The impact of genes on disease risk – Deborah Lyle – Waterpik
Featured Products Promotional FeaturesPosted by: Dental Design 4th July 2019
It is well known that oral diseases cause pain and discomfort, loss of confidence and self-esteem and can seriously disrupt a person’s life. Tooth decay or missing teeth can lead to social isolation and it has been reported that visibly decayed teeth or bad breath can disadvantage an individual when it comes to gaining employment or being promoted at work.[1]In addition, there is growing evidence to link oral diseases with systemic conditionssuch as cardiovascular disease, bacterial pneumonia, diabetes mellitus and low birth weight.[2],[3]These are the reasons why dental professionals work tirelessly to help patients to understand the importance of a good oral health and promote preventive strategies. However, at least 3.58 billion people worldwide are affected by oral disease and, caries in the permanent teeth remain the most prevalent.[4]
A number of reasons have been suggested as to why individuals develop caries but largely, it is attributed to poor oral hygiene as well as factors such as excessive consumption of sugar, snacking between meals and use of tobacco. Nevertheless, in spite of diligently following an effective oral health routine with exposure to fluoride and good dietary habits, some people still develop dental decay; whilst others that are not so conscientious, remain caries free.
It has been suggested that some individuals have a kind of natural immunity to caries and others have what is popularly known as “weak teeth,” which are less resistant to decay. In the past these variances have been attributed to factors such as excessive milk consumption, infections and repetitive or prolonged use of antibiotics in childhood. However, recent studies indicate that a genetic variation involved with the formation of tooth enamel, could make this hard tissue more or less susceptible to demineralisation under acidic conditions, which is relevant to the development of dental caries.[5],[6]
There is also substantial evidence that genetic factors are associated with an increased risk of developing periodontal disease.[7]For some time it has been suggested that the heritability of periodontitis seems to be biological rather than behavioural[8]and recent investigations into factors that may increase susceptibility to periodontitis have focused more strongly on genes. Moreover, in the last year, a systematic review of 13 studies with over 71,500 participants revealed that seven interleukins namely IL-1A, IL-1B, IL-4, IL-6, IL-8, IL-10, and IL-18 (particularly important in stimulating immune responses, such as inflammation); three fcγreceptors, FCGR2A, FCGR3A, FCGR3B, which are involved in the stimulation of antibodies and regulation of immune responses; and five inflammatory mediators COX-2, MMP-2, MMP-3, MMP-8, MMP-8 and MMP-9, were significantly associated with risk of development of periodontal disease.[9]
Although this article merely scratches the surface, it has been established that some people may have a strong genetic predisposition to certain oral diseases. This would indicate that the detection of such genes could enable clinicians to better identify high-risk individuals and implement targeted prevention and treatment. However, at present it has been acknowledged that further studies are required to discover how the thousands of genes in the human genome and the large number of bacteria within the oral cavity interact within the environment to alter disease risk.[10]Consequently, the fundamental messages and promotion of good oral health along with the reduction of sugary foods and drinks, alcohol and tobacco, exposure to fluoride and regular dental attendance remain significantly important. Indeed, regardless of whether a patient has “strong” or “weak” teeth, or an increased risk of periodontal disease, maintaining optimal oral hygiene should be the first and foremost concern for patients of all ages.
The Waterpik®Water Flosser is a safe and effective adjunct that can help patients to improve their oral hygiene routine considerably. This innovative device uses a combination of water pressure and pulsations to quickly and easily remove plaque and debris deep between the teeth as well as subgingivally, where string floss and brushes cannot reach. Since the inception of the first Waterpik®Water Flosser, more than 50 years ago over 60 clinical trials have been published, and collectively they demonstrate significant plaque removal, reduction of gingival bleeding and reversal of gingivitis.[11]In addition, dental professionals can access continuing professional development courses free of charge at https://www.waterpik.co.uk/professional/continuing-education/and gain verifiable CPD credits.
With the possibility of new diagnostic markers and gene-specific preventive strategies on the horizon, it is important to stay abreast of the investigations into the genetic components that may play a role in the risk, onset and progression of oral diseases. Equally, clinical studies help dental professionals to make informed decisions about dental care and the recommendations they make to their patients, which ultimately provides the best possible oral health outcomes.
For more information on Waterpik®please visit www.waterpik.co.uk. Waterpik®products are available from Amazon, Asda, Costco UK, Boots.com
and Superdrug stores across the UK and Ireland.
References
[1]Public Health England. Adult oral health: applying All Our Health. December 2017. https://www.gov.uk/government/publications/adult-oral-health-applying-all-our-health/adult-oral-health-applying-all-our-health[Accessed 19th December 2018]
[2]Xiaojing L. et al. Systemic diseases caused by oral infection. Clin Microbiol Rev. 2000 Oct; 13(4): 547–558. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88948/[Accessed 19thDecember 2018]
[3]Chaitanya Babu N. et al. Systemic manifestations of oral diseases. J Oral Maxillofac Pathol. 2011 May-Aug; 15(2): 144–147. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329699/[Accessed 19th December 2018]
[4]GBD 2016 Disease and Injury Incidence and Prevalence Collaborators.
Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet, Global Health Metrics 390 (10100) 1211-1259. Sept 2017.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32154-2/fulltext[Accessed 18th December 2018]
[5]Vieira A.R et al. Weaker dental enamel explains dental decay. Research article. April 2015. PLoS ONE, 1-8. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0124236#abstract0[Accessed 19thDecember 2018]
[6]Shimizu T. et al. Enamel formation genes influence enamel mircorhardness before and after cariogenic challenge. PLoS One. 2012;7(9):e45022. https://www.ncbi.nlm.nih.gov/pubmed/23028741[Accessed 19th December 2018]
[7]Tettamanti L. et al. Genetic susceptibility and periodontal disease: a retrospective study on a large Italian sample. Oral Implantol (Rome). 2017 Jan-Mar; 10(1): 20–27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5516423/[Accessed 19thDecember 2018]
[8]Michalowia B.S. Evidence of a substantial genetic basis for risk of adult periodontitis. J Periodontol. 2000 Nov;71(11):1699-707. https://www.ncbi.nlm.nih.gov/pubmed/11128917. [Accessed 19th December 2018]
[9]Klever da Silva M. et al. Genetic Factors and the Risk of Periodontitis Development: Findings from a Systematic Review Composed of 13 Studies of Meta-Analysis with 71,531 Participants. Int J Dent. 2017; 2017: 1914073. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424192/[Accessed 19thDecember 2018]
[10]Quazi B.K. et al. Genetics: An Insight to Periodontal Disease. IOSR-JDMS Sept 2017; 16(9) Ver. IX. 84-89. https://pdfs.semanticscholar.org/0587/06c6e4234fffe3d85012647ba9855ba847f0.pdf[Accessed 19th December 2018]
[11]Jolkovsky, D. L., et al. (2015). Safety of a Water Flosser: A literature review. Compendium of Continuing Education in Dentistry, 36 (2), 2-5. https://www.waterpik.co.uk/professional/clinical-research/pdfs/Water-Flosser-Proven-Safe-Review-2015.pdf{Accessed 19th December 2018]
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