Congenital craniofacial malformations vary widely in both expression and gravity. To understand congenital craniofacial malformations, knowledge of embryonic development is of essential importance. Craniosynostosis has its origin in the failure of suture development between 2 bone centres or in early closure of the suture by bone centre tissue fusion. Hereditary craniosynostosis phenotypes predominantly arise by autosomal dominant inheritance. So far, the majority of mutations have been found in fibroblast growth-factor receptor genes (FGFR-genes). Different phenotypes are not primarily created by disparities of the receptors, but particularly by tissue-specific expressions.

Although the molecular cascades that control craniofacial development are still largely unknown, the generation of mutant animal models and the identification of gene mutations that cause human craniofacial syndromes have recently given significant insight into how the unique structure of the head develops. Craniofacial structures are formed from the prechordal mesoderm, the craniofacial ectoderm as well as the neural crest cells which develop on the dorsal side of the neural tube. Normal craniofacial morphology as well as normal (in number and in morphology) tooth organs develop as a consequence of complex interactions between these embryonic tissues. A series of inductive and reciprocal signals between the epithelium and mesenchyme determine the growth, the form and the ultimate differentiation of tissues and organs. Genetic research has shown the involvement of numerous developmental genes encoding a variety of transcription factors, growth factors and receptors. Mutations have been associated with, among others, non-syndromal forms of cleft palate, agenesis of tooth organs and abnormalities in the cranial bones.

Caries is a multi-factorial disease, primarily caused by acids. Acids are produced by bacteria which ferment sugar. The aetiology and progress of caries are influenced by life-style and environmental factors, as well as congenital components. Based on, among other things, research concerning twins, the literature suggests that there are hereditary components of caries and life-style and environmental components. With the unravelling of the human genome, it is more easy to study individual genes in relation to the caries process. Because of its multifactorial nature, one has to realise that there is only a beginning of understanding the caries processes at molecular level.

Periodontitis is a complex, multifactorial disease and the susceptibility is genetically determined. In the last decade a multitude of research projects on genotyping of patients and controls in search of putative genetic risk factors has been performed. The disease (phenotype) however is also dependent on the presence of environmental and lifestyle factors, and their interaction with the various genes. Many candidate genes have been proposed and studied in relation to periodontitis. Most of the studied candidate genes code for proteins that play a role in the innate immune system. Some variants of candidate genes (gene polymorphisms) in the IL1 gene cluster and the FcγR genes are possibly associated with periodontitis. However till today there is no strong evidence for target genes and gene polymorphisms that play a key role in the susceptibility to and severity of periodontitis. Therefore genetic testing for periodontitis is currently not indicated.

New insights in the microbial genetics of pathogenic oral micro-organisms and the development of a new array of molecular genetic techniques together have led to alternative strategies in the development of antimicrobial agents. In this article the importance of insights in microbial molecular biology for the prevention and treatment of (oral) infectious diseases is illustrated. Following the introduction of relevant terminology, the role of microbial genetics in developing of target-based anti-microbial drugs for prevention and treatment of (oral) infections is discussed. Subsequently, the impact of microbial genetics on vaccine development and several, mainly still experimental, prevention strategies are discussed.

A dry mouth (xerostomia) is a serious side effect for head and neck cancer patients treated with radiotherapy. The degree of xerostomia is dependent on the dosage in the parotid glands. New, advanced radiation techniques, such as intensity-modulated radiotherapy, can reduce the dosage in the parotid glands, resulting in a significant improvement in the functioning of these glands by comparison with conventional radiation techniques.