Periodontal disease- risk factors Flashcards
what kind of disease is PD and why are risk factors important?
it is multifactorial and risk factors increase the probability of disease occurring so modifiable RF must be managed
why is BOP a risk marker and not a risk factor?
- it is used as an indication of disease
only 30% of sites with BOP go on to develop further LOA- must over treat as can not be predicated
what are local risk factors for periodontal disease?
factors that increase plaque accumulation:
- anatomical risk factors
- occlusal trauma risk factors
- Iatrogenic risk factors
what are anatomical risk factors ?
furcation involvement- PR- harder to clean- may lead to inadequate debridement due to access
root morphology- deep grooves- PR and may lead to inadequate debridement
tooth anatomy- deep tissues, PE teeth, crowding, enamel pearls at ACJ- make rsd difficult and PR
localised recession- due to trauma, dehiscence, frenum pull, chronic minor injury, factitious injury
what are occlusal trauma risk factors?
overbite- damaging st’s can lead to excessive gingival recession and LOA
primary occlusal trauma- excessive occlusal force causing tissue damage on health periodontium can be reversed by removing issue e.g mouthguard for bruxism
secondary occlusal trauma- excessive occlusal forces causing tissue damaged on impaired periodontium- increases LOA and bone loss
what are Iatrogenic risk factors?
- overhangs
- poorly fitted dentures
- deficient margins
- orthodontic appliances
what are systemic risk factors for periodontal disease?
- genetic
- environmental
- behavioural
- lifestyle
- metabolic
- haematological
what are genetic risk factors?
- genetic susceptibility to periodontal disease
- genetic conditions which increase the risk of periodontal disease
what are genetic conditions that increase your risk of PD?
- downsyndrome- causes reduction in function of PMNL
- chronic granulomatous disease - impairs function of phagocytes- inability to kill bacteria
how do you measure susceptibility to PD?
- age and OH
- based on severity and rate of progression of disease
how do you consider someones genetic susceptibility?
- take thorough family history to understand if family have history of PD or early tooth loss
- genetic testing for periodontitis associated gene- will be positive if increased IL1 which causes hyper inflammatory response- causing destruction.
if someone has a high genetic susceptibility what grade would they be and what should be given as advice?
grade C- possibility refer
- smoking cessation
- good diet
- healthy weight
- alcohol risks
what evidence is there to show genetics are involved in PD?
study on Sri-lankan tea workers and affluent Norwegian young people.
Gave same results:
10% of population develop destructive periodontal disease and tooth loss
10% of population are resistant to periodontal disease even with poor OH
80% will have slowly progressing PD if given adequate treatment
what are environmental risk factors?
- medications which increase your risk of PD due to impeding good OH
- cause gingival overgrowth
- phenytoin- anti-epileptic
- CCB- nifedipine, amlodipine
- cyclosporine- immunosuppressant
may require surgery
false pocketing may subsequently become true pocketing
what are behavioural risk factors ?
- OH
- smoking
- alcohol
