Genetics in Dentistry: A Review of Advances and Implications

ABSTRACT

Genetic factors have an appreciable role to play in oral health. This article investigates the genetic components of dental caries, periodontal disease, facial physical proportions, and other orofacial afflictions. Some of these disorders have been associated with specific genes. In genomics and molecular biology, the relationship between specific gene products and these kinds of disorders has been discovered. Genetic testing can thus be used to define people at higher risk for specific ailments, allowing for a specific therapeutic approach and early treatment. Gene therapy also offers great potential for treating several genetic diseases that affect oral health in the future. By exploring genetic data, we can get closer to a more effective way of applying it in dental practice.

INTRODUCTION

The scientific study of heredity and organism variation is known as ‘Genetics’. It investigates how genetic material, mainly deoxyribonucleic acid (DNA), is transmitted from one generation to the next to pass on features. The genetic code governing an organism’s traits is encoded in DNA, a complex molecule made up of nucleotides. Certain DNA segments called ‘genes’ encode proteins that affect a variety of characteristics, from physical appearance to illness risk. The study of genetics explores inheritance patterns, gene expression mechanisms, and the function of genetic diversity in illness and evolution.[1]

Both the development, maintenance, and diseases involving the orofacial complex are determined in large part, by genetic factors. These factors include congenital abnormalities such as cleft lip and palate, acquisition of disease susceptibilities, including dental caries, gingivitis, and periodontitis, and inherited tendencies towards temporomandibular joint dysfunction. Today knowledge of the genetic causes of oral disease has advanced greatly in the last two decades due to several factors among them is the high-throughput sequencing technology as well as the genetic analysis. This paper also aims to review the current literature on genetics in dentistry and determine its applicability in practice settings.[2]

REVIEW

Genetics is an important factor in all fields of dentistry because genetics affect not only the classification and diagnosis of oral diseases but also the treatment of patients and the effectiveness of the chosen therapy. Globally, dental caries has remained one of the world’s most widespread non-communicable diseases, and the genetics of the disease are well established. Genetic studies have identified that genetic variation that may be associated with the immune system, enamel formation, and saliva composition can predispose to caries. Individual genetic variations on the AMELX (amelogenin) and MMP20 (matrix metalloproteinase 20) genes have been associated with enamel hypoplasia which makes the individuals susceptible to caries formation.[3]

Periodontal diseases are mainly inflammatory diseases and have important hereditary factors. Researchers have found several putative vulnerability genes, including genes for IL1A and TNF genes which modulate inflammation rate. That probably explains why mutations within these genes may predispose an individual to periodontitis as they affect the ability of the immune system to respond to bacterial colonization and subsequent formation of biofilms. Also, COL1A1 gene polymorphisms have a relation with changes in the mechanical properties of periodontal tissue. In clinical practice, individuals more susceptible to PDs can be easily identified through genetic testing and should be advised about specific measures to prevent the development of these diseases besides other treatment options such as biological therapy that includes scaling and root planing or even other procedures including host modulation therapy.[4] Genetic research may help in planning orthodontic treatment. Genes affect the craniofacial architecture, dentoskeletal relationship, and biomechanical properties when subjected to orthodontic forces. Hartsfield JK Jr et al. (2009) in their general study on the genes that are involved in bone remodeling and specifically, those in the WNT signaling pathway, earliest indications of biomarkers for orthodontic treatment success in conjunction with mandibular and/or maxillary growth were also found. Besides, genetic tests may expand people’s finely tuned orthodontic treatment due to the relationship between certain patient genes, and specific procedures to achieve the best result.[5]

Advanced genetic knowledge in this branch has been shown to have positive effects on regenerative dentistry, oral pathology, pediatric, prosthetic, and dental implant specialty. Genes like PAX9 and MSX1 have been identified to enhance the process of tooth regeneration while stem cell technologies which are genetically directed, hold the future for the regeneration of periodontal tissue and dental pulp. In oral pathology, genetics helps in the diagnostic evaluation of the causes of the diseases, including oral precancers and cancers, and differential diagnosis of various hereditary dental disorders like amelogenesis imperfecta and Gardner syndrome with principles of early diagnosis and genetic counseling.[6] Genetic screening is useful in pediatric dental care since some kids are born with some of these abnormalities, such as cleft lip and palate, and hypodontia, which need time-sensitive interventions. Several genetic factors affect choices and outcomes in restorative dentistry; these affect materials, bonding, durability, and even patient response to corrective procedures involving teeth enamel, and dentin. Genetic factors also play a role in the success of dental implants, bone metabolic markers are associated with osseointegration success or failure and may be used to guide treatment strategies, particularly in patients with bone genetic disorders.[7]

DISCUSSION

Exploring dental disease genomics holds great potential for dentistry and a personalized approach to treatment. This form of testing can prove useful for risk assessment of dental diseases for which susceptible patients can be effectively treated using gene-based preventive measures such as care for dental caries and periodontal diseases.

This picture wraps up the clinical uses of genetics in dentistry [Image 1].

Image 1.

Clinical applications of genetics in dentistry

Dental genetic testing as a specialization is relatively new and involves an examination of a person’s DNA to find the link with certain genes responsible for oral conditions, and it offers potential for improvement of oral health care when it comes to diagnostics, treatment, and prevention. It requires obtaining a saliva sample or cheek swab from the patient, obtaining DNA out of the sample, and subsequently amplifying it to look for certain genetic markers like PCR or DNA sequencing. These variations are then compared to standard genetic markers associated with oral health diseases, and the patient is informed about the status by a genetic counselor. At present, dental genetic tests define the likelihood of developing some diseases like dental caries, periodontal diseases, and craniofacial anomalies, which benefit from timely interventions by creating individualized treatment approaches.[8] However, there are some drawbacks in undertaking this testing for example; the testing cannot predict definitively when these conditions will occur, and the fact that oral health is determined genetically as well as through environmental factors. Dental genetic testing is predicted to become more diagnostic and perhaps, include more risk factors as technology and genetic knowledge increases. Peer counseling at the patient level shall persist in helping the patients interpret their results about proper and appropriate oral health care.[9]

Thus, there are a few challenges; First, despite the progress achieved in genetics in dentistry, these findings are not as common in clinical practice. HCPs may not have time or other means through which to incorporate genetic information into patient management. Moreover, the moral issues of genetics for example privacy and discrimination have not been resolved to allow the normal testing for genetics in dental practice. However, there is hope for the future of genetic work in the field of dentistry. In the future, more advanced genetic techniques will offer the use of precise dentistry where a patient is treated according to his or her genes. This could lead to better, faster, and cheaper treatments in dental care.[10]

CONCLUSION

The genetic factor has become a significant factor when explaining oral health problems and the way they can be solved. Even though the genetics of widespread dental diseases are still being researched, advance in the understanding of these diseases implies involvement of genetics in a broad range of dental procedures. As genetics enters into the clinical arena, one can see that it has its problems, but one cannot deny the fact that it has the potential of transforming the preventive, diagnostic, therapeutic, and early diagnosis in dentistry. Current and future studies and innovations present the hope of making dental treatments more patient-tailored, accurate and efficient in their use in patient treatment. This trend is set to continue as the molecular basis of dental diseases continue to be identified and gene therapies harnessed themselves Thus, it becomes incumbent upon educators, researchers, and practitioners to keep up with such advances in order to best serve their patients.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.