Perio - Risk Factors

Question 1

List local acquired caused of perio (6)

Answer 1

calculus
overhanging restorations 
poorly contoured restoration margins 
Ortho and prosthetic appliances 
prosthetic crowns 

occlusal trauma can enhance progression of perio once already initiated

Question 2

list local anatomical causes of perio. (5)

Answer 2

malpositioned teeth 
crowding 
root grooves 
enamel pearls 
furcation

Question 3

list systemic non-modifiable causes of perio (3)

Answer 3

Age - older

sex - male

genetics

• Down syndrome
• papillion lefevre syndrome

Question 4

list systemic modifiable causes of perio (9)

Answer 4

smoking 
stress
hormonal changes 
poorly controlled diabetes 
medications 
poor nutrition 
leukaemia 
HIV
osteoporosis

Question 5

what is the relationship between osteoporosis and perio disease?

Answer 5

Low mineral density in both the jaws (from osteoporosis etc) can lead to accelerated periodontal disease as the thin and weak bone can be resorbed faster.

Question 6

what is the difference between active perio in smokers and in non-smokers?

Answer 6

smoker with active periodontal disease do not have increased bleeding sites due to vasoconstriction of the vessels.

Question 7

describe the relationship between CV disease, hypertension and atherosclerosis and perio disease?

Answer 7

Periodontal disease and atherosclerotic vascular disease have the same risk factors (smoking, diabetes etc) and a common pathological mechanism so they may have a causative effect on each other.

Question 8

describe the relationship between rheumatoid arthritis and perio disease?

Answer 8

P.gingivalis – a bacteria found in periodontal pockets – secretes an enzyme called PPAD which stimulates an immunological response to unrecognised compounds which destroy the surface of cartilage.

Question 9

describe the relationship between Alzheimers and perio disease?

Answer 9

Activation of the immune system from periodontal disease enhances the speed and quantity of beta-amyloid tissue production/plaques which blocks the spaces between nerve cells and blocks neurone impulses.

Question 10

what medications can have an effect on periodontal tissues? (3)

Answer 10

• Anticonvulsants - phenytoin
• Immunosuppresants – cyclosporin
• Ca channel blockers – amlodipine

Question 11

what do we use to assess controlled diabetes?

Answer 11

Glycated haemoglobin - HbA1c

measure sugars over the last 8-12 weeks