BDS3 Periodontal Disease Risk Factors Flashcards
Name the Acquired Local Risk Factors of Periodontal Disease
Plaque, Calculus, Overhanging and Poorly contoured restorations and Prosthetic crowns, Orthodontic appliances and Occlusal trauma
Name some Anatomical Local Risk Factors of Periodontal disease
Malpositioned teeth, Root grooves, Concavities and furcations, Enamel pearls
Name some non-modifiable Systemic risk factors of periodontal disease
Aging, Genetic factors, Gender(Males more susceptible), Genetic disorders (Down syndrome, Papillon-Lefevre syndrome)
Name some Modifiable Systemic Risk Factors of Periodontal disease
Smoking, Poorly controlled diabetes, HIV, Leukaemia, Osetopenia, Osteoporosis, Stress, Medications, Hormonal status, Poor nutrition, Socioeconomic status
Definition of Periodontal disease
A group of diseases affecting the periodontal tissues, representing an immune reaction (innate and adaptive) to adjacent microbial plaque. It is a multifactorial condition with complex etiopathogenesis.
Definition of Gingivitis
Common and mild form of periodontal disease that causes irritation, redness and inflammation of your gingiva. Does not always progress to periodontitis
Definition of Periodontitis
Inflammation of the periodontal tissues, causing shrinking of gums and loosening of teeth. May progress at different rates at different sites in the mouth and in different people
Definition of Periodontal Health
Outcome of the balance between bacteria of the dental plaque and the host immune system
What are genetic conditions associated with the impairment of immune system which can lead to Periodontal disease
Papillon-Lefevre syndrome, Chediak-Higashi synrdrome, LAS syndrome (Lance-Adams), Down’s syndrome, Chronic granulomatous disease
What are some disease that lead to impairment of immune system which can lead to periodontal disease?
Leukaemia, Agranulocytosis, Neutropenia, HIV infection
Definition of Risk Factor
Something that increases a person’s chances of developing a disease
Why is Smoking a risk factor for Periodontal disease?
- Has an effect on oral microbiota
- Increase activation of the immune system
- Decreased healing capacity due to reduced blood flow
How does obesity have an affect on periodontal health?
- Adipocytes secrete adipokines
- Examples are leptin, Adiponectin and resistin
- Have a proinflammatory effect and can lead to periodontal disease
What does a lack of nutrients do to the immune system?
Decrease function of immune system
What drugs can be a risk factor for periodontal disease?
- Anticonvulsant (Phenytoin)
- Immunosupresants (Cyclosporin) e.g. transplant patients
- Calcium channel blockers (Nifedipine, amlodipine)
How can some drugs affect periodontal health?
- Interaction between the drug and host fibroblasts
- Result in increased deposition of connective tissue supporting a hyperproliferative (abnormally high rate of proliferation of cells by rapid division) epithelium
What is gingival enlargement hyperplasia?
- Abnormal overgrowth of gingival tissues
- Caused by more fibroblasts
What is gingival swelling?
- Redness and inflammation of gingiva
- More intercellular fluid increased permeability of the vessels (caused by some drugs)
What is Chronic granulomatous disease?
- Abnormal leucocyte intracellular killing
How does HIV affect periodontal tissues?
- Increased risk of necrotising conditions
- No evidence of increased progression of periodontisis
How does Blood dyscrasias e.g. Neutropenia, Agranulocytosis and Leukaemia affect periodontal tissues?
- Reduced numbers/functions of neutrophils and macrophages
- Increases risk of NUG (Necrotising ulcerative gingivitis) and progressive periodontitis
How does pregnancy affect periodontal tissue?
- Increased risk of gingival inflammation (pregnancy gingivitis)
How does Osteoporosis and Osteopenia affect periodontal health?
- Low bone mineral density in maxilla and mandible as a result of osteoporosis
- Accelerates alveolar bone resorption in periodontal infection
How does Psychological stress affect periodontal health?
- In response to stressful events the hypothalamus-pituitary-adrenal axis is stimulated
- Leads to increased production and secretion of cortisol
- Cortisol can stimulate the immune system
- ANS is also stimulated leading to secretion of catecholamine and substance P which regulates immume/inflammatory response and affect bacterial adherence and growth
What are the Long term clinical complications of Hypertension?
- Heart failure
- Renal failure
- Dementia/stroke
- Vascular disease
Hypertension is main mortality reason among world population
What is atherosclerosis?
- Inflammation of the vessels wall
- Clogged with fatty substances called atheroma
What is preeclampsia?
- Condition that causes high blood pressure during pregnancy and after labour
- Can be serious if not treated
How does untreated periodontitis affect Diabetes Mellitus patients?
- Lead to circulating bacteria and bacterial antigens
- Lead to elevated circulating levels IL-6, TNF-alpha, CRP, oxygen radicals
- Both lead to systemic inflammatory state impaired insulin signalling and resistance
- Lead to elevated HbA1c levels and exacerbation of diabetes
- Increased diabetes complication
How does ongoing periodontal treatment affect Diabetes Mellitus patients?
- Reduced circulating bacteria and antigens
- Reduced circulating TNF-alpah and CRP (C-reactive protein)
- Reduction in systemic inflammatory state improvement in insulin signalling and resistance
- Reduction in HbA1c and improved diabetes control
- Less diabetes complications
