A problem among the world’s populations has been a lack of adequate knowledge about genetic diseases and how to prevent them. An essential fact is that a better understanding of an illness’s genetic makeup and etiology can lead to earlier recognition and detection of the disease, particularly in high-risk individuals. This experience will also aid in developing intervention strategies that will slow the progression of the disease. The newly developed new technology, which is based on genetic research, can improve the survival and quality of life of those who are affected. Development in this field would necessitate scientific training for the current generation. of hypothesis used in discovering the etiology of these diseases. Currently, it is now possible to go beyond the epidemiological methods and be able to act in the process of a particular disease or identify the location of the disease in the body.
Keywords: Dental disorders, genetics, mutation, oral health
Genetics and oral health
Genetics is a branch of Science that involves the study of genetic variations of the living things genes and hereditary effects. It is mainly concerned with the means and 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 different cells in the teeth of the oral mucosa and 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, that is, any disease resulting 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. Mutations can be as a result of external factors such as environmental such as smoking and chemicals. Although mutations can be advantageous at times leading to evolutionary benefits on a particular genotype, most of the mutation effects are usually negative. This may be deleterious hence causing the resulting disease, structural abnormalities among other effects. (Stanley, Feingold & Cooper, 2014) Various kinds of mutations exist and some of them include translocation, point mutation, silent mutation, insertion and deletion among others.
Clinical Decision Making in Dentistry Using Genetic Information
Genetics and Dental Caries
The studies carried out on the diet and dental caries revealed a variational pattern in a person being susceptible to dental caries even when under a controlled environment. About 35-55% of the dental caries phenotypic variations are attributed to genes. Some other predisposing factors are the density of the dental enamel, water fluoridation, the composition of the salivary glands secretions, the nutritional habits and the personal hygiene. The incidences of the 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 that can be used involve genetic tests for dental caries susceptibility has the capability of identifying the risk groups of patients. More so, the development of genetic tests may lead to a targeted therapy which can specifically be able to address the risks that an individual may face. (Stanley, Feingold & Cooper, 2014)
Genetics can be used in the prevention of dental caries from occurring. For instance, genetic engineering of the dental caries is useful in producing the transgenic strains of is the Streptococcus mutants species that do not have the specific gene necessary to produce decay of the teeth. Two residues Q1025 and E1037 that are found within p1025 that 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 that have colonization that is mediated by the surface adhesins molecules.
Genetics and Periodontitis
Fifty percentage of periodontitis cases are attributed to the genetic factors. This evidence is based on the study that was carried out on the genetic syndromes and the inherited diseases using the Familial studies, Population studies and Twin studies. The initial studies carried out to find the mode of inheritance of early periodontitis susceptibility found out that the increase in prevalence in women and the lack of father-to-son transmission in families showed that the disease is an X-linked dominant trait. When the analysis of the original pedigrees was done, it was found to be supportive of the inheritance of periodontitis linked to X chromosomes. (Kumar, Hirekalmath & Sunil, 2016). Evidence of the loss of attachment, gingival index, pocket probing depth and plaques index has also been confirmed by the several studies that were conducted using the identical and fraternal twins reared together and also by the identical twins reared apart. Patients with periodontitis disease that does not respond effectively to a certain treatment can be monitored and assessed using the relevant microbial organisms. Furthermore, identifying the patient genes that 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 also be used in preventing the periodontal diseases. This involves the use of DNA probes to help to identify the specific species sequences of the nucleic acid material that make up the DNA. This will permit the identification of the particular organism permitting the identification of the 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 these diseases. (Kumar, Hirekalmath & Sunil, 2016).An increase in the knowledge about the genetic disorders among the population can also help prevent these disorders. In most cases, the government of most 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 in the early detection and manage them.
Genetic Instability in Oral Cancer. Instability in the genetic makeup of oral cancer has been linked to mutations occurring in the proto-oncogene and in the tumor suppressor gene leading to failure to repair or loss of heterozygosity. Dr. Alfred Knudson (1971) proposed the two-hit hypothesis that tried to explain the genetics and oral cancer relationship. He suggested that several “hits” to DNA were needed to result in cancer. For instance, he viewed that in children who had inherited retinoblastoma, cancer was not caused by the first insult inherited from DNA, but was caused by the second insult caused to the DNA. On the other hand, in the non-inherited retinoblastoma, he concluded that two “hits” were needed before a tumor could be able to develop. Therefore, this theory indirectly led to the discovering of the genes that lead to cancer. (Kumar, Hirekalmath & Sunil, 2016).
In conclusion, it is evident that genetic disorders are a great concern in the current society, especially in the American population. The relationship between the oral health and genetics is so 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.
Naveen Kumar P G, Hirekalmath SV & Sunil L A. (2016) Genetics and oral health. Dent Med
Res [Serial online] 2016 [cited 2017 Jul 14]; 4:9-17. Available from: http://www.dmrjournal.org/text.asp?2016/4/1/9/171918
Stanley BO, Feingold E & Cooper M (2014) Genetic Association of MPPED2 and ACTN2 with
Dental Caries. J Dent Res 2014; 93(7):626-32. Available from: http://www.ada.org/en/member-center/oral-health-topics/genetics-and-oral-health