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Science in the News

Genetic Testing Offered for Periodontitis Risk

December 20, 2016 A number of factors contribute to risk of periodontal disease, including age, smoking, diabetes, individuals’ own dental hygiene, as well as regular preventive care provided by dentists. Prevention of periodontal disease is a desirable goal in itself, and some studies suggest that this may also reduce risk of major systemic diseases such as diabetes.1

Interleukin Genetics, Inc. is marketing a genetic test they claim can predict periodontitis risk by testing for genetic polymorphisms predisposing individuals to an enhanced interleukin-1 (IL-1) mediated inflammatory response.2 Their genetic test, previously marketed as the PerioPredict® Genetic Risk Test, was rebranded and relaunched in November 2016 as the ILUSTRA™ Inflammation Management Program.3 The association between the marker measured in the test and increased risk of periodontal disease came from a retrospective study of insurance claims data published in 2013.4  In 2015, Diehl and colleagues reanalyzed the findings of this study and determined that patient IL-1 genotype did not improve prediction of periodontal disease risk.5

Individuals reported by the Ilustra™ Inflammation Management program to have the target IL-1 genotype will be given access to a patient engagement platform for 18 months that will provide them with messages that include appointment reminders, tips on dental self-care, and health tips.  The program is being promoted as means of identifying and improving management of inflammation.6

Diabetes is an example of another condition where specific self-care behaviors can improve health outcomes. A recent randomized trial found that providing people with information about their genetic risk of type 2 diabetes failed to elicit engagement in beneficial behavior change.7  Moreover, a recent systematic review examining the impact of Diabetes Self-Management Education (DSME) programs, which work with people to better enable them to engage in self-care behaviors to improve health outcomes, found that programs that involved more than 10 hours were significantly more successful in bringing about improvement in the measured health outcome than those of shorter duration.  Further, in DSME programs where the intervention was only provided remotely (i.e. did not involve any face-to-face encounter with a provider) no significant improvement in health outcome was observed.8

Interleukin Genetics is sponsoring a study (not yet recruiting patients) to assess whether knowledge of genetic risk for severe periodontal disease using their PerioPredict® genetic test (recently rebranded as ILUSTRA™) changes dental care behavior/engagement. The planned enrollment is 800 individuals and completion is expected in June 2018.9

References

  1. Simpson TC, Weldon JC, Worthington HV, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev 2015(11):CD004714.
  2. Ioannidis JP. Preventing tooth loss with biannual dental visits and genetic testing: does it work? J Am Dent Assoc 2015;146(3):141-3.
  3. Interleukin Genetics. Interleukin Genetics Launches the ILUSTRA™ Inflammation Management Program.  Accessed November 21, 2016.
  4. Giannobile WV, Braun TM, Caplis AK, et al. Patient stratification for preventive care in dentistry. J Dent Res 2013;92(8):694-701.
  5. Diehl SR, Kuo F, Hart TC. Interleukin 1 genetic tests provide no support for reduction of preventive dental care. J Am Dent Assoc 2015;146(3):164-73.e4.
  6. Interleukin Genetics. Interleukin Genetics Reports Third Quarter 2016 Financial Results; 2016.
  7. Godino JG, van Sluijs EM, Marteau TM, et al. Lifestyle Advice Combined with Personalized Estimates of Genetic or Phenotypic Risk of Type 2 Diabetes, and Objectively Measured Physical Activity: A Randomized Controlled Trial. PLoS Med 2016;13(11):e1002185.
  8. Chrvala CA, Sherr D, Lipman RD. Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control. Patient Educ Couns 2016;99(6):926-43.
  9. U.S. National Institutes of Health ClinicalTrials.gov: Dental Engagement Study Behavior Modification (NCT02749318). Accessed November 21, 2016.

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Science in the News is a service by the American Dental Association (ADA) to its members to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.

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