What if I told you that no matter how frequently you brushed and flossed your teeth, you might still be at high risk for developing dental decay and gum disease? For some people this is the case. On the other hand, there are people who are not very consistent or thorough with oral hygiene, yet they never seem to have cavities or gum issues. How is this possible? A growing body of evidence indicates a link between genetics and susceptibility to oral disease. In order to explain how genetics plays a role in oral health, let’s first take a look at how genes work altogether.
Genes consist of DNA that codes for specific traits in humans. A unique set of genes are passed down from parents to offspring, creating unique individuals despite sharing DNA similarities with our parents. For example, there are specific genes that code for eye color, so an individual can express eyes of blue, green, or brown depending on their inherited genes for eye color.
Studies have shown that genes may influence the following oral health factors:
According to some research, the genes that increase risk for oral diseases, just like the genes for eye color, are familial (passed from parents to children). Children with high rates of dental caries often have one or more parents with similar problems and tend to have siblings with tooth decay.
Knowing your inherent risk for dental disease is important in developing your oral hygiene routine and can help your dentists provide individualized care for you and your family. As dental practitioners, understanding the role of genetics helps us focus more attention on preventative measures for patients who are more susceptible to developing oral disease.
Perhaps you've seen the warnings on medication bottles - do not consume alcohol with this medication or avoid grapefruit juice when taking this drug. Are you aware of the numerous combinations of food and drugs to avoid? Many common foods interact with drugs by either increasing their absorption or interfering with their mechanism of action. Here are some foods that often interact with medications.
Green leafy vegetables, which are high in vitamin K, can decrease the ability of blood-thinners to prevent clotting. Blood-thinning drugs such as Coumadin® (warfarin) interfere with vitamin K-dependent clotting factors. It is not necessary to avoid greens altogether, but problems arise from significantly and suddenly increasing or decreasing intake, as it can alter the effectiveness of the medicine.
Grapefruit juice increases the absorption of several drugs, for example cholesterol-lowering statins, so it is recommended to avoid grapefruit when taking statins. Unlike other citrus juices, grapefruit contains furanocoumarins, a class of compounds that alter characteristics of medications. Thus, grapefruit juice can cause the body to metabolize drugs abnormally, resulting in lower or higher than normal blood levels of the drug. Many medications are affected in this way, including antihistamines, blood pressure drugs, thyroid replacement drugs, oral contraceptives, stomach acid-blocking drugs, and the cough suppressant dextromethorphan. It's best to avoid or significantly reduce intake of grapefruit juice when taking these medications.
Glycyrrhiza, a natural ingredient used to make black licorice, can deplete the body's potassium while causing an increased retention of sodium. With potassium depletion, the activity of the heart failure medication digoxin, can be greatly enhanced, resulting in an abnormal heartbeat. Glycyrrhiza also can decrease the effectiveness of high blood pressure medicines and can break down warfarin, causing an increase in the body's clotting mechanism. Excessive amounts of natural licorice should be avoided when taking all of these medications. However, artificially-flavored black licorice is not a concern because it doesn't contain glycyrrhiza.
Salt substitutes typically replace sodium with potassium, and the increased intake of potassium can reduce the effectiveness of digoxin, resulting in heart failure. Additionally, ACE inhibitors might cause a significant increase in blood potassium levels, as these drugs are known to increase potassium.
Tyramine is an amino acid found in chocolate, aged cheese, smoked meats, fermented soy, and draft beers. Several medications interfere with the breakdown of tyramine, including monoamine oxidase inhibitors used to treat depression and drugs used to treat the symptoms of Parkinson's disease.
Always read drug warning labels and ask your physician or pharmacist about which foods or other drugs you should avoid when receiving a prescription for a new medication or trying a new over-the-counter drug.
As dentists, it’s our job to teach our patients the importance of daily brushing and flossing, in order to prevent the formation of dental decay and periodontal disease. However, to truly appreciate the benefits of oral hygiene, it’s important to understand the challenges we face as we go into daily battle with our toothbrush and floss.
Who is enemy number one? ORAL BACTERIA!
It’s estimated that at any given time, our mouth has a total of 20 billion oral microbes (bacteria), made up of at least 800 different species. The ability of specific bacteria to cause dental diseases is largely dependent on the environmental conditions found in the mouth, much of which can be controlled by our oral hygiene and what we eat. An important characteristic of pathogenic bacteria is the ability to create a biofilm, also known as plaque. Adhesion properties in bacteria are key to establishing communities and three-dimensional structures in plaque that are difficult to remove. Sugar provides the key fuel for bacteria’s ability to achieve strong adhesion. Once established, bacterial plaque will continue to multiply and grow.
Dental decay is a direct result of bacteria that release acid, and periodontal disease is associated with an over-accumulation of different species of bacteria. In either case, the destructive bacteria reaches a point where it dominates the good bacteria and infiltrates in such a way that causes destruction of the hard and soft tissues of the mouth.
With an understanding of how bacteria leads to disease, we can better equip our mouths to fight these organisms by: