2a - Risk factors for periodontitis Overview

Question 1

What is a risk factor?

Answer 1

Characteristic of a person or their environment which, when present, directly result in an increased likelihood of that person getting the disease, and when absent directly result in a decreased likelihood

Question 2

How can risk factors be categorised?

Answer 2

Question 3

Systemic risk factors for periodontitis?

Answer 3

Question 4

Eg of local risk factors for periodontitis?

Answer 4

Question 5

What is preventative care?

Answer 5

• ‘Preventive care’ refers to measures taken to prevent diseases instead of curing or treating the symptoms

Risk factors play a central part in disease prediction and prevention

Question 6

What is the difference between primary, secondary and tertiary prevention

Answer 6

Question 7

How do risk factor affect your role as a dentist?

Answer 7

Question 8

What is staging and grading?
What are grade modifiers?

Answer 8

• used to classify periodontal disease
• there are risk factors that can act as grade modifiers
• right one is v important as used here mostly

Question 9

How does smoking affect your risk of periodontitis?
(4)

Answer 9

Question 10

Prevalence of smoking in UK

Answer 10

14.8%

Question 11

SMOKING - effect on your care?

Answer 11

Advise your patient on:

• increased risk of periodontal disease
• dose dependent nature
  ↳ more you smoke = increased risk + severity of disease
  ↳ hence if can’t stop still benefit of even reducing amount
• reduced treatment outcomes

• Smoking cessation advice includes the ‘5 As’
• Ask, advise, assess, assist, arrange

• Refer to your local NHS Stop Smoking Service

Little research in e-cig

Question 12

How does DIABETES effect your risk of periodontitis?

Answer 12

• Diabetes, particularly poorly controlled diabetes, increases the risk of periodontal disease

• Diabetes reduced healing and treatment outcomes

• A bidirectional relationship exists between diabetes and periodontal disease

Question 13

How do you know if diabetes is controlled?

Answer 13

Question 14

DIABETES - effect on your care / how to manage?

Answer 14

• Communicate the effect of (poorly controlled) diabetes to your patient
• Communicate with GMP and diabetic team as required
• Offer support and advice (www.diabetes.co.uk)

If patient has a rapid rate of periodontal disease, could have undiagnosed diabetes: ask, assess and refer as appropriate

Question 15

How does GENETICS effect your risk of periodontitis?

Answer 15

• More recent summary evidence suggests that this risk may be up to 30% (Nibali et al. 2019)

Question 16

How does NUTRITION + STRESS effect your risk of periodontitis?

Answer 16

Question 17

1
Risk factors that dental caries and periodontitis share?

2
Why is identifying risk factors important?

Answer 17

(Both complex and chronic diseases - impact QOL)

1
- Inherited ( eg genetics)
- acquired ( eg socio-economic factors, biofilm load or composition, smoking, carbohydrate intake)

2
Important for prevention and management

Question 18

Eg of plaque retention at local sites that cause local risk factors

Answer 18

1. Supragringival calculus
   2 + 3. Overhanging restoration

Question 19

TIPS FOR WITH PATIENTS

Answer 19