Genotype and clinical management of periodontitis.

An increased level of interleukin-1 (IL-1) is a risk factor to adult periodontitis. The clinical significance of the initial finding that some people may have a genetic predisposition causing them to produce larger amounts of IL-1 in response to dental plaque has been clarified by numerous studies. While it appears that genotype-positive patients are at increased risk of severe periodontitis, genotype-negative patients must be carefully monitored because they are still at normal risk for the onset and progression of periodontitis. By knowing about the patient's genetic susceptibility, clinicians can modify their treatment plans to be either more or less aggressive. Genetic susceptibility determination should be part of a comprehensive examination, history, and risk-assessment evaluation for all but the few patients who are extremely compliant with their personal oral hygiene and periodontal maintenance schedule.