Dentistry: A New Nexus for Precision Medicine

UCSF faculty

Aleksandar Rajkovic, MD, PhD (left); Michael Reddy, DMD, DMSc; Amy Murtha, MD; and Laura Jelliffe-Pawlowski, PhD, exploring synergies at the Precision Medicine World Conference. Photo by Barbara Ries

The match of dentistry and precision medicine may not seem intuitive, but there is more synergy in their engagement than meets the eye.

At this year’s Precision Medicine World Conference (PMWC), two UCSF faculty from the School of Dentistry presented work that stradles the spectrum of precision medicine research. Ophir Klein, MD, PhD, professor and chief of the Divisions of Medical Genetics and Craniofacial Anomalies, discussed how the power of stem cells can be harnessed to treat human disease. On the clinical end, Michael Reddy, DMD, DMSc, the dean of UCSF’s School of Dentistry, focused on the possible connection between inflammation of the gums and an epigenetic risk for preterm birth.

It is widely known that pregnant women tend to have more inflammation of the gums. What Reddy investigated in two recent studies was the possibility of a two-way street: that the inflammation, in turn, might influence pregnancy outcomes. He conducted a multicenter study of women at high risk, who were supplied with “smart” toothbrushes and given dental hygiene instructions, along with regular reminders. The study showed a significant reduction in preterm births.

These findings, according to Reddy, raise the question whether the mechanism behind the improved outcome is genetic, epigenetic, or strictly a result of the social intervention. Was there a transmittable, biological disease that affected pregnancy?

Part of Reddy’s interest in attending PMWC 2020 was to find potential collaborators with a high level of technological expertise to dig deeper into the precise mechanism of the inflammation. This investigation would include using samples of oral microbiome, blood, umbilical cord, and placenta to search for genes that are activated or inactivated. Other analysis might include bacteria, as well as inflammatory mediators, along with social determinants of health. Could a precision medicine approach lead to a targeted intervention?

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