For protecting against oral diseases, patients are often advised to watch what they eat and drink, reducing the damage wrought by harmful sugars. As such, some patients may think of their oral health as something shaped by environment and behaviour. Whilst this is true, the role of hereditary factors also means that some patients are at a higher risk of disease and poor oral health than others.
Family history may be a concern for some patients; they may have heard horror stories of parents or grandparents losing teeth at a young age and think that this will apply to them. Two of the most common causes of tooth loss among adults are dental caries and periodontal disease – both are multi-factorial. Whilst the diseases aren’t hereditary, some of the health conditions that increase their risk levels are, and it’s these that patients should be made aware, helping to avoid tooth loss and preserve their oral health.
Generational impacts
Disease can travel from one generation to the next; diabetes, metabolic syndrome, cancer and cardiovascular disease are some of the health complications that can be intergenerationally passed on. Family history can identify vulnerable patients not just through shared genetics, but also through the similarities in environment, exposures and common behaviours. For instance, if a family lives in one area with the children living in the same situations as their parents, the susceptibility of oral diseases like caries will be very similar. This means that a parent with poor oral health is more likely to have a child with poor oral health, leading both to seek restorative work following tooth decay.
However, studies on the familial association with oral health complications are limited. As they are multi-generational, research can be limited and impacted by resources, time and focus, with some studies only assessing one effect at a time. Furthermore, there are no genetic tests for caries or periodontal disease. What is evident instead is how inherited conditions can present defects or preferences that increase the risk of oral disease, and therefore the risk of tooth loss.
Lowered barriers
There are many genetic conditions that directly affect the oral cavity: anodontia, hypodontia, amelogenesis imperfecta, dentinogenesis imperfecta, and cleft lip and palate. These can make brushing and interdental cleaning difficult, leading to a heightened risk of tooth decay. There are also lesser-known genetic conditions that can have an indirect impact on the oral cavity, such as osteogenesis imperfecta and mucopolysaccharidoses. Whilst considered rare inherited diseases, they are risk factors for oral disease with a current lack of awareness. Both conditions are associated with defects in the oral cavity; alterations in the genes disrupts the formation of enamel and dentine, removing the defensive barrier and exposing the teeth to harmful bacteria.
Taste preference
As taste can dictate diet, and unhealthy diets can impact the oral cavity, patients who may have a ‘sweet tooth’ are at risk of caries and periodontal disease. Opting for sugary foods over savoury may seem like a personal preference trait, but it can be an inherited trait: some patients carry certain alleles that lower the body’s sensitivity to sucrose, the main constituent of white sugar. Studies have found that specific polymorphisms found in the sweet taste receptor and glucose transporter genes are associated with caries risk, both individually and in combination, showing how biology can dictate behaviour. Dental practitioners should identify patients with a sweet tooth so that they can advise a moderated consumption of sugary foods and preserve dental health.
Restorative rescue
Despite behaviours such as smoking playing the biggest role in promoting oral diseases, family history is an essential factor for practitioners to consider when diagnosing or identifying at-risk patients. For some patients, unchecked caries or periodontal disease can lead to damaged or lost teeth, prompting the need for a restorative treatment that returns aesthetics and function to the oral cavity.
For a reliable filling material, you can consider the Brilliant EverGlow from Coltene. The material meets the aesthetic demands of the patient without compromising on function. Suitable for anterior and posterior restorations, Brilliant EverGlow has a smooth consistency for excellent handling and an exceptional polishability for long-lasting results. With the support of Coltene products, practitioners can deliver stunning treatments that make a difference.
To combat tooth loss, enhancing the narrative around family history and its association with caries and periodontal disease is essential. By emphasising the interplay between genetics and environmental factors, practitioners can guide at-risk patients to superior health outcomes and help protect restorations moving forwards.
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