I am a third year at NYU and currently enrolled in an elective known as Precision Medicine: Salivary Diagnostics and Genomics, a class that has truly opened my eyes. The way we practice dentistry is going to be vastly different and I can’t help but be excited for what’s to come!
In today’s age, modern medicine is making leaps and strides in the ability to properly diagnose and treat patients. Recently, the American Academy of Periodontics developed a classification system to better individualize the disease and the severity of it to which the patient is experiencing. Included in the classification system are four biomarkers that can be measured. Being that periodontal disease is the most common cause of tooth loss in the world and more than 50% of Americans suffer from this disease, it is crucial that we better understand the process and how to continually improve treatment and prevention for this condition.
Periodontal disease is associated with many major systemic conditions, such as diabetes, cardiovascular disease, and others. Currently, we are able to diagnose periodontal disease radiographically by observing any bone loss, as well as subgingival calculus accumulation. We can also clinically diagnose by observing pocket depth, gingival margin, mobility, furcation involvement, bleeding, and plaque accumulation. However, anyone can be born with a predisposition to periodontal disease. Presence of certain genetic factors, as well as certain bacterial factors, can be tested for in order to better understand which patients are more likely to develop the disease. The biomarker most highly associated with periodontal disease is IL-1, typically on chromosome 2. Today, there is a test available called PerioPredict, which detects the IL-1B gene. There are also bacterial components, referred to as Initiator Biomarkers. The most commonly found biomarkers are referred to as the “Red Complex”, compromised of Treponema denticola, Tannerella forsythia, and Porphyromonas gingivalis. Along with the IL-1 biomarker, there are other Host Inflammatory Response Biomarkers, such as IL-6, MMP-8, and MMP-9.
Therefore, with this knowledge, it becomes clear that we have the capability to truly help our patients with valuable preventative care and treatment as needed. An ideal biomarker panel will help guide in choosing an intervention that is both timely and appropriate in magnitude. An exam such as the one mentioned above can be done chairside with a simple saliva sample taken on a cotton swab. These are the kinds of improvements that our profession is striding toward and will help provide everyone’s patients with their own unique treatment that best suits their personal needs, and I, personally, truly look forward to providing my patients with this level of care.
Blog Contributor: Allison Rascon, NYU '20
Dental Economics Club, Secretary
Alumni Affairs, Representative
Class Council 2020, Member