Perio Risk Factors Flashcards
What are the systemic risk factors for periodontitis?
Non modifiable-
- aging, genetics, gener, genetic disorders (down’s, Papillon, lefevre), family history
Modifiable-
- Smoking
- Diabetes
- Stress
- Diet
- Obesity
Osteoporosis
Rheumatoid arthritis
Socio-economic status
What are the local risk factors for periodontitis?
Plaque biofilm
Plaque retentive factors- calculus, dental crowding, overhangs, partial dentures, ortho appliances.
What is periodontal disease?
A group of diseases affecting the periodontal tissues, representing an immune reaction to adjacent microbial plaque.
Over-activation of the immune system, leads to periodontitis in susceptible hosts.
What is periodontal health?
The outcome of the balance between bacteria of the dental plaque and the host immune system.
Less than or equal to 10% BOP and pocket depths less than 3mm.
What diseases are associated with the impairment of the immune system?
Papillon-Lefevrew syndrome
Down’s syndrome
LAS syndrome
Chronic granulomatous disease
Leukaemia
Neutropenia
HIV infection
What is a risk factor?
Something that increases a person’s chance of developing a disease.
Explain how smoking is a risk factor for periodontitis?
Causes an increased activation of the immune system
Decreased healing capacity- reduced blood flow- this can also suppress the signs and symptoms of periodontitis.
Promotes the invasion of pathogenic bacteria- favours colonisation of pathogenic bacteria.
The risk increases as the n umber of cigarettes increases per day.
Do not respond well to perio treatment.
How does sub-optimally controlled diabetes affect perio disease?
May modulate RANK (receptor activator of nuclear factor happy beta)L: OPG ratio- contribute to alveolar bone destruction.
In hyperglycaemia, products of AGE (advanced glycation end products) increases which leads to exacerbation of inflammation- production of pro-inflammatory cytokines and destructive MMPs.
What would be classified as diabetes in terms of HbA1c?
greater than 48 mmil/L or 6.5%.
What factors relating to diabetes, contribute to perio?
Degree of diabetic control
Age of onset
Duration of the disease
How is obesity and nutrition a risk factor for perio?
Lack of nutrients decreases the function of the immune system.
Adipocytes produce a lot of cytokines- adipokines.
- promotes inflammation.
What drugs cause gingival hyperplasia?
Anticonvulsants- phenytoin
Immunosuppressants- cyclosporin
Calcium channel blockers- amlodipine, nifedipine
Interaction between the drug and fibroblasts resulting in an increased deposition of connective tissue supporting a hyperproliferative epithelium.
What systemic diseases make you at an increased chance of getting periodontitis?
Papillon-Lefevre syndrome- defects in neutrophil adhesion
Down’s syndrome- abnormal leukocyte chemotaxis and phagocytosis
LAD syndrome
What acquired systemic diseases ad associated with an increased risk of perio?
HIV infection
Pregnancy
Scurvy
Blood dyscrasia- neutropenia, leukaemia
What other risks factors are present for periodontitis?
Osteoporosis- alters the balance of RANKL:OPG, increase release of pro-inflammatory cytokines, destruction of perio tissues (MMPs).
Psychological stress.
