Abstract
To identify whether periodontal traits derived from electronic dental records are biologically informative and heritable. The study included 11,974 adult twins (aged 30-92years) in the Swedish Twin Registry. Periodontal records from dental examinations were retrieved from a national register and used to derive continuous measures of periodontal health. A latent class approach was used to derive categorial measures of periodontal status. The correlation patterns in these traits were contrasted in monozygotic and dizygotic twin pairs using quantitative genetic models to estimate the heritability of the traits. For continuous traits, heritability estimates ranged between 41.5% and 48.3% with the highest estimates for number of missing tooth surfaces and rate of change in number of deep periodontal pockets (≥6mm). For categorial traits, the latent class approach identified three classes (good periodontal health, mild periodontitis signs and severe signs of periodontitis) and there was a clear difference in the hazard for subsequent tooth loss between these three classes. Despite this, the class allocations were only slightly more heritable than a conventional dichotomous disease definition (45.2% vs. 42.6%). Periodontitis is a moderately heritable disease. Quantitative periodontal traits derived from electronic records are an attractive target for future genetic association studies.
Highlights
Gum inflammation, a common reversible condition, is caused by tooth-associated bacteria which initiate an inflammatory response leading to host defence cell activation
Heritable contributions to periodontal disease have been explored in animal studies, twin-, family- and genome-wide association (GWA) studies in humans
Class III included under 10% of the population with more severe and generalized signs of periodontitis and higher levels of tooth loss
Summary
A common reversible condition, is caused by tooth-associated bacteria which initiate an inflammatory response leading to host defence cell activation. Heritable contributions to periodontal disease have been explored in animal studies, twin-, family- and genome-wide association (GWA) studies in humans. Two recent meta-analyses support a heritable contribution to periodontitis (Nibali et al, 2019; Nibali et al, 2020), albeit with considerable variation between and within studies. Heritable factors explained around 15% of periodontitis variance in family studies, 38% in twin studies and 7% in GWA studies (Nibali et al, 2019) and 43% in experimental animal studies (Nibali et al, 2020). There is no large-scale twin study employing clinically assessed periodontal data
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