Are your teeth doomed by your genetic makeup?

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'Doc, last night I dreamed all my teeth fell out!"

If you have had a dream of this genre you are not alone. Typically these dreams are about one's teeth crumbling, darkening or falling out.

These dreams are so common Sigmund Freud believed that when people dreamed about losing their teeth they were subconsciously afraid of aging (among other more disturbing notions).

Whether Freud was correct, many people in their middle years are concerned they may end up losing their teeth. Having seen their parents or grandparents struggle with uncomfortable or loose dentures, this generation is motivated to do whatever they can to preserve their natural teeth.

But they often have the question, "Can you inherit the tendency for eventual loss of teeth? Is it inevitable if your parents lost theirs?"

With the latest genetic DNA testing today's dentist can identify more precisely how likely tooth loss is. There are three broad categories of risk we can look at:

Genetic makeup -- We know we have inherited good and bad traits from our parents.

Our genetics determine how tall we are, the color of our hair, etc. They even make a difference in how susceptible we are to certain illnesses.

Your dentist can collect a sample of your saliva, (no needles involved), and a genetic test can be done to see whether you have the susceptibility for an exaggerated response to inflammation.

About 30 percent of the population has this genetic variation, which increases the chance of tooth loss by two to seven times. This is a reliable predictor of how someone's immune system will react to infection, and is a very accurate indicator of the probability of that person ending up losing their teeth -- especially in smokers.

Interestingly, this test is also a strong predictor of future problems with an individual's overall health, as this trait can affect how susceptible one is to heart disease, diabetes and other diseases that are related to inflammation.

Specific type and numbers of bacteria present in an individual's mouth -- A few nasty strains of bacteria trigger the majority of periodontal disease and eventual tooth loss.

Testing is done for 11 types of bacteria, including four very aggressive varieties, six moderately aggressive and one lower-risk bacterial type. These bacteria can be "caught" from a number of sources and will try to crowd out the approximately 500 strains of so called "friendly" bacteria that normally inhabit a healthy mouth.

When an individual picks up these aggressive bacteria, they start the process of destroying gum and bone support.

If there is poor nutrition, high stress, smoking or little or no oral hygiene, the process can progress very rapidly. Think trench-mouth.

Once harmful bacteria are identified your dentist may prescribe antibiotics or a specific mouth rinse to help you eradicate them. You may also need to be referred to a periodontist (gum specialist) if the condition is advanced or there are complicating factors.

Besides having more aggressive bacteria or increased genetic susceptibility, what other factors increase the chances of getting a new set of dentures?

A catch-all basket of habits, heredity, hormones and health issues.

The following is a list of important factors contributing to tooth loss. Current research places the first six as the most reliable predictors:

Heredity/family history

Medications

Smoking

Leaking dental restorations

Diabetes

Hormonal variations

Ethnicity

Suppressed immune system

History of periodontal disease

Exposure to aggressive bacteria

Poor oral hygiene

Poor nutrition

If worrying about your teeth is disturbing your sleep, ask your dentist to run the Oral DNA lab (www.oraldna.com) test. This will determine whether you have the genetic susceptibility for tooth loss and determine the variety of bacteria you may have come in contact with. Your dentist will also be happy to give advice on how to manage any other risk factors so you can enjoy your own teeth for life.

Sweet dreams.

Dr. Eric Gustavsen practices dentistry at Southpoint Dental Center, 1129 S. Second Ave. More information on his practice can be found at www.southpointdentalcenter.com.

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