Community Dental Health

cover art

Cover Date:
September 2006
Print ISSN:
0265 539X
Vol:
23
Issue:
3

Editorial - Population Genomics and Dental Public Health

Background
Most clinicians are familiar with the child who in spite of poor oral hygiene, evidence of a diet rich in sugar and little exposure to fluoride remains caries free. In contrast, the young adult patient who maintains excellent oral hygiene, attends the dentist regularly and is highly motivated in terms of dental care, but still experiences significant destruction of their periodontal tissues is also encountered. These scenarios raise the fundamental question, to what extent is dental and oral disease governed by nature or by nurture? In other words, to what degree do genetic or environmental factors influence susceptibility to dental disease and conditions? In early 2006, the Faculty of Public Health in the United Kingdom held a one day conference entitled “Genomics and Population Health”. This event brought together geneticists, public health practitioners and government officials. The primary purpose of the meeting was to explore current developments in the field of genomics and to discuss their potential to impact on the health of the public. The emerging fields of genetic epidemiology and public health genomics have received little attention in dental circles. The purpose of this article is to provide a brief overview of developments in this area and consider their implications for dental public health. of the impact of human genome variation on population health and how genetic information can be used to improve health and prevent disease. Across the world a number of population cohort studies are underway to examine the effects of genetic variation on common traits. In the U.K., the Biobank Project will gather information on the health and lifestyles of 500,000 volunteers between 40 and 69 years of age. Following informed consent, each participant will be asked to donate a blood and urine sample, have some standard measurements (such as blood pressure) and complete a confidential lifestyle questionnaire. Over the next 20 to 30 years UK Biobank will allow researchers to use these resources to study the progression of illnesses such as cancer, heart disease, diabetes and Alzheimer’s disease; however, there are no plans to study dental or oral conditions at this time. In addition, six Genetic Knowledge Parks have been established in England and Wales as part of the Government’s strategy to put Britain at the leading edge of advances in genetic technology. The Genetics Knowledge Parks are all linked to multidisciplinary centres of excellence and offer access to internationally recognised academic and clinical expertise on genetics in relation to healthcare. The Network is building the knowledge base on all aspects of human genetics, ensuring that the National Health Service is better placed to exploit the findings of genetics research. What then is the relevance of these developments to dental and oral disease?

What is public health genomics?
Genomics is the study of genes and their function. A recent United States Centres for Disease Control and Prevention (CDC) sponsored committee has defined “public health genomics” as an emerging field, which assesses the impact of genes and their interaction with behaviour, diet and the environment on the population’s health (Hernandez, 2005). The sequencing of the human genome completed in 2003, provided for the first time, the blueprint for humankind and has raised the possibility of a much greater understanding of health and disease and their determinants. However, although the basic sequencing of the human genome is complete, many years of research and development lie ahead in determining the value and role of genomic information in the prevention and treatment of disease.

Genetics and oral disease
Genetic influence on disease broadly falls into one of two groups: Mendelian-inherited disorders, involving one (monogenic) or multiple (polygenic) genetic loci, and complex disorders involving the interaction of multiple genetic loci and environmental factors. Simple Mendelian disorders are characterised by a clinical phenotype that is highly correlated with the presence of a specific genotype, i.e. mutation, that alters or abolishes protein function so significantly that a “disease” phenotype results. Many syndromes have been described that include dental conditions as part of a complex pleiotropic phenotype. However, Mendelian non-syndromic dental conditions are generally inherited as single gene disorders and include for example, amelogenesis imperfecta, dentinogenesis imperfecta, tricho-dento-osseous syndrome and Papillon-Léfevre syndrome (Hart et al, 2000). Although of great impact to the affected patient and the clinician responsible for their care, from a public health perspective, the low prevalence of these conditions limit their significance. The common oral diseases that impose a substantial burden on society; dental caries,

Developments in public health genomics
The US Federal Government has established an Office of Genomics and Disease Prevention within CDC and established the Human Genome Epidemiology Network, or HuGENet™. This is a global collaboration of individuals and organizations committed to the assessment

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Articles from this issue

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  1. Caries prevalence of 11.5 year-olds between 1989 and 2001 in a province of North-Eastern Greece
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  1. Editorial - Population Genomics and Dental Public Health
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  1. Dental check-up frequency: preferences of Dutch patients
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  3. 139

  1. Dental health attitudes and behaviour among dental students in Jordan
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  1. Equity in children’s utilization of dental services: effect of a children’s dental care programme
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  1. The Japanese version of the Oral Health Impact Profile (OHIP) – validation among young and middle-aged adults
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  1. Abstracts - The 11th Annual Conference of The European Association of Dental Public Health
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