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perio exam 2 > perio disease: epidemiology and risk factors > Flashcards

perio disease: epidemiology and risk factors Flashcards

1
Q

epidemiology

A

the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to control health problems

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2
Q

3 main purposes of epidemiology

A
  1. determine amount/distribution of disease in a population
  2. investigate disease casualty
  3. control the disease
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3
Q

whats the difference between public health and clinical practice in terms of perio disease?

A

health of group vs health in individuals

-determinants of disease: dental plaque in individuals vs low SES or access to preventative dentistry

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4
Q

what is the underlying assumption in epidemiology?

A

distribution of disease among members of a population is not random

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5
Q

prevalence

A

proportion of cases within a population at a given point in time
**proportion not rate
=# of cases present in population/persons at risk for dises
*estimates burden of disease in a given population

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6
Q

why is prevalence useful?

A

for estimating health care resource needs

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7
Q

what is prevalence influenced by?

A

population dynamics and additive/cumulative effect of aging

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8
Q

what results in higher prevalences?

A

more sensitive diagnostic tests and new treatment modalities that enhance survival

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9
Q

incidence

A

average percentage of unaffected persons who will develop the disease of interest during a given period of time
*(risk or probability that a person will become a case…it IS rate
=# of NEW cases in population/persons in pop at risk

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10
Q

observation studies

A

cross sectional
cohort
case/control
(retrospective mostly)

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11
Q

manipulation studies

A

community intervention trials

randomized clinical trials

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12
Q

what leads to causality exploration?

A

case/control cohort

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13
Q

what leads to causality determination?

A

clinical trial

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14
Q

retrospective cohort

A

exposure–> outcome

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15
Q

case control

A

exposure

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16
Q

RCT and prospective cohorts

A

exposure–>outcome

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17
Q

retrospective measures at —

A

end

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18
Q

prospective measures at —

A

beginning

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19
Q

experimental study

A

preventions and treatments for diseases, active manipulation

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20
Q

observational study

A

causes, preventions, and treatments for diseases, passively

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21
Q

what increases the probability of making the correct diagnosis?

A

diagnostic tests

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22
Q

sensitivity

A

probability of a positive test among persons with disease

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23
Q

specificity

A

probability of a negative test among persons without the disease

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24
Q

positive predictive value

A

probability that a person has the disease given that a positive test has been obtained

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25
Q

negative predictive value

A

probability that a person does not have disease given that a negative test has been obtained

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26
Q

sens/spec is the probability of what?

A

a test result

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27
Q

predictive values are probability of what?

A

disease status

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28
Q

risk

A

predicts the ‘‘who will get the disease” in a specific period of time

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29
Q

risk factors

A

characteristics of individuals that place them at increased risk for getting disease

30
Q

risk assessment

A

predicting an individual’s probability of disease

-helps clinicians to modify risk factors as part of therapy

31
Q

prognosis

A

prediction of the course or outcome of disease

32
Q

outcomes of periodontitis

A

tooth loss, recurrent disease, and loss of function

33
Q

prognostic factors of periodontitis

A

tooth type, furcation involvement, bone loss, pocketing, mobility, occlusal force, home care, smoking, and systemic disease

34
Q

periodontal index systems

A

numerical rating scale for perio status of a person or population that considers prevalence and severity
-measurement of perio pockets and gingival tissue status

35
Q

a good index is…

A 
reproducible
easy to use
rapid
valid
reliable
adequate specificity
adequate sensitivity
36
Q

periodontal disease indicators

A 
plaque index
ging inflamm
probing depths (most objective index)
bleeding upon probing
clinical attachment levels
radiographic assessment of bone loss
37
Q

gingival indices

A 
measure one or more of: 
color
contour
bleeding
extent of ging involvement 
ging crevicular fluid flow
38
Q

gingival health and periodontal health

A
  • no perio loss
  • no inflamm
  • no PD (<3 mm)
  • no rec
  • no CAL loss (> 1 mm)
  • no BOP
39
Q

gingivitis

A

no perio loss, inflammation present

  • no PD
  • no rec
  • no CAL loss
  • BOP
40
Q

gingival health on reduced perio

A

perio loss but no inflamm

  • no PD
  • recession
  • CAL loss
  • No BOP
41
Q

T/F gingival plaque isn’t the only cause of periodontitis

A

true

42
Q

_____% of non-institutionalized US pop 13 years and older had gingival bleeding in at least one gingival site

A

54%

43
Q

on average per person, ____% of site had gingival bleeding

A

10

44
Q

among persons with gingival bleeding, an average of ____ %sites had gingival bleeding

A

18

45
Q

gingivitis is more prevalent among—

A

adolescents

46
Q

are males or females in all age groups more likely to get gingivitis?

