PD: Systemic risk factors (session 1) Flashcards
Inflammatory response key players
PMNs, Cytokines, IL1, PGE2, Osteoclast activation.
Linea alba
Streak white line on buccal mucosa typically from cheeky bitting etc.
Rothman’s causality pies
An individual factor that contributes to cause disease is shown as a piece of a pie, like the triangles in the game Trivial Pursuit. After all the pieces of a pie fall into place, the pie is complete, and disease occurs. The individual factors are called component causes.
Obesity (BMI)
> 30 (25 = overweight)
How does being fatter encourage greater desire to eat?
High adipose tissue (fat) means the insulin will not work correctly, encouraging patients to continue to eat.
How does adipose tissue cause greater inflammation in patients?
Adipose tissue produces cytokines, TnF alpha IL6, Pro inflammatory mediators, Adipokines (leptin etc. which are proinflammatory).
How could adipose tissue increase bacterial activity?
Bacteria can use cytokines (a product of adipose tissue) as an energy source, increase proteolytic activity and increase anaerobes.
Dysbiosis results as aerobic pathways become fermentation.
Poorly controlled diabetes are ___ more at risk of periodontitis.
three times
HbA1c
Average blood glucose (sugar) levels for the last two to three months.
Foods the associated with advanced glycation end products.
Fried food, processed food, meat, cheese.
Vascular aging and damage.
Foods the associated with advanced glycation end products.
Fried food, processed food, meat, cheese.
Vascular aging and damage.
Sleep apnoea
When your breathing stops and starts while you sleep.
Sleep apnoea
When your breathing stops and starts while you sleep.
How can sleep apnoea affect periodontitis?
36% higher chance of developing severe periodontitis over control patients.
Sleep regulates immune and inflammatory processes.
Prebiotic foods
Fibres, cruciferous vegetables ( 🥦 )
Five major complications of Diabetes Mellitus
- Atherosclerosis (the buildup of fats, cholesterol and other substances in and on the artery walls).
- Retinopathy (a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina)).
- Nephropathy (the deterioration of kidney function)
- Neuropathy (a result of damage to the nerves located outside of the brain and spinal cord)
- Impaired wound healing
What is the 6th complication of diabetes mellitus as described by Loe (1993)?
Periodontal disease
Target levels for HbA1C
Less than 48 mol/mol (6.5%) - Diabetes UK.
How often should you ask a diabetic patient about their HbA1c level?
At each visit, compare this with the clinical findings to see how it compares.
What features of the papillae may indicate diabetes?
Purpling or pus discharging (multiple sites - systemic indicatior)
Four major biochemical effects of uncontrolled diabetes
- Increased formation of advanced glycation end-products (AGE).
- Altered Immune Cell Function.
- Altered Fibroblast Function.
- Poor wound healing.
How might AGE negatively affect the cellular function of various cell types throughout the body?
Many cells within the body have specific cell surface receptors for AGE. Therefore these cells (endothelial cells, fibroblasts, neurones, monocytes/macrophages) can be negatively affected. AGE products also lead to oxidative stress.
How is the reduced neutrophil (PMN) function be illustrated in the mouth?
Persistent bacterial infection and tissue damage found (multiple pus producing sites).
Hyper-responsive monocytes and macrophages result in…
Increased secretion of pro-inflammatory mediators such as cytokines (IL-1 & TNF α) & prostaglandins (PGE₂).
Results in increased tissue damage and impaired wound healing.
