SYNOPSIS
Pediatric oral health, similar to other health conditions and traits, is determined by the interaction of environmental factors and genetic influences. This is the case for early childhood caries (ECC), the most common disease of childhood. The complexity of exogenous-environmental factors (e.g., knowledge, behaviors, cultural and social influences) interacting with innate-biological predispositions (e.g., large number of polymorphisms conferring small protective or deleterious effects) results in a remarkable continuum of normal variation, as well as oral health and disease outcomes. Optimal oral health and care or precision dentistry warrants comprehensive understanding of these influences as well as tools enabling intervention on modifiable factors. The article reviews the current knowledge of the genomic basis of pediatric oral health and highlights known and postulated mechanistic pathways of action relevant to ECC. Although validated and replicated loci and pathways remain elusive, the knowledge base of oral health genomics in early childhood is rapidly expanding.