Chapter 5 - General periodontal risk factors

Question 1

what is the most important known risk factor for periodontal disease?

Answer 1

Cigarette SMOKING

Question 2

if you smoke you are not only more likely to have perio problems but also…

Answer 2

have a reduced success from treatment and a higher chance of recurrance

Question 3

why do smokers have increased risk and reduced success to tx? 4 reasons

Answer 3

• a reduction in gingival blood circulation (masks the signs of gum disease)
• impaired white blood cell mobility and function
• impaired wound healing
• an increased production of inflammatory substances (cytokines) particularly due to nicotine which results in an increases the production of collagenase

Question 4

what does collagenase do?

Answer 4

breaks down the peptide bonds in collagen

Question 5

Why is treatment of periodontitis for patients with diabetes more difficult?

Answer 5

they have impaired wound healing (especially if poorly controlled)

Question 6

what affect do hormonal changes have on the ginigvae?

Answer 6

can exacerbate the gingival response to plaque and therapy

Question 7

3 main times for hormonal change

Answer 7

• puberty
• pregnancy
• menopause

Question 8

why, in pregnancy, is there an increased severity of gingivitis?

Answer 8

• increased circulating levels of progesterone
• causes increased permeability of gingival vessels
• and consequently increased bleeding and swelling

Question 9

define pregnancy epulis

Answer 9

the enlargement of the dental papilla which gives lesions of around 2cm in diameter

Question 10

what is the treatment of a pregnancy epulis?

Answer 10

best to avoid surgical removal until after birth unless very large and troublesome.

most resolve through good plaque control and tend to spontaneously resolve at the end of preganacy

Question 11

how are patients with leukaemia more likely to get periodontal disease?

Answer 11

if there has been altered leukocyte function

Question 12

what is the link between periodontitis and age

Answer 12

older patients are more liekly to have periodontitis than young because they have had many years of exposure to plaque and to the various risk factors known to be assocaited with periodontitis ( ie smoking, type 2 diabetes)

Question 13

although inconclusive evidence why is it thought that stress is a risk factor for periodontitis development?

Answer 13

stress can affect a patients

• immune response to plaque
• behaviour (ie poorer OH/smoking more etc)