Genetic Influences in Caries and Periodontal Diseases

Abstract

Deciphering the relative roles of heredity and environmental factors ("nature vs. nurture") in the pathogenesis of dental caries and diseases of the periodontium has occupied clinical and basic researchers for decades. Success in the endeavor has come more easily in the case of caries; the complex interactions that occur between host-response mechanisms and putative microbiologic pathogens in periodontal disease have made elucidation of genetic factors in disease susceptibility more difficult. In addition, during the 30-year period between 1958 and 1987, only meager resources were targeted toward the "nature" side of the nature/nurture dipole in periodontology. In this article, we present a brief history of the development of genetic epistemology, then describe the three main research mechanisms by which questions about the hereditary component of diseases in humans can be addressed. A critical discussion of the evidence for a hereditary component in caries susceptibility is next presented, also from a historical perspective. The evolution of knowledge concerning possible genetic ("endogenous", "idiotypic") factors in the pathogenesis of inflammatory periodontal disease is initiated with an analysis of some foreign-language (primarily German) literature that is likely to be unfamiliar to the reader. We identify a turning point at about 1960, when the periodontal research community turned away from genetics in favor of microbiology research. During the past five years, investigators have re-initiated the search for the hereditary component in susceptibility to common adult periodontal disease; this small but growing body of literature is reviewed. Recent applications of in vitro methods for genetic analyses in periodontal research are presented, with an eye toward a future in which persons who are at risk-genetically predisposed-to periodontal disease may be identified and targeted for interventive strategies. Critical is the realization that genes and environment do not act independently of each other; the appearance or magnitude of heritability may differ with various environments.

Caries Through Time: An Anthropological Overview

“…The hypotheses of an increase in the susceptibility or resistance diminishment by genetic reasons or the installation of a particularly cariogenic flora have not been sufficiently corroborated (De Soet & Laine, 2008;Hassell & Harris, 1995;Shuler, 2001;van Palenstein et al, 1996) while dietary changes seem to be the most reasonable answer. In the modern western world and increasingly in other regions of the globe approximately half of consumed calories comes from carbohydrates and almost half of it is sucrose.…”

Genes and Gene Polymorphisms Associated with Periodontal Disease

“…Although periodontal disease nosology has changed many times over the timeframe of these reports, most familial reports for periodontitis are for early-onset forms now called aggressive periodontitis (Korkhaus, 1952;Cohen and Goldman, 1960;Benjamin and Baer, 1967;Butler, 1969;Fourel, 1972Fourel, , 1974Jorgenson et al, 1975;Melnick et al, 1976;Sussman and Baer, 1978;Ohtonen et al, 1983;Saxen and Nevanlinna, 1984;Van Dyke et al, 1985;Boughman et al, 1986Boughman et al, , 1992Beaty et al, 1987;Long et al, 1987;Marazita et al, 1994;Stabholz et al, 1998). Reports of the familial nature of chronic forms of periodontitis are less frequent, although German studies of the familial nature of chronic forms of periodonitis from the early 20th century have been reviewed by Hassell and Harris (1995). This aggregation within families strongly suggests a genetic predisposition.…”

“…To determine the evidence for genetic factors in familial aggregation of a trait, more formal genetic studies are required. There have been many clinical reports suggesting a familial aggregation of periodontitis, but until recently the research tools to pursue these reports were lacking (Boughman et al, 1988;Hassell and Harris, 1995;Hart and Kornman, 1997).…”

Le recours au fluor chez les nourrissons et les enfants

“…En raison d'une prédisposition génétique ou environnementale à une forte prévalence de caries (17)(18)(19)(20)(21), le fluor topique seul peut être insuffisant pour prévenir la carie (c'est-à-dire qu'il se peut que l'ajout de fluor n'apporte aucun bénéfice net et que d'autres mesures, comme un traitement antibactérien et des modifications au régime, peuvent être nécessaires) (catégorie II-3, recommandation C) (22).…”