Oral Pathology and CRISPR-Cas9

With the arrival of a system to edit the DNA, the dental community has suddenly found themselves entwined in a new set of imponderables. The profession may have been sitting back wondering what could be done to give their patients a modified genetic profile. Many of us observed that an oral-facial defect of genetic etiology was beyond real help. We had no capacity to modify a genetic defect but we often used the old “work around” to mount a treatment plan that alleviated the problem.

The profession is aware of the large number of genetic faults that occur in and around the facial structures. Our response was often one of inaction because we were not able to adopt any treatment plan that approached some finality of outcome.

This week Time magazine reminded us once again that the CRISPR-Cas9 is challenging the very nature of our being. They report that Kathy Niakan at the Crick Institute in London has been granted the right to use this emerging technology on a viable human embryo…an astonishing fact that brings to mind some of the most memorable announcements in medicine over the past many decades.

While CRISPR-Cas9 has been researched in animals since 2012, its use on human tissue has taken a back seat as the methodology has matured. Now Time magazine considers the CRISPR-Cas9 technique to be “precise, efficient, affordable and easy to use.”

Many of our dental colleagues have suggested that our interest in the etiology of genetic-based oral anomalies makes little difference if we cannot change the human genome. But now we are faced with an exciting challenge…find the offending gene and manipulating the genetic structure to produce a normal genome sequence.

This author has advocated a change in our “mind set.” We must look closely for a genetic fault in Primary Molar Ankylosis. It seems only a matter of time that our profession will be able to identify the causative genes in many oral pathologies. If the research laboratory can tell us which genes are at fault for a specific disorder, we may find that in the near future a CRISPR solution to the fault can revise the genetic structure of the genome…a thought that was inconceivable until just recently.

The old “hack” that suggests we overlook some genetic faults since we cannot change the gene may be “out of date.” Oral pathology may have a new beginning...starting this year, an outlook that supersedes the
“status quo” and delivers to our profession a new window on treatment procedures that were once deemed to be impossible.

In our lifetime will we observe oral genetic anomalies corrected using CRISPR-Cas9 technology? What…What…What, a research tool that completely overturns our ideas of disease and how it is treated? A basic revision of our textbooks, a redo of drug therapies based on genetic structure, a modification of medicine at its very core…astounding!
Send me back to Dental School!