Dentistry/Genetics?

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Question
Dear Dr. Moss.

Thank you for this wonderful free service you offer!

I was wondering if there is a genetic aspect to caries (in addition to oral care and diet)? I am 29 years old and I have always taken excellent care of my teeth, including brushing and flossing at least twice a day, avoiding acidic, sugary and starchy foods and visiting the dentist every six months. Despite this, I have many deep fillings on the verge of needing root canals and I require a new or replacement filling at almost every check-up. My mother and one of my brothers (who also took great care of their own teeth) lost their teeth in their 30s (both due to extensive decay).

One of my other brothers, who is a couple of years older than I am, drinks three to five cans of soda daily, eats a lot of junk food and has a very acidic and sugary diet in general, and brushes his teeth only once or twice a week. He went to the dentist a couple of months ago (for the first time in over six years!) and he did not have a single cavity! The only cavities he has are two very small ones placed over ten years ago. I asked my dentist about this and he said genetics or 'luck' plays very little to no part in caries development, but I find this hard to understand.

My dentist says my brushing and flossing is fine, but I am really concerned about losing my own teeth, despite my very best efforts to take care of them.

Thank you for your response!

Answer
DEar Mathew,
I agree with you genetics does play a big part in susceptibility to caries.
However you will be surprised to learn that diet plays only a small role in people who are not susceptible.
In your own case  from your description, my feeling is that your problem is due more to your salivary production and flow patterns.  Either you are not producing enough , or for some reason their is a deficiency.  Hard to tell without examining you personally.
Flossing and brushing daily doesnt do much to help when you have that kind of condition.
The mineral for tooth repair comes from the saliva, not from the dentifrice.
Hope this helps a little, I am sorry you are having so many problems with your teeth.
All the best,
Dr. Moss

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Stephen J. Moss

Expertise

I am a professor emeritus at New York University, with a background that includes extensive research, scientific writing and biology. I also am an international consultant in health education, particularly in developing education on new science for health professionals and consumers. I am a past president of the American Academy of Pediatric Dentistry, former head of the NYU Division of Oral Biology and I represent the World Dental Federation at the United Nations. I travel around the world to provide health education to professionals and consumers.

Experience

Having retired from New York Universit, where I directed the pediatric dentistry training program, a walk-in dental clinic and research on oral biology, I formalized my professional and consumer health education initiative in the form of Health Education Enterprises. This entity consults and provides information on new science pertaining to oral and general health, particularly leading edge concepts that can be employed in the health professions to improve the public's health. As such, I am an expert in communicating new science and its usefulness to professional and lay audiences alike. I also had a pediatric dentistry practice in New York City for nearly 30 years.

Organizations
I am affiliated with the American Dental Association, the World Dental Federation, the International Association of Pediatric Dentistry and the American Association of Pediatric Dentistry among other formal organizations. My experience has included a research fellowship at the National Institutes of Health and work at the Forsythe Dental Research Center

Publications
lpha Omegan USA, Nowa Stomatologia Poland, Journal of Public Health Dentistry, The Journal of the Southeastern Society of Pediatric Dentistry USA, News Bulletin Japan, Journal of Marmara University Dental Faculty Turkey, Italian Journal of Paediatric Dentistry Italy, Asian Dentist Singapore, The Journal of the Israel Dental Association Israel, ROBRAC Brazil, Italian Journal of Paediatric Dentistry
Italy, FDI World, STOMA Portugal, Pediatric Dentistry The Philippines, Modern Stomatology Bulgaria, Journal of the Indian Society of Pedodontics and Preventive Dentistry India

Education/Credentials
I obtained a doctor of dental science (DDS) degree, a master of science degree and am a board certified pediatric dentist.

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