Aetiology of Periodontal diseases- local factors

Question 1

What is the primary aetiological factor of periodontal disease?

Answer 1

Bacterial plaque

Question 2

What are Secondary local factors (plaque retentive factors) of periodontal disease?

Answer 2

o Dental Calculus
o Other plaque retentive features
o Lack of saliva

Question 3

What is dental calculus?

Answer 3

Mineralised dental plaque covering the enamel or root surface. Calcium and phosphate crystals

Supragingval: found in sites of saliva pooling, light coloured and frosted

Subgingival calculus: found in periodontal pockets, these are hard and dark, difficult to remove

Calculus acts as a plaque trap and needs to be removed professionally.

Question 4

Give examples of Local plaque retentive factors

Answer 4

• Tooth position
• Gingival anatomy
• Tooth shape/ abnormalities
• Root anatomy
• Carious cavities
• Overhanging restorations
• Removable prostheses/ appliances

Question 5

How is tooth position a local plaque retentive factor?

Answer 5

Malalignment and crowding increase plaque accumulation. Need to demonstrate to patients how to remove effectively.

Open contacts will lead to food packing also instruct patients to remove food periodically.

Question 6

How is gingival anatomy a local plaque retentive factor?

Answer 6

Gingival overgrowth presents as a plaque trap in itself difficult for patients to remove plaque around these areas.

Prominent frenum: makes it difficult for patients to brush around the area.

Question 7

How are tooth abnormalities a local plaque retentive factor?

Answer 7

Enamel projection increases plaque accumulation around the area.

Question 8

How are root anatomy and abnormalities a local plaque retentive factor?

Answer 8

Furcation is where the roots divide this is usually covered by bone there has been bone loss this surface will present as an area for plaque to attach to.

Root depression e.g. canine fossa 1st first premolars.

The root groove’s unevenness on the tooth surface is another plaque retentive feature.

Question 9

What is Xerostomia?

Answer 9

Xerostomia (Dry mouth) is reduced or lack of salivary flow.

This can result in an increased gingival inflammation due to lack of salivary antibacterial factors present in the saliva.

Question 10

Who tends to have Xerstomia?

Answer 10

Mouth breathers they have:
o Incompetent lips
o Drying of labial tissues
o Patients taking polypharmacy

Patients with certain conditions e.g. Sjogren’s syndrome

Salivary gland disease