Local Periodontal Risk factors

Question 1

What is a risk factor and what are the type of risk factors involved in periodontitis?

Answer 1

Risk factors:
• An exposure that increases the probability of disease
• Periodontal risk factors can be: local, systemic, modifiable or non- modifiable

Periodontal disease is caused by the host response and bacteria/ plaque biofilm

Question 2

What do local risk factors do, and what are the two types of risk factors?

Answer 2

Local risk factors:
• Increases biofilm retention
• Increases biofilm pathogenicity
* Cause direct damage to the periodontium

1. Risk factors that increases plaque retention
   • Dental calculus
   • Tooth morphology

2. Local risk factors include the  following
• Mispositioned teeth
• Dental restorations and appliances
• Oral hygiene habits
• Occlusal forces

Question 3

List the types of local risk factor involved in the aetiology of periodontal disease. (7)

Answer 3

• Dental calculus
• Tooth morphology
• Malpositioned teeth
• Food impaction
• Dental restorations and appliances
• Oral hygiene habits
• Occlusal forces

Question 4

Describe dental calculus as a type of local risk factor involved in the aetiology of periodontal disease.

Answer 4

• Calculus has irregular, rough surfaces/ it has ledges. Bacteria and plaque catches onto this rough surface
• It causes direct damage to the periodontium
* Since it is calcified, the patient cannot remove it so it just gets worse and worse

Question 5

Describe tooth morphology as a type of local risk factor involved in the aetiology of periodontal disease.

Answer 5

• Developmental defects -> pits and fissures, tiny openings from PDL detachment, cracks in the teeth that harbour plaque and bacteria,
• Tooth and root concavities
• Deposits are hard to remove because deposits lie sheltered in tooth defects
• Poorly contoured restorations
* Carious lesions

Question 6

Describe malpositioned teeth as a type of local risk factor involved in the aetiology of periodontal disease.

Answer 6

Hinders proper plaque removal

Question 7

Describe food impaction as a type of local risk factor involved in the aetiology of periodontal disease.

Answer 7

• Trapped food between teeth
• Leads to periodontal breakdowns
* Alters the gingival contour

Question 8

Describe dental restorations and appliances as a type of local risk factor involved in the aetiology of periodontal disease.

Answer 8

• Crowns that are not reaching to the alveolar crest initiates bone resorption, and they tend to harbour bacteria
• Partial dentures, fixed bridges actually harbour dirt/ plaque when not cleaned regularly
• Poorly contoured restorations can harbour bacteria, for instance, if they have a rough surface or they over extend from the natural occlusion of the tooth
• Hard to clean around braces as food gets stuck at the cervical regions of teeth
* Lingual bars make it hard to clean in interproximal regions

Question 9

Describe oral hygiene habits as a type of local risk factor involved in the aetiology of periodontal disease.

Answer 9

• Mouth breathing; dehydrates gingival tissue
• Improper use of interdental aids- loss of contour tissue
• Tongue thrusting; force against anterior teeth causing lateral pressure to the periodontium
• Ineffective or traumatic tooth brushing
• Inadequate regularities in tooth brushing
* Incorrect use of dental equipment; interdental brushed can effectively remove biofilm from a root concavity, but floss cannot do this

Question 10

Describe occlusal forces as a type of local risk factor involved in the aetiology of periodontal disease.

Answer 10

• Parafunctional occlusal forces: clenching/ bruxism
• Occlusal trauma; excessive force places causes to periodontium, may initiate bone resorption and can accelerate existing periodontitis
• Widening of the PDL due to occlusal trauma
• Causes sensitivity, mobility and pain
* Unhealthy periodontium; excessive forces placed on unhealthy periodontium will accelerate existing periodontitis