Monographs in Oral Science

When dental caries or erosive tooth wear lesions progress into dentin, the speed of their progression into the pulp will be modulated in part by the physiology of the dentin-pulp complex. In some individuals, this physiology allows for a quicker progression of the lesions. Research on the longevity of dental restorations has focused almost solely on the technical aspects needed to improve the adhesive properties and longevity of the restorations. Studying the possible individual variations in the quality of dental tissue may enable further developments targeting specific dental tissue phenotypes...

When dental caries or erosive tooth wear lesions progress into dentin, the speed of their progression into the pulp will be modulated in part by the quality of the dentin physiology of the tooth. Some individuals may have dentin that allows for quicker progression of lesions, and therefore being more susceptible to the formation of periapical lesions, or even being more prone to loss of extensive restorations. This chapter discusses the results of the initial studies exploring phenotypes that consider manifestations of deep caries or erosive lesions in dentin...

Dental caries is initiated by an unbalance between periods of demineralization and remineralization, and the consequence is localized loss of minerals right under the enamel surface of certain teeth that, if left to progress, may lead to irreversible loss of structure. One approach proposed to overcome the limitation of simply counting the number of teeth or surfaces affected by caries was to characterize the initial loss of minerals from the dental enamel in the laboratory as a way to phenotype individuals for genetic studies of dental caries or erosive tooth wear...

Dental caries is a bacteria-mediated disease that inherently triggers a response from the host. The impact of this response is discussed in this chapter with a focus on genes involved in either the innate or the adaptive immune system. Since erosive tooth wear involves losses of structure not mediated by bacteria, the impact of the immune system is likely neglectable.

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Behavioral change is one of the proposed interventions to address concerns regarding dental caries and erosive tooth wear. The impact of these interventions, however, is difficult to measure, and they are rarely considered in clinical studies. This chapter briefly discusses behavior having a genetic origin and describes several pathways that should be targeted for future studies.

The use of fluorides to address dental caries experience in populations was one of the biggest successes of public health in the twentieth century. The widespread use of fluorides also brought fluorosis to areas that otherwise would not be affected. This chapter briefly discusses the impact of fluorides on dental caries and amelogenesis and emphasizes the impact of fluorides on genes that are relevant to amelogenesis, dental caries, erosive tooth wear, and fluorosis.

A dietary pattern rich in refined sugars is associated with higher caries experience. However, people show differences in references for certain foods, and these differences are genetic in origin. In this chapter, dietary preference is the focus of the discussion of individual susceptibility to dental caries and erosive tooth wear.

Saliva interfaces with all oral tissues and modulates the development of dental caries or erosive tooth wear. Its mechanical function of coating all surfaces combined with the components in saliva modulates individual susceptibility to dental caries or erosive tooth wear. The effort to associate genes known to regulate saliva roles with dental caries experience has been carefully reviewed in the literature, and this chapter reflects on these studies from their conception standpoint, highlighting limitations in design, and adds a review to the work on erosive tooth wear...

The formation of the dental enamel is a consequence of a complex series of events and when disturbed, visible consequences ranging from hypoplasia to hypomineralization occur. Less dramatic alterations of the enamel structure and conformation are argued to modulate individual susceptibility to dental caries or erosive tooth wear. The effort to associate genes known to regulate dental enamel formation with dental caries experience has been carefully reviewed in the literature, and this chapter reflects on these studies from their conception standpoint, highlighting limitations in design, and adds a review to the work on erosive tooth wear...

Erosive tooth wear is the classic gene-environmental model. It requires the exposure to acids, typically from the diet or from the gastric content of the host, and shows variation among individuals and populations, which suggests it to be determined by more than one gene, each with small individual effects. This genetic component is not easily studied since a precise assessment of acidic exposure is complicated. In humans, this is commonly done by self-reported data. In this chapter, evidence is discussed that supports the assumption that a genetic component exists, inspecting data from wine tasters, and ex vivo experiments combining different dental enamel specimens and saliva compositions...

