Beyond Proper Hygiene: Genetics and Oral Health

The American Dental Association recommends brushing your teeth twice a day with fluoride toothpaste and flossing at least once a day as part of a healthy dental care routine. However, dentists are also learning the impact of genetics on a patient’s oral health. Recent studies have shown that 60 percent of the risk for developing tooth decay is genetic and 40 percent is environmental.

For dentists, one of the benefits of getting a genetic history for each patient is knowing being aware of what signs to look for in the future. For example, if your family has a history of gum disease, your dentist may ask you to come in for a cleaning and fluoride treatment every four months instead of every six months as a preventative strategy.

How does genetics make a difference?

Saliva

The Caries Assessment and Risk Evaluation (CARE) test was created at the University of Southern California with funding by the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health. The CARE test measures sugar chains called oligosaccharides in a patient’s saliva, which also appear on teeth. These sugar chains are 100 percent genetically determined. “Bad” sugar chains promote tooth decay while “good” sugar chains actually repel the bacteria that causes cavities. Researchers were able to predict a child’s future cavity history within one cavity with more than 98 percent accuracy based on the CARE test.

Tooth Enamel

Your teeth have an outer covering called enamel which is the hardest tissue in the body. It protects your teeth from daily biting and chewing and acts as insulation against excessive temperatures. The structure of your tooth enamel is based on genetics. Unfortunately, any damage that occurs to tooth enamel is permanent– there is no way for it to repair itself. People with soft tooth enamel are more susceptible to tooth decay because it is easier for bacteria to invade the tooth.

Microbes

Plaque, the sticky layer that forms on teeth when they aren’t brushed, contains hundreds of microbe species. Some of these microbes are bacteria that feed on sugar and release acids on tooth enamel, causing cavities. Researchers have discovered that people with certain species of mouth bacteria have lots of cavities. These bacteria have a genetic link.

Taste

A taste study from the Monell Chemical Senses Center explored the genetics of tooth decay. It found some people have genes that allow them to taste certain flavors while others do not. For people who have the ability to perceive a wider variety of tastes, there appears to be a higher risk of tooth decay.

The Other 40 Percent

Of course, no matter what your genetic history, there is plenty you can do to protect your oral health. In addition to brushing and flossing, it is important to:

• not smoke
• eat a balanced diet
• avoid sugary drinks

In addition, you should see your dentist at least once every six months for a thorough cleaning and exam. Always schedule your appointments in advance because your dentist can book up quickly.