Modern Hygienist - February 2009 - (Page 24)

patients | GENETICS The DNA difference Understanding genetic risk factors behind periodontal disease. by Bill Landers One way or another, every aspect of periodontal disease comes down to genetics; from who gets it to how severe it is to whether it can ever be cured. It’s turning out to be so important that we’re going to have to change everything we thought we knew about periodontal disease, yet again. Back in the 1970s, most everyone thought calculus and plaque caused periodontal disease. Researchers were just beginning to suspect specific bacteria might be the actual culprits. It was another 10 years before the evidence became overwhelming, and it took another 20 years to change the clinical calculus paradigm to a bacterial infection paradigm—maybe longer. Some clinicians are still in denial. Now that most of us accept the idea that periodontal diseases are caused by bacteria, research is finding there’s a lot more to it than just which bacteria are present. It turns out periodontal diseases have much more in common with auto-immune medical diseases—such as multiple sclerosis, and rheumatoid arthritis—than a simple bacterial infection. The most striking new finding is that most of the damage to the periodontium is not caused by the bacteria! It is caused by the OraTec’s BANA Test is a highly sensitive, inexpensive, easyto-use chairside test for periodontal risk. In just 5 minutes, the test can detect bacteria associated with periodontal disease by applying tongue swabs or subgingival plaques to a test strip. Visit oratec.net. inflammation generated by our own immune systems. Our own white blood cells (WBC) do most of the damage to the tissue, not bacterial toxins. And what determines and governs immunological responses? Genetics. fact It is estimated that each person has between 50,000-100,000 genes. Source: Family Caregiver Alliance BACTERIAL GENETICS Bacterial genetics matter because not all bacteria provoke an inflammatory response. Some bacteria have particular proteins on their cell walls (antigens) that trigger our immune watchdogs. So, which bacteria patients harbor still matters. Of the 500 or so species that can live in the oral cavity, most are seemingly benign. A few dozen are capable of possessing antigens that provoke a strong immune response. When they multiply in a host (that would be us), special WBCs called T and B lymphocytes detect the antigens on the cell walls of pathogens and initiate an immunological chain reaction that eventually stimulates cells in the long bone marrow to produce millions of additional WBCs, mainly PMNs (polymorpho- Inﬂammatory Genes Interleukin-1 Production Normal Normal Interleukin-1 Inhibition IL-1 Receptor Antagonist Normal Abnormal Inhibition Effect No genetic abnormalities • IL-1 Production Normal • Inhibition Lacking • IL-1 Production Increased • Inhibition Normal • IL-1 Production Increased • Inhibition Lacking Abnormal Production Abnormal Production Normal Abnormal Inhibition 24 modernhygienist.com | February 2009 PHOTO: NOEL HENDRICKSON/GETTY IMAGES http://www.oratec.net http://www.modernhygienist.com

Table of Contents Feed for the Digital Edition of Modern Hygienist - February 2009

Modern Hygienist - February 2009 Contents Editor's Letter Letters News Modern Solutions Caring for Kids The DNA Difference A Healthy Perspective The Economic Impact on You How Single Moms Make it Work Ad Index Classified Economy 101

Modern Hygienist - February 2009

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