One third of the population have a genetic tendancy to develop periodontal disease. Many people are born with a “sensitivity” to plaque bacteria. One could describe it as an “allergy”. For these individuals plaque bacteria causes inflammation on contact, triggering the immune system to go into hyperdrive.  This hyper-inflammatory response creates an overproduction of harmful enzymes, allowing chronic periodontal destruction to ensue.  A simple genetic test called PST can be performed. 

The PST Genetic Test identifies patients genetically predisposed to severe periodontal disease. Early detection of patients at increased risk facilitates prevention/early intervention efforts. For those patients already affected with periodontal disease, the PST Genetic Test assists a clinician in creating a personalized treatment plan. The information gained from this test can be useful for all dental professionals and their patients.

The PST Genetic Test detects specific variations in the interleukin-1A and interleukin-1B genes. The presence of these variations (a PST-positive result) increases the risk for periodontal disease 3 to 7-fold and for tooth loss 3-fold. The combination of a PST-positive test result and smoking leads to an even greater likelihood for severe periodontal disease and early tooth loss.  www.kimballgenetics.com
For more information on genetics and periodontal disease go to these sites:

www.perio.org
www.dentistry.com
www.umm.edu

The good news is that advanced technologies will now allow us to alter the usually predictably poor outcome of genetic periodontal disease. Host factors, such as genetics, must be addressed to effectively put periodontal disease into remission. No longer will only cutting the pockets out with gum surgery, or only doing perioscopy, be the entire solution for many individuals.  A synergistic approach must be incorporated involving addressing the hyper-inflammatory response. 

Individuals with a genetic predisposition must be identified before anything we do clinically will be successful long term. These individuals over-produce destructive enzymes four fold, which causes severe destruction of the periodontium. The chronic nature of this disease can fool even the most astute clinician. Damage to the periodontium can occur quickly or slowly, therefore, preventative care becomes crucial.

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