Genetic Testing in Periodontitis: A Narrative Review on Current Applications, Limitations, and Future Perspectives

Background: Periodontitis is a multifactorial inflammatory disease with a complex interplay between microbial, environmental, and host-related factors. Among host factors, genetic susceptibility plays a significant role in influencing both disease onset and progression. Over the past two decades, a wide range of genetic tests, ranging from single-nucleotide polymorphism (SNP) analysis to genome-wide association studies (GWAS), have been explored to assess individual risk profiles and potential treatment responses. However, despite initial enthusiasm, the clinical integration of genetic testing in periodontics remains limited. This narrative review aims to critically examine the current landscape of genetic testing in periodontitis, including commercially available tests, their scientific validity, and their clinical utility. Methods: Most relevant studies which were published in recent years were identified by using the major scientific search engines, including PubMed, Scopus, and Web of Science. Articles discussing genetic susceptibility, key gene polymorphisms, and emerging technologies were included in this narrative review. Results: Polymorphisms in genes coding for IL-1, IL-6, TNF-α, and in others involved in immune modulation and bone metabolism, are associated with periodontitis. Nevertheless, there are limitations related to heterogeneity in study design, population stratification, and gene–environment interactions. Moreover, emerging technologies, including polygenic risk scoring and machine learning approaches, may enhance the predictive value of genetic tools in periodontology. Conclusions: A deeper understanding of genetic susceptibility could pave the way for precision dentistry and personalized periodontal care, but significant hurdles remain before genetic testing can become a routine component of periodontal diagnostics.