Question 1

What BMI is considered obese and overweight?

Accepted Answer

- greater than or equal to 30 is obese - 25 is overweight

Question 2

what happens when we have over-nutrition?

Accepted Answer

- higher circulating glucose - more adipose tissue - greater inflammatory drive - treatment becomes more complicated

Question 3

Describe obesity and periodontitis

Accepted Answer

- Obesity means a greater risk of dysbiosis - Obese patients have less diverse microbiomes, greater effect on females - dysbiosis results as aerobic pathways become fermentation

Question 4

What happens if u reduce the amount of processed food and replace it with more wholesome food, and cut back on sugar

Accepted Answer

The biofilm changes, even if you have got a higher quantity of bacteria, the bacteria that are there both in the gut and orally become the more friendly type and the bleeding on probing will reduce in our patients and the pockets are reduced even without any oral hygiene

Question 5

If u have poorly controlled diabetes and have refined food/sugar what occurs?

Accepted Answer

- poorly controlled diabetes are 3x risk of periodontitis - high HbA1c affects the microbiome, loose good bacteria, destabilises immune system - oxidative stress, bacterial burden, low grade systemic inflammation IL6 significantly higher - advanced glycation end products (AGE) increase oxidative stress, these products are found in almost all 'bad' foods

Question 6

What complications arise from obesity ?

Accepted Answer

More likely to suffer sleep apnoea - stressful, 36% higher chance of severe periodontitis over control patients - sleep regulates immune and inflammatory processes - weight loss helps reset the oral microbiome - complicates treatment - more tissue makes surfaces harder to keep plaque free - high cho diet favours plaque formation (and root caries) - tissue and tongue spread make access difficult - safety, comfort, and the dental chair - comorbidity

Question 7

what is diabetes mellitus?

Accepted Answer

is a chronic medical condition characterized by elevated levels of blood sugar (glucose). This happens either because the body cannot produce enough insulin or because the cells do not respond adequately to the insulin produced.

Question 8

describe chronic hyperglycaemia

Accepted Answer

- results in varying degrees of dysfunction of the carbohydrate, lipid and protein metabolism causing widespread cellular and molecular dysfunction - this causes significant disturbance of the immune response, angiogenesis and wound healing leading to microvascular and macrovascular systemic pathology

Question 9

What are the 5 major complications that can arise from diabetes mellitus?

Accepted Answer

- atherosclerosis - retinopathy - nephropathy - neuropathy - impaired wound healing

Question 10

How is long term blood glucose control assessed?

Accepted Answer

By measuring the glycated haemoglobin (HbA1c) score from a blood sample

Question 11

what is the recommended target level of glycaemic control?

Accepted Answer

- HbA1c of less than 48mmol/mol (6.5%) - increased chance of preventing/delaying the complications of diabetes - the higher the HbA1 score above 48mmol/mol the higher the risk of developing the long term complications of diabetes

Question 12

what should be aware of in terms of DM and periodontal disease ?

Accepted Answer

- recurrent periodontal abscesses &/or exaggerated periodontal inflammation may indicate undiagnosed diabetes especially if the oral hygiene and periodontal treatment (debridement appears to have been adequate consider referral to GMP for investigation - periodontal disease in DM is associated with an exaggerated & prolonged inflammatory response to the periodontal microflora - diabetes has many complex negative effects on the host response to periodontal infection

Question 13

What are problems with uncontrolled diabetes?

Accepted Answer

- Increased formation of advanced glycation end-product (AGE) - altered immune cell function - altered fibroblast function - poor wound healing

Question 14

what does chronic hyperglycaemia lead to?

Accepted Answer

non-enzymatic glycation (additional fructose or glucose) of proteins results in the formation of stable advanced glycation end products (AGE)

Question 15

What is the link between AGE and DM

Accepted Answer

AGE formation is significantly increased in DM with greater levels of AGE formation being associated with poorer levels of glycaemic control

Brainscape's Knowledge GenomeTM

periodontal disease and systemic risk factors Flashcards

Brainscape's Knowledge Genome^TM