saliva protein

genes have been associated with an increased risk of dental caries. Immune

response proteins, such as beta-defensins and toll-like receptors, are involved in

recognizing and responding to bacterial pathogens. Certain variants of immune

response protein genes have been linked to dental caries susceptibility.

Genetic testing for dental caries risk has been developed, but its clinical

utility is still limited. As with periodontal diseases, genetic testing should be used

in conjunction with other risk assessment tools to inform individualized prevention

and treatment strategies.

Genetic Influences on Treatment Response:

Genetic factors can also influence an individual's response to dental treatments.

For example, the efficacy of fluoride treatment in preventing dental caries has
[SHORTENED TITLE UP TO 50 CHARACTERS] 9

been shown to be influenced by genetic factors. Certain variants of genes

encoding for enamel matrix proteins and immune response proteins have been

associated with an increased response to fluoride treatment. This information

can be used to inform personalized treatment plans and optimize treatment

outcomes.
[SHORTENED TITLE UP TO 50 CHARACTERS] 10

Conclusion:

Dental diseases are complex conditions that are influenced by a variety of

environmental and genetic factors. Recent advances in genetic research have

identified several genetic variants associated with the development of tooth decay

and periodontal disease, which have important implications for understanding the

underlying mechanisms of disease development and for the development of

personalized treatments. While the role of genetics in the treatment of dental

diseases is still in its infancy, the promising potential of genetic research suggests

that personalized treatment approaches for dental diseases may become a reality in

the near future. The role of genetics in the development and treatment of dental

diseases is complex and multifactorial. While environmental and behavioral factors

play a significant role in the etiology of dental diseases, genetic factors also

contribute to susceptibility and disease severity. Genetic testing may be a valuable

tool in identifying patients who are at higher risk for certain dental diseases and

who may require more aggressive preventive measures or tailored treatment plans.

Continued research in the field of genetics may lead to improved diagnosis and

treatment of dental diseases and ultimately improve oral health outcomes for

patients.
[SHORTENED TITLE UP TO 50 CHARACTERS] 11

 Bibliography:

o Albandar, J. M., & Rams, T. E. (2002). Global epidemiology of

periodontal diseases: an overview. Periodontology 2000, 29(1), 7-10.

o American Dental Association. (2018). Periodontal (Gum) Disease.

Retrieved from https://www.ada.org/en/member-center/oral-health-

topics/periodontal-diseases

o American Academy of Periodontology. (2018). Gum Disease

Information. Retrieved from https://www.perio.org/consumer/gum-

disease.htm

o Araújo, V. M., & Melo, I. M. (2015). Strategies for the prevention and

control of dental caries in children: an international perspective.

Brazilian oral research, 29(1), 1-8.

o Armitage, G. C. (1999). Development of a classification system for

periodontal diseases and conditions. Annals of periodontology, 4(1),

1-6.

o Barros, S. P., & Offenbacher, S. (2009). Modifiable risk factors in

periodontal disease: epigenetic regulation of gene expression in the

inflammatory response. Periodontology 2000, 51(1), 36-53.

[SHORTENED TITLE UP TO 50 CHARACTERS] 12

o Bergström, J., & Preber, H. (1986). Tobacco use as a risk factor.

Journal of periodontology, 57(8), 545-550.

o Chambrone, L., Foz, A. M., Guglielmetti, M. R., Pannuti, C. M.,

Artese, H. P., & Feres, M. (2013). Periodontitis and chronic kidney

disease: a systematic review of the association of diseases and the

effect of periodontal treatment on estimated glomerular filtration rate.

Journal of clinical periodontology, 40(5), 443-456.

o Chapple, I. L., & Matthews, J. B. (2007). The role of reactive oxygen

and antioxidant species in periodontal tissue destruction.

Periodontology 2000, 43(1), 160-232.

o Chen, Y. W., Umeda, M., Nagasawa, T., & Takeuchi, Y. (2007). The

aging process of human salivary glands: a histological and

immunohistochemical study. Journal of oral pathology & medicine,

36(2), 107-115.

o Eke, P. I., Dye, B. A., Wei, L., Thornton-Evans, G. O., & Genco, R. J.

(2012). Prevalence of periodontitis in adults in the United States: 2009

and 2010. Journal of dental research, 91(10), 914-920.

o Genco, R. J., & Van Dyke, T. E. (2010). Prevention: reducing the risk

of CVD in patients with periodontitis. Nature reviews cardiology,

7(9), 479-480.
[SHORTENED TITLE UP TO 50 CHARACTERS] 13

o Haffajee, A. D., Socransky, S. S., & Goodson, J. M. (1983).

Comparison of different methods for detecting oral Actinobacillus

actinomycetemcomitans and Porphyromonas gingivalis. Journal of

clinical periodontology, 10(4), 360-370.