Periodontal Disease and Systemic Risk Factors 1 & 2 Flashcards
What does systemic mean?
Affecting the entire body. e.g. High Blood pressure
Why do we need to know about a patients alcohol consumption?
- Excessive alcohol can cause liver disease which in turn can affect dental treatment and prescribing.
- It is a risk factor to Periodontal Disease
- High intake compromises treatment outcome
Excess alcohol intake can result in the following dental conditions:….
Short term:
Dental trauma
Facial injury
Long term:
Oral cancer
Periodontal disease
Non-carious tooth surface loss.
What does “NHANES III” stand for?
Third National Health and Nutrition Examination Survey
What is the Role of Vitamin C?
- Essential for collagen! i.e. healing
- Defends against oxidative stress and free radicles. Promotes chemotaxis
- Also essential for iron absorption.
What is the Role of Vitamin D?
- Essential for skeletal development
- Modulation of immune system
Deficiency of vitamin D associated with reduced immunity and increased autoimmunity .
How much Vitamin D a day do we need?
•Need at least 30 mg per ml serum but optimal is 40-60
What are the 2 main theories linking Psycho-social stress & Chronic Disease?
1. Psychoneurogenic model.
Poor coping behaviour to chronic stress results in activation of the Hypothalamus-Pituitary-Adrenal (HPA) axis & Sympathetic Nervous System.
This reduces the efficiency of the immune system (host response) resulting / exacerbating in chronic disease
2. Behaviour-orientated model.
Poor coping behaviour to chronic stress results in changed behaviour.
Results in “at risk” health behaviour which potentially promotes chronic disease:
- ↑ smoking.
- ↑ alcohol intake.
- Poor diet.
- ↓oral hygiene.
- Disturbed sleeping patterns
Poor compliance with health/dental care (↓ attendance)
What is HbA1c ?
HbA1c is a measure of how well controlled your blood sugar has been over a period of about 3 months
What does Advanced Glycation End products (AGE) increase?
Advanced Glycation End products (AGE) increase oxidative stress, these products are found in almost all ‘bad’ foods.
What are some additional complications with obesity?
- Obesity 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
- More difficult to access appointments
Classically Diabetes Mellitus is described as having 5 major complications, what are they?
- Atherosclerosis.
- Retinopathy.
- Nephropathy.
- Neuropathy.
- Impaired wound healing.
More controlled diabetes is less likely to develop periodontits.
What is the Recommended target level of control?
Recommended target level of control = HbA1c of less than 48 mmol/mol (6.5%) (Diabetes UK).
What may indicate undiagnosed Diabetes?
Recurrent periodontal abscesses or exaggerated periodontal inflammation.
Especially if there has been adequate OH.
What are some problems with uncontrolled Diabetes?
- Increased formation of Advanced Glycation End-Products (AGE). AGE formation is associated with altered collagen metabolism.
- Altered Immune Cell Function
- Altered Fibroblast Function
- Poor wound healing
