periodontial diseases and systemic health

Question 1

modifying factors for periodontal disease

Answer 1

diabetes, pregnancy/puberty/menopause, smokeing

Question 2

what can smoking, diabetes, or pregnancy influence in the periodontium

Answer 2

susceptibility to gingivitis and periodontitis, plaque growth and composition, clinical presentation, disease progression, and response to periodontal therapy

Question 3

how can diabetes affect your mouth?

Answer 3

xerostomia, candida, periodontitis, multiple periodontal abscess

Question 4

t/f. glycemic control is worse after periodontal therapy

Answer 4

false. it gets better because periodontitis can increase insulin resistance

Question 5

oral bacteria involved in type 1 diabetes

Answer 5

capnocytophaga

Question 6

oral bacteria involved in type 2 diabetes

Answer 6

p intermedia, c rectus, p gingivalis

Question 7

diabetes effects on healing and Tx response

Answer 7

decreases collagen sysnth by fibroblasts
increased degradation by collagenase
glycosylation of existing collagen and wound margins
defective remodeling and degradation of new collagen

Question 8

in what trimester is gingival inflammation the highest

Answer 8

2nd and 3rd

Question 9

microbial effects during pregnangy

Answer 9

increased p intermedia, increase in spirochetes, napthoquinones from steroids used by p intermedia

Question 10

host effect during pregnancy

Answer 10

increased vascular permeability = increased gingival exudate
decreased keratinization
decreased PMN chemotaxis and phagocytosis, Ab, Tcell response

Question 11

describe the relationship between menopause, osteoporosis, and periodontitis

Answer 11

due to decreased absorption and increased elimination of Ca
osteoporosis and post menopausal pts may not cause periodontal disease, but it may affect the severity of the preexisting disease

Question 12

daily exposure

Answer 12

cigarettes per day

Question 13

cumulative exposure

Answer 13

pack years (# packs smoked per day x # years smoked)

Question 14

what qualifies a current vs former vs nonsmoker

Answer 14

current smoked > cigs in lifetime and currently smoke
former smoked >100 in lifetime and do not currently smoke
nonsmoker have not smoked > 100 cigs

Question 15

t/f. inflammation in response to plaque accumulation is reduced in smokers compared to nonsmokers

Answer 15

true.

Question 16

smokers are how much more likely to develop periodontitis

Answer 16

4x

Question 17

t/f. 42% of perio cases attribute to current smoking

Answer 17

true. and 11% are attributable to former smokers

Question 18

smokers are how much more likely to have aggressive perio

Answer 18

3.8x

Question 19

t/f. negative effects of smoking on host response are not reversible

Answer 19

false. they are

Question 20

what happens to the microbial enviornment in smokers with perio

Answer 20

increase in pathogens in shallow perio pockets and increased levels of pathogens in deep pockets

Question 21

smokers will typically have increased levels of what pathogens?

Answer 21

t. forsythia, Aa, P ging

Question 22

what happens to the immune-inflammatory response in smokers with perio

Answer 22

increased TNF alpha, PgE2, and neutrophil collagenase and elastase in GCF, increased production of PgE2 by monocytes in response to LPS

Question 23

what happens to the oral physiology of smokers with perio

Answer 23

decreased blood flow, decreased clinical signs of inflammation, increased recovery time

Question 24

for implant therapy, smoking increases the risk of failure by how many times

Answer 24

2x, and it is greater in the max than the mand

Question 25

t/f. peri implant bone loss is increased in non smokers

Answer 25

false

Question 26

approximately how many poor treatment responders are smokers

Answer 26

90%

Question 27

t/f smoking is associated with tooth loss

Answer 27

true. everything bad happens to your periodontal health if youre a smoker

Question 28

t/f. there are 30% more site with probing depth reduction of >2 mm in quitters vs nonquitters

Answer 28

true.

Question 29

name 3 benefits of smoking cessations

Answer 29

shift toward less pathogenic microbiota, recovery of the gingival micro-circulation, improvements in immune-inflammatory response