A

males

47
Q

the prevalence of gingivitis is esp high for males aged ___ to ___

A

13-17

48
Q

it is clear from experimental and epidemiologic studies that ______ is the direct cause of gingivitis

A

microbial plaque

49
Q

smoking as a risk factor for perio disease

A

smoking is one of the most important risk factors for adult periodontitis, but its role in gingivitis is unclear

50
Q

define periodontitis

A

inflammation of periodontium that extends beyond the gingiva and produces bone loss and destruction of connective tissue attachment of teeth

51
Q

3 primary forms of periodontitis

A
  1. necrotizing
  2. periodontitis
  3. systemic disease
52
Q

current classification of periodontitis is based on ___-

A

CAL which is more indicative of disease accumulation throughout time

53
Q

staging is based on

A

severity

complexity

54
Q

grading is based on

A

progression

risk

55
Q

stage I

A
  • CAL: 1-2 mm
  • RBL: coronal third
  • tooth loss: none
  • local complexity: max probing depth < 4 mm; horizontal bone loss
56
Q

stage II

A

-CAL: 3-4 mm
-RBL: coronal third
-tooth loss: none
-local complexity: max probing depth <5 mm
mostly horizontal bone loss

57
Q

stage III

A

CAL: > 5 mm
RBL: extending to middle third of root and beyond
tooth loss: less than or equal to 4 teeth
local complexity: state II complexity plus probing depths of >6 mm, vertical bone loss > 3 mm, furcation involvement class II or II, moderate ridge defects

58
Q

stage IV

A

CAL: > 5 mm
RBL: extending to middle third of root and beyond
tooth loss: more than 5 teeth
stage III complexity plus need for rehab due to masticatory dysfunction, occlusal trauma, severe ridge defects, bite collapse, less than 20 teeth

59
Q

for each stage add

A
  • localized
  • generalized
  • molar/incisor pattern
60
Q

grade A

A 
slow
no bone loss over 5 years
% bone loss/age: <0.25
heavy biofilm with low levels of destruction
non smoker
non diabetes
61
Q

grade B

A 
moderate
bone loss: <2 mm over 5 years
% bone loss/age: 0.25 to 1.0
destruction commensurate with biofilm deposits
<10 cigs/day
HbA1c: <7% in diabetics
62
Q

grade C

A 
rapid
bone loss: > 2 mm over 5 years
% bone loss/age: > 1.0
destruction exceeds expectations given biofilm deposits; periods of rapid progression or early onset
> 10 cigs/day
HbA1c>7%
63
Q

what is the prevalence of periodontal pockets ?

A

> 4 mm —-23%

64
Q

the increase in prevalence of attachment loss with increasing age is not seen with–

A

pocket depth

65
Q

PSR may lead to—

A

underestimation of periodontitis

66
Q

estimated that approximately —– of USA population >30 years has perio disease

A

half

67
Q

what’s the typical profile of periodontitis?

A
  • becomes clinically significant after 30 years old
  • slow progression of attachment loss over time
  • males more than females to have attachment loss and more teeth with pockets
  • increased prevalence with age is more likely a reflection of cumulative effect of CAL over time
68
Q

3 main microorganisms for perio

A

A actinomycetemecomitans
porphyromonas gingivalis
t. forsythia
*the presence of these pathogens is not sufficient to cause disease

69
Q

what are other local factors that may cause perio?

A

diabetes, smoking, nutrition, SES, genetics, systemic diseases

70
Q

non-modifiable risk factors

A

age
gender
race
gene polymorphisms

71
Q

modifiable risk factors

A

biofilm formation control
cigarette smoking
psychosocial factors
systemic disease

perio exam 2 (4 decks)

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