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GENE DEFECTS ARE BLAMED FOR GUM DISEASE.

A DRAMATIC breakthrough by scientists may spell the end of gum disease.

A US research team have identified a single gene which they think is at the root of the problem.

They say gum disease is caused when the gene is defective and if it can be cured, dentists may become virtually redundant within the next few decades.

Until now, regular brushing and avoiding sugary food and drink have been the key to dental health.

However, future generations could find themselves relying just as much on genetic treatment, according to the Journal of Medical Genetics.

It reports how scientists carried out some detailed detective work before blaming gum disease on a gene for the enzyme cathepsin C.

Cathepsin C, which is found in skin and bone cells, triggers several of the chemicals which control the body's immune responses.

The investigation got under way last year when a team of researchers discovered mutations in that one gene were responsible for a condition known as Papillon-Lefevre syndrome.

It causes sufferers to experience scaly, warty thickening of the skin, principally on the hands and soles of the feet.

The disease also erodes the soft tissues lining the mouth and causes an inflammation of the gums called gingivitis.

Scientists have now discovered that different mutations of the same gene are responsible for the gum disorder called prepubertal periodontitis.

This is a rare but rapidly progressive gum disease which affects up to two per cent of young children.

The breakthrough came after researchers studied 14 members of an extended family in Jordan.

Four of the children were found to have gum disease and extensive bone loss - and they also had mutations in both copies of their cathepsin genes.

All four parents and two other children carried one copy of the mutated gene and one copy of the normal cathepsin gene - a factor which seemed to protect them from developing severe gum disorders.

Doctors say this suggests normal functioning of the cathepsin C gene is needed for healthy gums.

He added: "Smoking and bacterial infections are thought to have a major role in both initiating and speeding its development.

"But genes are the crucial factor which decide who develops severe gum disease."

And Bruce Baum, of the American National Institute of Dental and Craniofacial Research, said dentists were the health professionals most likely to eliminate the need for themselves by the end of this century.

He said: "In the next 100 years, there will be a dramatic worldwide reduction in the common dental diseases that have been a source of pain and misery to people throughout history."

However, the immediate future is bleak and experts say Scots will face an epidemic of oral disease over the next 20 years.

Men over 40 are most at risk, with alcohol and smoking the main enemies.

A particular worry is oral cancer, which kills 2000 people every year in the UK - and that figure is rising.

However, a survey in the British Dental Journal, says only 56 per cent of the population know what oral cancer is about.

That compares with 86 per cent for cervical cancer, 96 per cent for skin cancer and 97 per cent for lung cancer.

Iain Hutchison, of the British Association of Oral and Maxillofacial Surgeons, said: "The tragedy with oral cancer is that it is readily visible to patients when they look in the mirror, but most have never heard of the possibility of cancer appearing in the mouth.

"This means they do not seek professional advice for long periods until the cancer has grown in size."

Typically, 95 per cent of all oral cancer cases in Britain occur in people aged over 40.

The average five-year survival rate of patients with oral cancer is 50 per cent - that compares with 90 per cent for prostrate cancer.
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Author:McLEAN, JIM
Publication:Daily Record (Glasgow, Scotland)
Date:Feb 17, 2000
Words:634
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