Open Wide (for personalized medicine and dentistry)

Some people fear the dentist and rarely go.  Others, like me, love going to the dentist and can’t wait for their next appointment.  Despite this, I recently had 2 cavities filled.  So what gives?  It’s no surprise that regular dental care helps prevent periodontal disease and cavities, but there must be other risk factors involved. 

Over $100 billion dollars a year are spent on dental care, 76% of this going towards preventative care.  The present model of prevention assumes all adults are at equal risk for dental disease and therefore should go biannually for treatment (aka the one-size-fits-all approach to dental medicine).  Yet, is it really necessary?

A new study published this month suggests that there is actually little evidence to support the twice a year treatment protocol and that instead, preventative dental care should be determined by a combination of genetic and conventional risk factors.  They stratified individuals at high and low risk of developing periodontal disease based on their diabetic and smoking status in combination with their interleukin-1 genotype (all known factors for developing periodontal disease), and then looked at tooth loss based on periodontal disease for those receiving cleanings once vs. twice a year.  They found in the low-risk individuals, one cleaning a year was just as good as two, whereas in the high-risk individuals, two cleanings a year were better than one.  More proof that personalized medicine, and in this case personalized dental medicine, will be the wave of the not-so-distant future.

-Dr. M