Evidence of a contribution of genetic factors to dental caries risk

Abstract

SummaryDental practitioners would find value in understanding the genetic contribution to caries risk for at least 2 reasons. First, they would be able to explain to patients that some forms of decay are more strongly associated with inherited risk. This would help explain for both the patient and dentist why persons with similar behavioral risks (eg, tooth brushing frequency or dietary habits) have different caries rates, thus avoiding the "blaming the victim" that sometimes accompanies preventive health messages in dentistry. In addition, future technological developments may make it possible to some day identify patients who are genetically at higher risk for caries. These patients then could be monitored more closely and provided with more aggressive prevention programs. SUBJECTSThe literature was searched for evidence of a contribution of genetic factors to increased or decreased risk for dental caries. A search for global evidence of caries heritability was carried out using twin studies. Next, separate searches were carried out for evidence of heritability for 3 potential mechanisms associated with caries risk that included variation in the quality of the dental hard tissues, variation in host immune response, and variation in sugar metabolism. Each of the 4 searches is treated separately below. Inclusion criteria for the selected studies were not provided. No meta-analysis was attempted, since the selected studies, particularly twin studies, employed different statistical models to assess heritability (correlation coefficients, concordance rates, heritability estimates and intra-pair twin covariation). Twin Studies of Global Evidence of Dental Caries Heritability-10 articles employing the twin model study design (a total of 609 pairs of monozygotic (MZ) twins and 569 pairs of dizygotic (DZ) twins) -50% of studies with children and adolescents of an age range of 3 to 17 years -40% of studies in young adults and adults Studies of Inherited Variations in Dental Enamel-4 reports employing cohort and case-control study designs in participants with epidermolysis bullosa NIH Public Access

Caries: Review of Human Genetics Research

“…This could offer an explanation for both the patient and dental practitioner why persons with similar behavioral risks ( i.e. , tooth brushing frequency or dietary habits) have different caries risk and/or caries activity [Bretz et al, 2003]. …”

<b><i>ACE</i></b> Insertion/Deletion Polymorphism Associated with Caries in Permanent but Not Primary Dentition in Czech Children

“…Studies of twins reared together [Bretz et al, 2003[Bretz et al, , 2005 or of families [Wang et al, 2010] have shown that dental caries is highly heritable, with 20-65% of variation attributable to genetics. Shaffer et al [2015] even observed significant evidence of gene-by-sex interactions for caries experience in both the primary and permanent dentitions.…”

Association of Sweet Taste Receptor Gene Polymorphisms with Dental Caries Experience in School Children

“…Studies concerning the relationship between dental caries and nutritional indices in children have been performed by various study groups [Harris et al, 2004;Oliveira et al, 2008;Tramini et al, 2009]. The importance of genetic factors in caries is supported by twin studies that have estimated that 40-60% of caries susceptibility is genetically determined [Boraas et al, 1988;Conry et al, 1993;Bretz et al, 2003Bretz et al, , 2005Wang et al, 2010]. Animal model studies also strongly support the genetic contribution to caries [Liu et al, 1998;Shuler, 2001;Nariyama et al, 2004].…”