Aetiology Of Gingivitis And Periodintitis Flashcards
Define epidemiology
The study of the distribution and extermination of health+related states in the population and application to control health problems
What are the 3 plaque hypotheses?
Non-specific plaque hypothesis
Specific plaque hypothesis
Ecological hypothesis
Define “non-specific plaque hypothesis”
Periodontal disease is due to bacterial accumulation irrespective of its composition
What is the problem with “non-specific plaque hypothesis”
Doesn’t consider pathogenicity or host factors
This does not prove clinically
Define the specific plaque hypothesis
Periodontal disease is the result of an infection with a a single specific pathogen
What does the specific plaque hypothesis aim to address?
Target specific bacteria
Attempts to address why some patients have considerable plaque deposits but don’t progress to severe periodontal disease
Define the ecological hypothesis
Disease is the result of an Imbalance in the total micro flora due to ecological stress resulting in the enrichment of some ‘oral pathogens’
What is the effect of anaerobic bacteria?
Increased host inflammation
Increased proteins/glycoproteins used as a substrate to shift the microbial composition
This causes host mediated tissue damage
What are the 3 tri-factors?
Host/genetic
Micro-organisms
Environment
What is an example of an environment promoting plaque?
Overhangs
What is the red complex?
The red complex, which appears later during biofilm development, comprises species that are considered periodontal pathogens, namely, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia
What do bacteria use as food?
Proteins and glycoproteins
What are the 7 host factors which playa role in aetiology?
- Periodontists has a microbial element
- Bacteria and microbes are essential
What is the majority of damage from periodontist caused by?
Due to inflammatory host response to bacteria, biofilm rather than direct bacterial activity
What are the 2 types of systemic and local factors?
Non-modifiable
Modifiable
What are examples of systemic host factors?
General health
Lifestyle factors
Environmental factors
Is diabetes a modifiable factor?
Yes
Control of disease
What is an example of a lifestyle factor associated with periodontal disease?
Smoking
Drinking
What is an unmodifiable general health factor?
Chemo/cancer
What is an example of an environmental factor?
Dehydration due to environment
How would you describe the relationship between periodontitis and diabetes?
Bi-directional
How does cardiovascular disease relate to periodontitis?
The persons usually overweight
May be a smoker or ex-smoker
Systemic inflammation
What type of diet are you likely to see more systemic inflammation?
Carbohydrate
How does prolonged stress promote periodontal disease?
Can cause suppression if the immune system which may tip the host/bacteria balance in favour of the disease
Poor self care etc
What medication can promote inflammation? (Gingival enlargement)
Calcium channel blocker
Phenytoin for epilepsy
Ciclosporine
What normal changes can cause gingival enlargement?
Pregnancy
Adolescence
Can the dentist help with local factors?
Yes, educate
Remove
What are examples of local factors caused by dentist?
Defective restoration margins
Poorly designed dentures
Appliances with excessive gingival coverage
What is iatrogenic damage?
Damage/injury caused by the dental treatment
Patient not ready
What is false pocketing?
Gingival inflammation, not a true pocket
What is the defined size of a periodontal pocket?
Over 4mm
Why does mouth breathing effect gingival health?
Dry out
Body unable to fight off bacteria in a normal manner
Is calculus a local or systemic factor?
Local - area for more plaque build up
What are the symptoms of gingivitis?
Bleeding gums
Swollen gums
What are the symptoms of periodontal disease?
Bleeding gums
Food stuck
Receding gums
Black triangles
How would you assess the gingivae via gingival indices?
0 - no bleeding
1 - bleeding
Taken from gingival margin
What aspect of gingival do you lose when gingivitis occurs?
Lose stippling
What do black triangles indicate?
Historic periodontal disease
How do you deal with a patient at risk of periodontitis?
Remove supragingival plaque
Educate
