Have you ever had patients tell you they inherited their poor oral health? Numerous studies have shown oral genetics influence the composition of oral bacteria. The oral microbiome includes over 600 different microorganisms, and of the 91 most common bacteria, roughly half show heritability, with some more likely than others to determine oral colonization1.   

In a study published just a few months ago, researchers found that while the oral microbiome (biofilm) in children is influenced by both genetics and environmental factors, the genetic influence on oral microbes diminishes with age, along with its effect on mitigating the development of cariogenic bacteria.2 

genetics of oral health

Evidence has supported the concept that caries formation is multifactorial in both children and adults, and occurs when specific bacteria in the mouth metabolize sugars, resulting in increased acidity and tooth demineralization.3 In adults, a specific bacterial etiology can cause an inflammatory response, which can then lead to the destruction of periodontal tissue, formation of pockets, and eventual tooth loss.4 

The role of genetics in the composition of human saliva is becoming more well-known, with genomic variations influencing the number and composition of bacteria in saliva and mucosal surfaces. Unfortunately, the study of genomics and oral disease is young, and more research is needed to pinpoint when, how and why genetics can influence oral health. 

So, how can we use this information in our practice? The microbial bionetwork of dental caries may be highly individualized with changes throughout our patients’ lifespan. This produces multiple opportunities for preventative interventions at all stages of life. 

Since genetics can play a role in oral health, having a complete oral history which includes that of the immediate family could identify those patients most at risk. The modulation of environmental contributions and use of pH-neutralizing techniques may be key factors in controlling the proliferation of cariogenic microbes and improving the prevention, diagnosis, and treatment of caries and other oral diseases.3

Educating your patients on the negative influence of a diet high in sugar products, untreated gastric reflux, smoking, excessive alcohol intake and other health-related problems can help to mitigate potential changes leading to oral disease.

As research into how biomarkers change over a person’s life continues, we may soon have a way to predict when during their lifespan patients are most susceptible to the development of caries, periodontal disease, and other oral health conditions, and can intervene before any damage occurs. Exciting stuff.


  1. Davenport, E. R. (2017). Tooth be told, genetics influence oral microbes. Cell Host & Microbe, 22, 251-252.
  2. Gomez, A., Espinoza, J. L., Harkins, D. M., Leong, P., Saffery, R., Bochmann, M., … & Nelson, K. E. (2017). Host genetic control of the oral microbiome in health and disease. Cell Host & Microbe, 22, 269-278. https://doi.org/10.1016/j.chom.2017.08.013
  3. Takahashi, N., and Nyvad, B. (2011). The role of bacteria in the caries process: Ecological perspectives.  Journal of Dental Research, 90, 294-303. https://doi.org/10.1177/0022034510379602
  4. Stone, V. N., & Xu, P. (2017). Targeted antimicrobial therapy in the microbiome era. Molecular Oral Microbiology, August 1. Advanced online publication. https://doi.org/ 10.1111/omi.12190