One of the most pressing issues today is a lack of necessary information about genetically related diseases and prevention methods. A crucial factor in identifying the etiology of the disease and thus promoting its control is the early identification of genetic disease in risk groups. Furthermore, this information will help develop management techniques that will help prevent disease progression. The study on genetic knowledge has been significantly improved thanks to current advanced technologies, greatly improving the affected population’s living standards. As a result, it is important to instill awareness by training the current generation at the required level to allow successful disease prevention. More so, the use of epidemiology approaches in enhancing the generation of hypothesis used in discovering the etiology of these diseases has also played an important role in the management of the genetic diseases. Currently, over and above the epidemiological approaches used, it is possible to find the location of a particular genetic disease in the specific part of the body to ease in the prevention of progression in the body.
Keywords: mutations, dental disorders, oral health, genetics.
Genetics and Oral Health
Genetics is a branch of Science which involves the study of genetic variations of the living organisms’ genes and hereditary effects. It is mainly concerned with the means as well as the effects of transmitting and generating of the biological inheritance components. The genetic constitutions of a particular person govern the growth, migration, and differentiation of the cells in the teeth of the oral mucosa as well as other structures in the cranial facial outlook. These signals are responsible for maintaining the aging process and the integrity of the dividing cells. Therefore, a problem to the genetic constitution, such as mutations, may lead to genetic diseases which result from the individual genome abnormality (Kumar, Hirekalmath & Sunil, 2016).
Mutation can be described as a permanent change in the DNA sequence leading to observable effects. Sometimes mutations result from external factors, including environmental such as smoking and chemicals. Although mutations can be advantageous at times leading to evolutionary benefits on a particular genotype, most of their effects are usually negative. This may be deleterious hence causing the resulting disease or structural abnormalities among other effects (Stanley, Feingold & Cooper, 2014). Various kinds of mutations exist; some of them include translocation, point mutation, silent mutation, insertion as well as deletion among others.
Basic Genetic Principles
There are 23 pairs of chromosomes in each of the human body cells. Within each of the pairs, one chromosome is inherited from each of the parents. These chromosomes contain thousands of the DNA sequences some of which are recessive and others are dominantly expressed. The expression of the gene is dependent on several factors, including time, type of cell containing the genes, and the environment of residing of the person as well. It is necessary for the expression of the genes to be controlled in order to achieve the proper growth, development, and the functioning of a particular organ in the body (Corby, 2009).
Currently, various tests are in the use to monitor the genetic diseases resulting from mutations in the genes or abnormalities which may occur to the chromosomes. In the case where the gene is already known, it will be sequenced and then compared with a known and normal sequence of the genes. When the chromosome is abnormal, the karyotype is usually analyzed using the basic fluorescent markers in order to determine if the complementarity exists in the chromosomes and if there are some significant changes such as deletion within the chromosome sequence. The more complex diseases are monitored using the marketed tests within the markets which measure the risk which the disease has on the affected individual. It is necessary to always have the complex genetic diseases monitored in order to manage and reduce their progression. This will allow the normal body functioning all of which will stimulate the immune system to be in a good condition to fight the impending diseases. Hence, the person should be vigilant and get the tests as soon as possible (Corby, 2009).
Clinical Decision Making in Dentistry Using Genetic Information
Genetics and Dental Caries
The studies carried out on the diet and incidences of dental caries diseases on the affected person showed a pattern which was varying independently of the controlled conditions in a given environment. In the case of dental caries, about 35-55% of its phenotypic variations are attributed to the genetic makeup of a person. Some other factors which contribute to the acquisition of the disease include the fluorine content of water, dental enamel density, contents within the salivary gland secretions, the nutrition of a person, and their general hygiene as well. The incidences of dental caries are increased by the inherited disorders of the immune system, the flow of the salivary secretions, and the tooth development. Some of the potential clinical utilities which can be used involve genetic tests for dental caries susceptibility has the capability of identifying the risk groups of patients. Moreover, the development of genetic tests may lead to a targeted therapy which can specifically address the risks an individual may face (Stanley, Feingold & Cooper, 2014).
Thus, genetics can be used in the prevention of dental caries from occurring. For instance, genetic engineering of dental caries is useful in producing the transgenic strains of is the Streptococcus mutants species which do not have the specific gene necessary to produce decay of the teeth. Two residues Q1025 and E1037 found within p1025 which enhance binding were identified by site-directed mutagenesis. In an experiment conducted in vivo using the human streptococcal organism models, the p1025 when applied to the teeth did not promote the replication of the S. mutants. Therefore, this new antimicrobial method can be used against other microorganisms which have colonization mediated by the surface adhesins molecules.
Genetics and Periodontitis
According to the studies carried out on the inherited diseases and the genetic syndromes, more than half of the periodontitis cases are due to the predisposing genetic makeup of a person. The initial studies carried out in order to find out the means by which people inherited periodontitis discovered the prevalence of this disease in women. Furthermore, the lack of transmission between the father and the son in most families revealed that the disease is linked to the X chromosome of the sex gametes. This was supported by the results released from the studies carried out on the original pedigree analysis (Kumar, Hirekalmath & Sunil, 2016). Patients with periodontitis disease which does not respond effectively to a certain treatment can be monitored and assessed using the relevant microbial organisms. Furthermore, identifying the patient genes which possess the risk of the microbial imbalance can be a useful strategy because the interactions of the gene and their environment are among the important factors in comparison of the microbes and the host.
Genetics can be used in preventing the periodontal diseases as well. This involves the use of DNA probes in order to help identify the specific species sequences of the nucleic acid material which make up the DNA. Moreover, this will permit the identification of the particular organism. Thus, an appropriate gene replacement therapy can be thereafter helpful in the correcting the genetic disorder identified. Furthermore, epidemiology studies play a key role in the prevention of many diseases (Kumar, Hirekalmath & Sunil, 2016). An increase in the knowledge about the genetic disorders among the population can help prevent them as well. In most cases, the government of different countries publicize more on the public health disorders but do not put an effort in educating the public on the genetic disorders. As a result, little knowledge regarding these diseases will be found in the general population. Hence, a better understanding of genetic diseases will help detect and manage them earlier.
Genetic Instability in Oral Cancer. Mutations in the proto-oncogenes and the tumor suppressor genes have been associated with the instances of oral cancer which results from the genetic problems in the body of an individual. The relationship existing between the genetics and the oral cancer was described by Dr. Alfred Knudson (1971). He came up with a two-hit hypothesis which elaborated on the relationship that exists between the two. According to Knudson, several disruptions to the body DNA were required to cause cancer. Therefore, for a person like a child to inherit the genetic disease, a first-time mistake to the DNA did not result in cancer but the disease is a consequence of the subsequent attacks of the DNA which has led to the disease. Hence, this theoretical studies enabled the discovering of the genes which lead to cancer (Kumar, Hirekalmath & Sunil, 2016).
It is evident that genetic disorders are a great concern in the society today, especially in the American population. The relationship between the oral health and genetics is evident in disorders such as dental caries, periodontitis, and oral cancer. The knowledge of the relevant genetic materials involved in these disorders can be helpful in managing them. Initially, the traditional epidemiologic approach was used in developing the hypothesis used in determining the etiology of these diseases. But now, several advanced methods based on the current technology have been developed that are used to monitor and manage these diseases.
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