Chapter 10 Flashcards
Risk factors and étiologic factors
Risk factor: any attribute, characteristic, or exposure associated with increased likelihood of developing disease or injury.
Etiologic factor: any attribute, characteristic, or exposure known to cause disease
Local Risk factors
- Acquired local risk factors: calculus, overhanging restorations, poorly contoured restorations
-Anatomic risk factors: Malpositioned teeth, root grooves, concavities, and furcations
systemic risk factors
- Uncontrolled diabetes
-stress
-hormonal changes
-systemic bone disorders
-neutrophilic disorders that manifest as periodontitis and fall under current diagnostic category of periodontitis as manifestation of systemic disorders
Tobacco Use
- Most significant known risk factor for periodontitis
-Has profound impact on periodontitis development and treatment response
Medications
- Can have side effect of contributing to gingival enlargement
-Examples: Calcium channel blockers, anticonvulsants, immunosuppressants
Biological Equilibrium
Physiologic mechanism that functions to maintain state of balance in internal environment of body
Also called homeostasis
Periodontal health
- State of biological equilibrium within oral cavity between biofilm bacteria and host
- Bacterial challenge must be contained at level tolerated by host
- Can be thought of as balance scale
No disease progression if sides in balance
Periodontal Disease
- Presence of certain risk factors can tip balance, leading to disease
- Risk Factor in one individual may not be risk factor for another individual
Example: diabetic patient with poor glycemic and plaque control at higher risk than diabetic patient with good glycemic and plaque control
The delicate balance between health and disease
- When active periodontal disease sites present in mouth: Goal is to return oral cavity to state of biological equilibrium
Periodontal equilibrium and dental plaque biofilm
- Individual patients respond differently to plaque biofilm
- Many patients exhibit gingivitis without clinical signs of progression to periodontitis
May have no systemic or acquired risk factors that disrupt biologic equilibrium,
- In some individuals, gingivitis progresses to periodontitis
- Theorized that immune response is responsible for tissue destruction
- Some individuals possess systemic risk factors that significantly increase susceptibility
- Many patients unable or unwilling to perform thorough self-care necessary to control plaque biofilm
-Must increase frequency of professional care to compensate (can be effective in restoring balance between health and disease
Local Risk Factors
- Often possible to eliminate local risk factor (correcting faulty restoration)
- May be able to compensate by improving self-care or increasing frequency of professional care (using tufted dental floss around abutment teeth of fixed bridge)
Systemic Risk Factors
- May be able to control or eliminate if patient is willing to do so (working with physician to keep diabetes controlled)
Genetic Risk Factors
- If contributing risk factor cannot be controlled, must add weight to health side of scale
Example: abnormal neutrophil function
- Increases susceptibility to severe periodontitis
- Cannot be controlled, but can assist patient in maintaining health by increasing extent of professional care
Periodontal Risk assessment
- Process of identifying risk factors that increase individual’s probability of disease
- AAP describes risk assessment,ent process as:
Increasingly important in periodontal treatment planning and should be part of every comprehensive dental and periodontal evaluation
Assessment of the individual
Becoming possible to:
- Consider individuals risk factors for periodontal disease
-Classify patients into high or low risk groups
- Example: smokers at higher risk than nonsmokers
