Aetiology of periodontal disease: Systemic factors

Question 1

Give 5 examples of systemic factors that may increase a patient’s risk of developing periodontal disease

Answer 1

1. Smoking
2. Diabetes
3. Pregnancy
4. Medications that cause gum inflammation
5. Genetic factors

Question 2

Outline the increased risks that smokers may present with (regarding gum health)

Answer 2

• More likely to develop periodontitis
• More likely to experience greater bone loss
• More likely to develop periodontal pockets
• More likely to lose teeth
• Masks gingivitis: less bleeding (constriction of blood vessels in gingiva)
• Smokers often don’t respond as well to periodontal treatment

Question 3

How can uncontrolled diabetes affect the risk of periodontal disease/progression?

Answer 3

It increases the risk.

Diabetics usually have impaired immune response, impaired wound healing, recurrent/multiple periodontal abscesses

Question 4

How can periodontal treatment affect glycaemic control?

Answer 4

It can improve glycaemic control

Question 5

How does pregnancy affect the risk of perio disease?

Answer 5

Increases gingival response to plaque.

Increased progesterone results in increased gingival blood flow

(similar effect with puberty and contraceptive pill - anything hormone related)

Question 6

Which drugs can induce gingival overgrowth?

Answer 6

Calcium channel blockers:

• Usually prescribed for hypertension
• Amlodipine, Nifedipine,

Phenytoin:
- Usually prescribed for epilepsy

Ciclosporin:

• Usually prescribed for some autoimmune disorders (e.g. rheumatoid arthritis, lupus)
• Immunosuppressant

Question 7

Give 3 examples in which genetics can play a role in periodontal disease

Answer 7

• Familial tendency
• Racial predilection
• Association with specific genetic polymorphisms

Question 8

What type of mutation causes hereditary neutropenic conditions?

Answer 8

Single point mutation

Question 9

In hereditary neutropenic conditions - is the periodontal affect in just the permanent dentition, the deciduous, or both?

Answer 9

Both

Question 10

Give an example of hereditary neutropenic conditions (of 3)

Answer 10

Papillon Lefèvre syndrome (hyperkeratosis - scaly hands/feet)

Chediak Higashi Syndrome (characterized by reduced pigment in the skin/eyes (oculocutaneous albinism), immune deficiency, tendency to bruise and bleed easily)

Leukocyte Adhesion syndrome