Yes, genetics do count, even when it comes to periodontal disease! With a simple test we can now know if our patient will have an over expression of inflammation to the presence of pathogenic bacteria. And with this information we can personalize their treatment and maintenance accordingly.
The Perio Sensitivity Test (PST) is a one-time test that determines whether or not an individual is positive for Genotypes IL-1A and IL-1B.
In Caucasian populations the prevalence of the PST-positive genotype ranges from 30 to 40%, in some ethnic groups it may be even higher.
An individual who is “PST-positive” is at a 3-7 fold increased risk for severe periodontal disease. This genotype predisposes an individual to more severe periodontal disease, which may require more aggressive treatment.
It is also important to understand that whenever the PST-positive genotype is present, it is associated with an overproduction of IL-1, a cytokine that amplifies inflammation throughout the entire body, including the blood vessels. This exaggerated inflammatory response also places the patient at greater risk for cardiovascular disease and stroke.
Knowing your patient is PST+ can and should influence how we maintain this patient when it comes to disease remission. For example, let’s take a husband and wife scenario. Mr. and Mrs. will have a very similar pathogen report. This should not surprise us since they live and communicate very closely. But what if Mr. is PST+ and Mrs. is not? Although they share a similar pathogen count, Mr. is going to need a much more assertive intervention and maintenance plan due to his over expression of inflammation. He is at much greater risk of chronic inflammation, not only in his mouth, but in his entire body. He simply cannot afford to have ‘bad bugs’ in his pockets. Therefore he may need to be seen every 10 weeks, where Mrs. may be able to maintain disease remission with a 4-month interval.
Do genetics count? Absolutely! Remember, about 30% of the patients you treat carry this genetic marker. Understanding the implications of genetics is the next level in personalized periodontal treatment for your patient base. Inspired Hygiene offers a wide-array of coaching services, including implementation of salivary diagnostics/genetic testing. If you are interested in taking it to the next level, please contact us for more information at firstname.lastname@example.org or 877.237.7230.