Personalized Dentistry Meets OMICS and “One Health”: From Cinderella of Healthcare to Mainstream?

Introduction

O MICS: A Journal of Integrative Biology has pioneered and accelerated varying strands of novel scholarship in life sciences and biotechnology for over a decade. Identifying and integrating the biological, social, and political determinants of health, not to mention the gaps between the knowledge silos that pertain to postgenomics diagnostics and therapeutics, are among the salient objectives of the journal, which now serves a global readership in 170 countries (Özdemir, 2013). In this editorial, we highlight one longstanding gap and observe some insights across the omics landscape that can help elide the gap.

From Oral Health to One Health

Oral health is vital to general medical health (and vice versa) but remains the Cinderella of healthcare. To end the history of this unjustifiably neglected branch of health, there must be greater integration between medical and dental life science scholarship towards “one health”.

“One health” is a rapidly emerging concept in 21^st century medicine that views human, environmental, plant, microbial, ecosystem, and planet health in a holistic manner. No doubt, these diverse strands of scientific lore are more relevant and interdependent today than we have come to believe in the past. But within the human health domain itself, oral health and medicine have been sadly separated for time immemorial, and still we have seen relatively little effort to integrate the two.

To be sure, some hints of progress are evident. For instance, the need for an intersection of omics and dentistry research has been highlighted in a recent article in this journal. Gürsoy et al. (2014) carried out in silico modeling combined with in vivo validation of estradiol-modulated inflammatory biomarkers in pregnancy-induced gingivitis. Pregnancy-associated gingivitis is a bacterial infection-induced inflammatory disease affecting the gingiva and is extremely common, occurring in about 35% to nearly all pregnant women. Elevated female sex hormone concentrations in pregnant women seem to relate to enhanced susceptibility for gingival inflammation. To date, virtually no personalized biomarker-guided routine treatment is available for treatment of periodontal diseases. Personalized dentistry and development of oral disease susceptibility/prognosis biomarkers are directly related to the aims of omics and system sciences. Discovery and development of new salivary biomarkers with the aid of omics biotechnologies (genomics, proteomics, metabolomics) can help dentists to diagnose and treat periodontal diseases, and even predict treatment outcomes in the field of oral health to shape future global health policy. To advance evidence-based personalized dentistry, it would also be essential to carry out social epidemiology and outcome studies to better characterize the extent of person-to-person and between-population variability in treatment (pharmacological, surgical, other interventions) outcomes in dentistry.

Much more work remains to be done. With anticipated advances in personalized dentistry and tailored therapeutics for individuals or subpopulations, omics-in-dentistry is a highly promising avenue of research and developmental applications. This journal would welcome submissions of scholarly manuscripts for rigorous peer-review in the field of omics that pertain to both oral and medical health, and various ways of achieving “one health” more broadly.

Ready for Dentomics?

In anticipating the future of omics-in-dentistry (or “dentomics”), we can look back to the success of another. Often forgotten is that one of the most important and established “omics” fields is economics, which continues to have vast impacts on the emergence of new fields of postgenomics and biotechnology scholarship. In this vein, the “early cycle health technology assessment, HTA” (Steuten and Ramsey, 2014) offers a veritable potential to map and steer the anticipated coming together of omics technologies and dentistry research, as well as their interactions with the concept of “one health”.

We can also look to infrastructure science, such as biobanks, which have been successfully established in some life sciences fields, such as oncology, and see how they shape knowledge production and society. Dentistry might usefully draw lessons on the ways in which biobanks play a role in 21^st century infrastructure science as well as the bioeconomy (Birch and Tyfield, 2013). More than a collection of biological specimens, biobanks are constitutive of, and constitute, important sociological, economic, and political science structures and functions. Indeed, often they portray themselves, and are portrayed as, an emerging enabler of the knowledge economy.

Finally, it is noteworthy that the concept behind “one health” has existed for millennia. From Hippocrates' “On Airs, Waters, and Places” (circa 400 BC) to the Human Microbiome Project ongoing today, we have observed and learned how resident microbial communities and their genes (the microbiome) coexist throughout the human body. The active interaction and symbiotic relationship between the human host and her/his microbiome is indisputable, and thus should be evaluated as a whole to achieve better standards in diagnosis and treatment of oral diseases. Such convergence of human (oral and general), animal, and environmental (e.g., microbial) health must become the model and practice for 21^st century personalized dentistry.

The scientific community is increasingly paying attention to omics (be it genomics, transcriptomics, proteomics, or metabolomics), and it is increasingly figuring out how to handle (both store and analyze) the large amounts of data these sciences generate. With the combination of in silico and bioinformatics-based approaches, the landscape of protein–protein, compound–compound, or protein–compound interactions can be visualized. Thus, it is now possible to better comprehend disease mechanisms and identify biomarkers and/or molecular targets for diagnosis and therapeutics, respectively.

Conclusions

In sum, then, there are key insights to learn and apply. We believe the time has come for the dentistry community to meet the innovations brought about by omics technologies, early cycle HTA, biobanks, and “one health.” Let us at last allow this Cinderella to blossom. Let us work together to progress towards personalized dentistry and systems diagnostics, both for oral/dental diseases and their tailored treatments. In the not too distant future, may we tell a happy tale of the integration between medical and dental life science scholarship, encompassing “one health.”