The study of twins is a powerful tool to infer the presence and amount of contribution of genetic variation to a particular trait or disease. The ability to compare identical or monozygotic twins with dizygotic twins permits the direct comparison of pairs of individuals that share 100% of their genomic DNA with pairs that share only 50%, with the assumption that these pairs are under the same environment. In the case of dental caries, the environment is same parents, under the same roof, with the same diet, oral hygiene habits, culture, and lifestyle...

Research in animal models, particularly rodents, has been used as a tool for gaining insight into the genetics contribution to dental caries. This chapter dissects some of these data, particularly the early studies motivated by observations in humans, complementing them with more recent ones designed specifically to map genes for dental caries. Finally, it offers a critical view of the rationale and lack of ethical principles of the use of nonhuman species in research.

The evidence for a genetic component to dental caries is in comparison much less explored in the literature than the other classically described components of the disease: microbiota and diet. Diet can be said to have been conclusively linked to the etiology of dental caries by the results of the Vipeholm study, which did not deal with any microbial aspect of the disease. What is much less emphasized is that these same results provided one of the most robust lines of evidence that exist in support of a genetic component to dental caries...

In humans, traits and diseases are inherited primarily by complex or multifactorial modes. These imply that contributions come from more than one gene, and these can be influenced by the environment. They are the mechanisms that underlie inheritance of dental caries, erosive tooth wear, and amelogenesis. Major gene effects (monogenic or Mendelian inheritance) and chromosomal abnormalities explain the scenarios that do not fit well with complex or multifactorial inheritance. Furthermore, there are numerous non-traditional modes of inheritance...

Mutations in several genes can lead to amelogenesis imperfecta. These same genes and other members of their pathways quite possibly may also contribute to individual susceptibility to dental caries and/or erosive tooth wear. This chapter provides an analysis of the function of the genes which, when mutated, cause amelogenesis imperfecta and discusses how mechanisms involving hypomorphic alleles in one or more genes, methylation changes, and imprinting disorders could be underlying individual susceptibility to dental caries and/or erosive tooth wear...

When analyzing the activity of antimicrobial agents, it should be considered that microorganisms mainly occur in biofilms. Data obtained for planktonic bacteria cannot be transferred non-critically to biofilms. Biofilm models should consider both the relevant microorganisms and the conditions present in the environment. The selection of the model depends on the question to be answered. In dentistry, single species, multispecies, or microcosms originating from saliva or dental biofilm are used to culture biofilms...

The intraoral biofilm requires mechanical removal due to its physical properties. When exposed to the biofilm, interdental areas need special devices to be used. The most effective ones and the first choice are interdental brushes. However, they may not be adequate in the case of very narrow interdental spaces. Despite the difficulties in handling, dental floss may have some advantage in subgingival cleaning. Data are present for gingivitis and periodontitis, but almost no information has been published on gingivally healthy individuals...

In reality, most microorganisms are not free floating. They exist in biofilms, a community of many of them from the same species or from other genera and attached to surfaces.Microorganisms undergo a transition from free-floating, planktonic microorganisms to a sessile, surface-attached one. Contact with a surface induces changes in gene expression, and a strong attachment of microcolonies occurs only after a few hours. The maturation of a biofilm is associated with matrix formation. The matrix is of importance as it provides stability and protects against environmental insults, it consists of polysaccharides, water, lipids, proteins, and extracellular DNA...

The goal of modern periodontal therapy, both during the initial stages and during maintenance, is to create biologically acceptable tooth surfaces through sub- and supragingival cleaning, which enables binding of the connective tissue to the greatest extent possible. In past centuries, the focus of periodontal treatment was on the removal of the supposed cause of periodontal disease, the supra- and supragingival calculus and "infected" root cementum. The findings on the importance of biofilm<A51_FootRef>1</A51_FootRef> (plaque) and the endogenous responses to biofilm metabolism have shifted the therapeutic focus to elimination of the biofilm...