CARIES (tooth decay) has been one of the most common dental health conditions in the world, regardless of whether a nation is developed or developing.
Even with the advent of technological advancements, tooth decay is not a problem that affects one country, indicating that there are many factors involved.
A great deal of research has been carried out and it has been determined that tooth decay is, indeed, a multifactorial problem caused primarily by four main factors, namely: plaque, acid, bacteria (Streptococcus mutans) and sugar concurrently.
Obviously, environmental influences have an impact on the latter. However, where does genetics come into play?
Have you ever questioned why, despite having the exact same diet and dental hygiene practices, one person may be experiencing more tooth decay than others?
The genetic composition of an individual may provide the answer.
This is not to say that genetics can cause tooth decay, but rather that they can predispose an individual to it.
What does this mean?
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Differences in genetic constitution are the factor that causes inter-individual variations in susceptibility to tooth decay.
The genetics of dental caries enables health professionals to identify high risk groups as well as individuals who show resistance despite being hooked to tooth decay-causing diets.
Although genes are not directly involved in the reaction that occurs during the formation of caries, they, however, affect the process.
It is important to understand how caries develops so that we can comprehend how hereditary factors come into play.
How do caries develop?
The development of caries involves a process called demineralisation (which is the loss of minerals on the enamel) resulting in a compromised tooth structure.
The demineralisation of the enamel occurs because of the production of acid by the caries causing bacteria (Streptococcus mutans), which requires food debris (sugar) to ferment as well as plaque to adhere to teeth so that this process is not disrupted, so as to multiply rapidly since plaque can harbour a lot of bacteria.
For this process to successfully occur, there are other factors that are involved for example the salivary flow rate, buffering capacity (pH) which can be affected by the type of food we eat and the beverages we consume, localisation of the tooth in the mouth and surface properties of the teeth.
How do genetics come into the picture?
Genes can function as a risk or protective factor for caries.
Several genes can affect enamel resistance (tooth genes) and a different group can affect salivary content (saliva as a risk predictor), response to infection in the mouth (immune response) and taste preferences (taste genes) as well as dietary habits.
The question is how?
Tooth genes
During pregnancy, the development of a tooth starts as a thin membrane that eventually becomes a tooth.
Genes called ameloblastin, emalin, amelogenin and tufftelin mostly regulate this process genetically.
There are many processes that take place during the development of teeth in the uterus, but during amelogenesis (formation of the enamel) the calcification or mineralisation process is one of the longest and most significant.
It typically starts after 14 weeks of pregnancy and continues for years after that.
If this process is impacted by gene mutation during tooth formation, it may lead to a weaker tooth structure that is more vulnerable to cavities.
Weak, discoloured and decay-prone teeth are the result of a genetic condition called Amelogenesis Imperfecta, which affects the development of the tooth enamel.
Conversely, Dentinogenesis Imperfecta is a hereditary condition that affects the development of the tooth’s dentin, resulting in fragile, brittle and discoloured teeth.
Tooth decay is typically more common in people with these diseases than in others.
Saliva as a risk predictor
Saliva is composed of antimicrobial peptides or proteins (mucins, lactoferrin, antibodies, etc) which are also determined genetically.
These proteins and peptides can serve as a predicator of caries risk in children.
Saliva plays a significant role in preventing dental cavities because it enables the removal of dietary carbohydrates and germs from the mouth and, with the aid of these proteins, can prevent certain harmful micro-organisms from adhering to tooth surfaces.
The less saliva you have, the more likely you are to develop tooth decay, which is why it is recommended that you eat sugar-free gum after meals to promote salivary production and aid in clearance.
If a child’s genes are mutated or the process of these peptides is compromised during development, it may make them more vulnerable to dental cavities.
Immune response in the mouth
The mouth’s structure reflects its significant function in digestion.
Nonetheless, the mouth cavity is also a place of high immunological activity, where a lot of germs are initially encountered and combated.
A wide range of genetic changes impact the immune response and determine the colonisation of bacteria that cause tooth decay.
Taste genes
Did you know that taste is somehow genetically determined?
Genetic variety may contribute to considerable differences in sensory perception among people, including taste sensitivity.
Both central (in the brain) and peripheral (in the mouth) taste processing can be regulated by genes related to taste perception.
Both separately and together, glucose transporter genes and sweet taste receptors are linked to the risk of cavities.
This explains why some people have a higher craving for sweet foods, colloquially termed a “sweet tooth”.
A person who has a sweet tooth should pay closer attention to their oral hygiene regimen.
In conclusion genetics play a significant role in the susceptibility of an individual to caries, however it is not the cause of tooth decay.
Dental decay is significantly more influenced by environmental variables.
Therefore, you might want to take your oral health more seriously if you know that your family members may still have tooth decay issues despite frequent brushing of the teeth and a prudent diet choice.
You may add the following to your dental care regimen: using an electric toothbrush, flossing once daily, using mouthwashes, scraping your tongue and using tablets and solutions that detect plaque.
It is recommended that you brush your teeth for at least two minutes, but you can increase the time to three or four minutes.
This will drastically lower the chances of tooth decay.
Patience Matambo is a final year BSc Dental Surgery student at the People’s Friendship University of Russia. She can be reached at patiencedental2024@gmail.com
