Clicky

Answers to your Questions about ILUSTRA | ILUSTRA

 

Frequently Asked Questions About the ILUSTRA Inflammation Management Program 

 

 

Please contact us if you don't find your answer here.

The ILUSTRA Genetic Risk Test identifies individuals who have an increased inflammatory response to oral bacteria based on their personal genetics. ILUSTRA enables patients and dental professionals to anticipate this risk and develop a preventive plan that may help to avoid the onset of inflammation, and the severe consequences of many chronic diseases like diabetes, cardiovascular disease, chronic kidney disease, and periodontal disease, as well as adverse pregnancy outcomes. ILUSTRA is a benefit offered through an employers' healthcare plan and requisitioned by healthcare professionals.

ILUSTRA is quick, easy, and painless. Performed by using a soft swab rubbed inside the cheek to collect cheek cells for a genetic sample, which are then mailed to Interleukin Genetics’ CLIA certified laboratory for analysis. The test can easily be administered at employer-hosted events, in clinics, or even self-administered at home.

ILUSTRA identifies people who have a genetic variation in Interleukin-1 Beta that causes an overproduction of inflammatory cytokines, which, when triggered by an accumulation of bacteria, can result in the destruction of the bone and tissue that support the teeth.

Periodontitis is a multi­factorial, chronic disease. The clinical presentation of periodontal disease is driven by two factors: (1) bacterial plaque, which is essential for initiation and progression of the disease; and (2) the body's immuno-inflammatory “host response” to bacteria which, when overly aggressive, causes breakdown of the tissue and bone that support the teeth. This host response varies greatly within the population and is determined by each individual's genetic makeup (DNA) and acquired or environmental factors, such as smoking and diabetes. These factors determine how aggressively the body's immuno-inflammatory system will react to the bacteria that form in the mouth, and may increase the likelihood of developing severe periodontal disease.

ILUSTRA identifies one of several known risk factors for periodontal disease. A negative result does not mean you have no risk, it means you have a "normal risk" profile (based on your genetic status). You should continue practicing good oral care at home and visit the dentist twice annually for exams and cleaning. The dentist will also evaluate other risk factors like whether you smoke or have type 2 diabetes, factors which are important to assess when determining an individuals personal risk. People with positive test results are more likely to develop moderate to severe periodontal disease and the consequences associated with it, as well as increased systemic inflammation, which is associated with diabetes, heart disease, stroke, and problems with pregnancy.

The IL-1 genetic association with severe progressive periodontal disease and the overall value in clinical application have been well established. The IL-1 genetic test is a very thoroughly studied personalized genetic test, including more than 125 studies; multiple studies with more than 1,000 patients; and two prevention studies, one with 10 years of monitoring and the other with 16 years of follow-up involving more than 80,000 patient-years of data. Individuals with the IL-1 genetic variation have an altered biological response to noxious stimuli, such as bacterial plaque on the teeth, and overproduce the IL-1 protein in the gingiva1,2, which affects disease severity through a hyper-inflammatory response. IL-1 is one of the strongest activators of bone and connective tissue destruction that is characteristic of severe periodontitis. In animal models, blocking IL-1 alone reduces periodontitis severity by 50-60%.3

Before there is disease, there is risk for disease. Knowing an individual's personal risk can help you determine a treatment plan for your patients with the ultimate objective of disease avoidance. Risk assessment should be a routine part of a periodontal evaluation and is a powerful tool for empowering wellness.

First, there is no substitute for clinical experience and in ­office assessment. For example, recall frequency may be relevant to oral health issues unrelated to periodontal disease or tooth loss, such as oral cancer and dental caries. But using a proven, risk ­based assessment that takes into account the risk factors for periodontal disease and tooth loss (IL­1 genotype, smoking, and diabetes) provides a concrete, evidence ­based approach to prognosis. When these risk factors are considered up front, there is no reason for a "wait­ and ­see" approach. Rather, proper hygiene visit schedules, referrals, and maintenance intervals can be optimized.4-7

No. ILUSTRA is not a diagnostic test. It does not detect the presence of disease. It is a predictive or “prognostic” test that identifies individuals at increased risk for the development of severe periodontal disease. The test, coupled with additional risk factors and a dental exam performed by a dental professional, provides a prognosis for future health or disease balancing all risk factors and exam outcomes. This can help patients and clinicians collaborate to create a personalized, risk ­based prevention plan.

Federal law protects genetic information. The Interleukin Genetics laboratory cannot share genetic test results with anyone not personally authorized to receive them, unless required by law. Only the test ordered for ILUSTRA is genetically analyzed, and the sample is destroyed once the test results are completed. View the Interleukin Genetics Privacy Policy

The ILUSTRA Genetic Risk Test results take about two weeks to be reported, once we receive the sample for processing. These results are made available only to the employee’s specified dental health professional. Employers will not have access to any of an employee’s personal information including the ILUSTRA Genetic Risk Test’s results. Employees who take the test are also allowed by law to request a copy of their test results from the laboratory. Information on whether the patient tested positive or negative may also be shared with their insurance provider for the purpose of increasing their coverage, once written consent to do so has been obtained from the patient. The patient can choose to opt out of sending the test result to the insurer. If the patient chooses to opt out, they may not be eligible to receive coverage for additional preventive dental visits (adult prophylaxis) if the test result is positive for the genetic variation.

At this time a limited number of employer groups offer this important dental health benefit. Please check with your human resources department or medical director to see if ILUSTRA is covered by your insurance plan.

You can find more information at ILUSTRA.com, or by contacting our Customer Service at support@ilustra.com, or by calling 1-­855-503-­9160.

References

  1. Chen H, Wilkins LM, Aziz N, et al. Single nucleotide polymorphisms in the human interleukin-1B gene affect transcription according to haplotype context. Hum Mol Genet 2006;15:519-529.
  2. Rogus J, Beck JD, Offenbacher S, et al. IL1B gene promoter haplotype pairs predict clinical levels of interleukin-1beta and C-reactive protein. Hum Genet 2008;123:387-398.
  3. Delima AJ, Karatzas S, Amar S, Graves DT. Inflammation and tissue loss caused by periodontal pathogens is reduced by interleukin-1 antagonists. J Infect Dis 2002;186:511-516.
  4. Eickholz P, Kaltschmitt J, Berbig J, Reitmeir P, Pretzl B. Tooth loss after active periodontal therapy. 1: patient-related factors for risk, prognosis, and quality of outcome. J Clin Periodontol 2008;35:165-174.
  5. McGuire MK, Nunn ME. Prognosis versus actual outcome. IV. The effectiveness of clinical parameters and IL-1 genotype in accurately predicting prognoses and tooth survival. J Periodontol 1999;70:49-56.
  6. Persson GR, Matuliene G, Ramseier CA, Persson RE, Tonetti MS, Lang NP. Influence of interleukin-1 gene polymorphism on the outcome of supportive periodontal therapy explored by a multi-factorial periodontal risk assessment model (PRA). Oral Health Prev Dent 2003;1:17-27.
  7. Lang NP, Tonetti MS, Suter J, Sorrell J, Duff GW, Kornman KS. Effect of interleukin-1 gene polymorphisms on gingival inflammation assessed by bleeding on probing in a periodontal maintenance population. J Periodontal Res 2000;35:102-107.