ICS2/5: Risk Factors in Periodontal Disease 2

Question 1

what is dose response?
why is important to demonstrate it?
absence of dose response relationship - rules out causal r/s?

Answer 1

• the relationship between exposure level to a proposed risk factor and disease prevalence
• demonstrable dose response helps build evidence of risk factor status
• no it does not. there is still a threshold relationship that could exist instead of dose response one.

Question 2

how is tobacco dosage assessed?
how to calculate?
what does this measurement provide?

Answer 2

• in “pack years”
• number of packs/day x number of years person smoked
• provides an estimate of life time exposure/dose to smoking

Question 3

level of dependence:
high dependence is shown by how much tobacco exposure?
why do people develop high dependence to tobacco?

Answer 3

• shown by smoking at least 15-20 cigarettes per day. or smoking within 30 minutes of waking
• smoking provides rapid, high but transient concentration of nicotine. it has a short half life and requires smoker to maintain levels on a repetitive and regular basis.

Question 4

smoking: evidence as risk factor
dose dependent response regarding?
what do longitudinal studies show?

Answer 4

• severity of LOA & bone loss
• smokers have significant risk of disease progression (LOA, bone loss, increased pocket depths) compared with non-smokers

Question 5

according to evidence provided, how does smoking affect periodontal treatment outcome?

Answer 5

multiple studies report reduced treatment outcomes (increased treatment failure) in smokers compared with non-smokers

Question 6

positive effects of smoking cessation?

Answer 6

• reduced bone loss and tooth loss
• reduction in pocket depth over 12 month period
• the longer pt has stopped smoking, the more their tissue response to treatment becomes to that of a never-smoker

Question 7

smoking cessation: what are the classifications of smokers?

Answer 7

pre-contemplators (not interested)
contemplators (interested unready)
active quitters (making an attempt)

Question 8

to be continued

Answer 8

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