Factors affecting periodontal disease
There are five risk factors for the development of periodontal disease. They include:
1. Genetic predisposition
2. The presence of a subgingival bacterial biofilm on the surface of the tooth root and epithelial shell
3. Lifestyle risk factors such as smoking and poor oral hygiene
4. Systemic diseases
5. Various factors, including both tooth-related and random (stochastic) factors, occlusal/functional programs, iatrogenic aspects, etc.
The degree of skin influence of these five factors depends on the individual patient and the situation.
Genetic predisposition
Since periodontitis is relatively rare before the age of 35, the earlier periodontitis occurs, the more likely it is that the disease is linked to genetic factors. Conversely, the later the disease first manifests itself, the smaller the contribution of genetic predisposition to the development and progression of periodontitis.
People with a genetic predisposition to the development of periodontitis have expression (expression) of genes that affect how quickly and strongly the immune system reacts to the presence of potentially harmful bacteria on the soft tissues of the gums and arteries. The more reactive the inflammatory response, the sooner symptoms and harmful effects of periodontal disease can occur.
How genetics affects periodontal disease
In the course of studies of the influence of various genes associated with periodontitis, in addition to selected genes that affect the development of periodontitis, it was found that several genes affect not only the development of periodontitis, but also the development of other chronic inflammatory diseases, for example, atherosclerotic cardiovascular diseases.
In other words, in the presence of similar cardiovascular diseases or diabetes, there is also a high risk of developing periodontal diseases, since there is a possibility of the manifestation of an abnormal (aberrant) inflammatory reaction associated with both conditions.
This aberrant reaction affects how quickly and severely the human body has an inflammatory response to bacteria, regardless of whether the affected area is in the gums or in the arteries. The more severe the inflammatory reaction to bacteria, the higher the probability of developing periodontal disease.
In addition to genetics, the most likely role is played by epigenetics - that is, the modification of genes under the influence of the environment. For example, epigenetic changes can be caused by aging, systemic diseases, microbial composition, lifestyle, etc. These changes can lead to increased susceptibility to periodontal diseases.
Thus, patients with a genetic predisposition to a rapid or severe inflammatory response to bacteria may be at greater risk for periodontal disease and various other atherosclerotic diseases.
What this means for your patients
The younger the periodontitis develops, the more likely it is that genetics played a significant role in the disease. However, even in these cases, it should be remembered that genetics is only one of the five main risk factors that determine susceptibility to periodontal disease. The most significant factor that can be influenced most easily is compliance with the rules of oral hygiene.
Not only should oral hygiene be considered the best way to prevent periodontal disease, but if there is a possibility that there may be a genetic predisposition to the development of periodontal disease, oral hygiene should be given even greater priority.
For those who believe they may have a genetic predisposition to periodontitis, it is important to emphasize that the development of periodontal disease is never a "predicted" outcome, regardless of the predisposition.
Everyone can significantly reduce the risk of periodontal disease by practicing regular, effective oral health rituals.
On our website, we offer a wide range of products that help everyone maintain the health of their mouth and body.
Read more about how genetics influences periodontal disease here