Dentists, physicians of the oral cavity have an increasing responsibility for the overall health of their patients. The relationship between diabetes and oral health; heart disease and oral health; sleep apnea and oral health; is only the beginning of the professions growing connection with human health. Dentists are one of the few physicians that actually look inside the body and the oral tissues. Dentists are often the first to diagnose airway problems in children, sleep apnea, high blood pressure, ……………… (See pathology book)
The radiographs we take can be extremely valuable in diagnosing sinus ………………………….. (See pathology book)
The genetic makeup of saliva may prove to develop into a primary diagnostic tool in the future. In many ways we improve the quality of our patients lives by correcting growth and development disorders, cosmetic dentistry, pain relief and improving the ability to enjoy and eat food.
Dental schools and dental research have given the profession excellent roots into the biology of oral health. The challenge for the future may be very similar to what we have been taught in the past. The interaction between genetics, cell and molecular biology and how the human body functions and heals it self are even more important today. Materials and implant science are acceleration our clinical procedures and expanding bio-mechanics and bio-engineering principles.
Dentists must not loose sight of the biological solutions and applications to oral health problems. Occlusion is a biological function and is subject to the terms, conditions and requirements of the human body.
A biologic occlusion has five sub categories and every concept of occlusion must satisfy all five components.
BIO-GENETICS
BIO-CHEMISTRY
BIO-RESISTANCE
BIO-MECHANICS
BIO-ENGINEERING
Sometimes the best way to solve a problem is simply to ask the right questions. Dr. Major Ash ……………..
Bio-Genetics (volume 14, number 2, 2004)
The Oral Care Report sponsored by Colgate and edited by the Harvard School of Dental Medicine states: “The unraveling of genomic information provides a basis for detailed studies of molecular mechanisms involved in oral, dental, and craniofacial disorders, and opens vast opportunities for changing the face of dental practice.”
Most diseases have a genetic component and oral disorders can have a single gene mutation or a complex multiple genetic interaction. Examples of a single gene mutation include Hereditary Gingival Fibromatosis (slow progressive benign enlargement of gingival tissues.), Amelgensis Imperfecta (defective enamel) and Dentin Dysplasia.
More common disorders are caused by a complex interplay between multiple genetic and environmental factors. Dental disorders include cleft lip and palate, congenitally missing teeth, dental caries, periodontal diseases, head and neck cancers and autoimmune disorders.
In the future, genetic testing may become a routine part of dental practice. Genetic testing can state whether a genetic variation associated with a disease is present or absent in an individual and also provide a measure of disease susceptibility. “As we develop a more refined understanding of how genetic, environmental, and behavioral factors interact in the etiology of common diseases, genetic testing is expected to become a useful tool for the design of individualized treatment and prevention plans.”
Bio-Chemistry
As dentists, we know the bio-chemistry of the oral cavity because our dental school education focused heavy on the subject. The bio-chemistry of caries and periodontal disease are the foundation for many of the procedures we perform on a daily basis. Prevention of decay, soft tissue and osseous bone destruction are all predicated in changing the bio-chemical environment. Home care instruction, fluoride treatment, toothpaste mouth rinses, (prescription and over the counter) and even dental floss change the oral environment form a pathologic biochemistry to a more neutral physiologic condition.