In the case of TNF-α, Leme et al., 2022 [14], AL-Dahhan et al., 2021 [18], Nazemisalman et al., 2018 [22], Ribeiro et al., 2017 [23], Sharma et al., 2017 [24] and Gornowicz et al., 2012 [26] demonstrated that the levels of this cytokine in saliva of children and young adults with DC were increased and also associated with disease progression and severity. This evidence concerns the gene TNF and dyskeratosis congenita.