Understanding the Role of Genetics in Periodontitis by Dr Ranu Acharya

We are excited to announce the addition of a highly skilled periodontist to our practice. This new specialist brings a wealth of knowledge and expertise, particularly in understanding the complexities of periodontitis, a multifactorial disease resulting in the destruction of supporting tissues around the teeth.

Is Periodontitis a Genetic Disease?

There is a common misconception that periodontitis is solely a genetic disease. However, periodontitis is better described as a phenotype variance in presentation across different population sets. While genetics play a role as a modifying risk factor, it is not the sole cause of the disease.

Genetic and Non-Genetic Factors in Periodontitis

Complex diseases like periodontitis involve an interplay between genetic and non-genetic factors. Certain genetic mutations, such as those seen in Papillon-Lefevre Syndrome, can lead to severe forms of periodontitis. However, for most people, periodontitis is influenced more by factors like oral microbiota, smoking habits, and oral hygiene, rather than a single genetic defect.

Assessing Genetic Influence in Clinical Practice

Determining a genetic influence on periodontitis during routine clinical practice can be challenging. Without genetic tests, clinicians rely on family history, radiographic bone loss assessments, and patient histories of early tooth loss due to periodontal reasons. These methods, although indirect, help identify patients who might be at higher risk due to genetic susceptibility.

Treatment Planning for Periodontitis

Effective treatment plans for periodontitis involve several phases:

1. Initial Phase Therapy: Removal of biofilm deposits.
2. Corrective Phase: Surgical or prosthetic interventions as needed.
3. Maintenance Protocol: Tailored to the patient’s presentation based on the Periodontal Risk Assessment (PRA).

The PRA, as initially suggested by Lang & Tonetti in 2003, included the IL-1 genotype as a risk factor. However, later studies have shown that IL-1 genotype has a limited association with periodontitis risk.

Periodontitis is a multifactorial disease caused by a combination of oral microbiota, patient habits, and genetic susceptibility. While genetics is not an etiologic factor, it is a significant modifying risk factor. In the future, advancements in genetic testing could lead to more personalised diagnosis and treatment, potentially identifying at-risk individuals before the onset of chronic periodontitis. This progress would greatly enhance preventive care and optimise healthcare resources.

We look forward to our new specialist contributing to the advanced care and understanding of periodontal diseases within our practice.