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PERIO - get ready for clinic > Risk factors > Flashcards

Risk factors Flashcards

1
Q

What process gives rise to periodontitis?

A

dysbiosis

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2
Q

what factors alter someone’s susceptibility to periodontal disease?

A

genetics
inflammatory drive
biofilm

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3
Q

what is management dependant upon?

A

risk factor control

if grade A and B - usually plaque control based

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4
Q

what results in breakdown of the periodontium and bone resorption?

A

inflammatory response

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5
Q

what is essential to prevent an aberrant host response and dysbiosis?

A

immune fitness - immune response to plaque

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6
Q

what can alter immune response?

A

diet
genetics
hyperglycaemia

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7
Q

what is the gut microbiome driven by?

A

nutrition

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8
Q

what does an increasing carb intake result in?

A

higher circulating glucose

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9
Q

what is a result of having more adipose tissue?

A

insulin doesnt work as effectively and inhibits hormones that make you feel full (leptin)

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10
Q

what hormone makes you feel full and can be interrupted by adipose tissue?

A

leptin

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11
Q

what does adipose tissue do to the inflammatory drive?

A

increases inflammatory drive

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12
Q

what is the result of increased inflammatory drive?

A

more oxidative stress - hyperresponsive immune system

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13
Q

what does adipose tissue produce?

A

cytokines
Tnf alpha IL6
Pro inflammatory mediators
adipokines

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14
Q

why are cytokines bad?

A

bacteria use as energy source
= increase in anaerobes
= dysbiosis

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15
Q

what risk does poorly controlled diabetes have on periodontitis?

A

x3

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16
Q

what are found in bad foods that increase oxidative stress?

A

advanced glycation end products (AGE)

17
Q

how can we reduce the risk of dysbiosis from obesity?

A

encourage symbiosis
- weight loss to reset oral microbiome
- reduced refined carbs and AGE products
- prebiotic diet: cruciferous diet to feed gut microbiome

18
Q

what can obesity lead to?

A

diabetes

19
Q

signs of diabetes?

A

bop
lack of immune fitness - suppuration

20
Q

what is the determining factor of the association between DM and chronic periodontitis?

A

degree of blood glucose (glycaemic) control

21
Q

are all diabetes patients at risk of periodontitis?

A

no, only ones with poorly controlled glycaemic levels

22
Q

what should glycated haemoglobin levels be?

A

48 mmol below/ 6.5% below

23
Q

what may indicate undiagnosed periodontitis?

A

recurrent perio abscesses - pus
exaggerated perio inflammation

24
Q

what are the problems with uncontrolled diabetes?

A

increased formation of AGE products
altered immune cell function
altered fibroblast function
poor wound healing

25
Q

what effect has AGE got on collagen?

A

reduced collagen production
increased collagenase (removes collagen)
impaired collagen turnover

26
Q

what can chronic hyperglycaemia alter with immune cell function?

A

reduced neutrophil function = persistent infection
hyperresponsive monocyte and macrophages = oxidative stress
altered fibroblast function = reduced tissue formation and healing

27
Q

what are the effects of poor glycaemic control on periodontitis?

A

increase risk
- pockets leak bacteria and exotoxins throughout immune system
= increased insulin resistence

28
Q

what vitamin is essential for collagen?

A

c

29
Q

what is vitamin D essential for?

A

skeletal development
modulation of immune system

30
Q

how much vitamin D do we need?

A

40-60ug a day

31
Q

what foods may help inflammation?

A

omega 3
cruciferous vegetables

32
Q

what are key dietary advice points for perio?

A

healthy diet
- cruciferous veggies
- vit D and C, fresh fruit and veg
reduce carbs
be aware of AGE foods

33
Q

what are the oral effects of stress?

A

reduced salivary flow - plaque formation
increased stress hormones - reduce gingival blood flow

34
Q

what are the stress hormones?

A

noradrenaline
adrenaline

35
Q

how does smoking effect the periodontium?

A

staining
calculus build up
more keratin

36
Q

why does smoking cause calculus build up?

A

increase saliva flow = increase pH = precipitate of calcium phosphate

37
Q

why do smokers gums look healthy?

A

less BOP - reduced inflammatory response and vascularity
higher amount of keratin laid down on surface

38
Q

what is smoking a major risk factor for?

A

necrotising gingivits

PERIO - get ready for clinic (6 decks)

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