Week 4 Sharma: Perio affect on Systemic Health

Question 1

What is focal infection?

Answer 1

Source of infection that affects other sites e.g. caries, periodontitis, abscess

Question 2

How do microbes in dental plaque cause CT and bone destruction?

Answer 2

Microbes in dental plaque induces local and systemic inflammatory response. Immune reaction can also affect other systems, leading to systemic diseases.

Question 3

What conditions is perio linked with?

Answer 3

• CHD- atherosclerosis
• Stroke
• Osteoporosis
• Preterm LBW baby
• Diabetes
• Lung infection

Question 4

What are similarities between CVD and periodontal disease?

Answer 4

• Occur more commonly in populations that are older
• Predominantly affects males
• Use tobacco products at higher rates
• With higher stress levels
• Have fewer financial resources
• Are socially isolated

Question 5

How is dental plaque linked to pneumonia?

Answer 5

Pneumonia causing bacteria in dental plaque is aspirated and can cause pneumonia

Question 6

Does periodontitis cause CVD and stroke?

Answer 6

No- can’t be considered a cause but can be considered an additional risk factor

Question 6

How do periodontal pathogens affect CVD?

Answer 6

Chronic bacterial challenge and proinflammatory cytokines from perio pathogens produce vascular effects such as hypercoagulability, atheroma formation and thromboembolism

Question 7

How does periodontal infection contribute to ischaemic heart disease?

Answer 7

Inc in fibrinogen, WBC, Von Willebrand factor → Inc blood viscosity → ischaemic heart disease

Question 8

How does periodontal infection contribute to atherosclerosis?

Answer 8

Bacteraemia of gram -ve LPS → endothelial damage, monocyte migration→ cytokine/growth factor production → atherosclerosis (vessel wall thickening)

Question 9

What is the brief explanation for how dental plaque can lead to MI?

Answer 9

Bacteria from plaque enters blood stream and triggers inflammatory reactions within the body such as release of CRP from liver. This results in vessel hardening and atherosclerosis. MI can result if artery becomes blocked

Question 10

How does diabetes lead to alveolar bone loss?

Answer 10

Diabetes → Inc RANKL, AGEs, ROS and inflammation enhanced PDL and osteoblast apoptosis, reduced bone formed, enhanced osteoclast production → alveolar bone loss

Question 11

How does periodontal disease cause diabetes?

Answer 11

Gram -ve periodontal infection → inc insulin resistance → worse glycaemic control

Question 12

How does perio tx impact diabetes?

Answer 12

Dec inflammation → improved insulin sensitivity → improved glycaemic control

Question 13

What is the risk of perio with pregnancy?

Answer 13

• Pre term, low birth weight infants
• (<37 weeks, <2.5kg)

Question 14

How is perio linked with adverse pregnancy outcomes?

Answer 14

• Bacteria and products in amnion → increase prostaglandins in amnion → preterm low birth weight babies

Question 15

How should pregnant patients be managed with perio?

Answer 15

• Preventative oral care services should be provided early in pregnancy
• If perio therapy required, schedule early in 2nd trimester
• Presence of acute infection or abscess require immediate intervention irrespective of stage of pregnancy

Question 16

How is periodontal disease associated with pneumonia?

Answer 16

Pneumonia causing bacteria in dental plaque are aspirated and can lead to pneumonia