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Clinical Practice > Risk Assesment of Perio Disease > Flashcards

Risk Assesment of Perio Disease Flashcards

1
Q

what are the two types of risk factors?

A
  • Local - local to oral cavity, factors which influence plaque accumulation.
  • Systemic - host response
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2
Q

what are the 3 types of local risk factors?

A

anatomical risk factors
iatrogenic risk factors
trauma from occlusion

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3
Q

what are some anatomical risk factors?

A

furcation involvement
root morphology
localised gingival recession
dental anatomy and tooth arch relationships

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4
Q

why is furcation involvement a risk factor?

A

difficult area to clean = plaque stagnation area

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5
Q

why is root morphology a risk factor?

A

root grooves are associated with localised deep narrow pockets that do not respond to RSD - usually lateral upper incisors

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6
Q

what dental anatomy make cause perio problems?

A

enamel pearls

- close to CEJ, makes RSD difficult, can be removed

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7
Q

what are some iatrogenic risk factors?

A 
overhangs
poorly designed dentures
ortho appliances
defective crown margins
defective bridge pontics
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8
Q

why are overhangs a risk factor?

A

interproximal area is very hard to clean and creates stagnation area

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9
Q

what are some systemic risk factors?

A 
genetic/inherited factors
environmental risk factors
behaviuoural risk factors
life style risk factors
metabolic risk factors
haematological risk factors
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10
Q

why is Downs syndrome a risk factor?

A

defects of PMNL chemotaxis and phagocytosis

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11
Q

why is chronic granulomatous disease a risk factor?

A

defect in killing ability of phagocytes

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12
Q

why is hypophosphotasia a risk factor?

A

poor mineralisation and formation of cementum - attachment compromised

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13
Q

why is Ehlers Danos a risk factor?

A

defects in collagen synthesis, hypermobility of joints and severe periodontal destruction

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14
Q

what drugs can cause issues in the periodontium?

A

anti epileptics - phenytoin - 50% have gingival overgrowth
Ca channel blockers - nifedipine/amlodipine overgrowth in 5-20%
immunosuppressants - cyclosporin - 30% overgrowth

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15
Q

why can gingival overgrowth cause issues?

A

makes OH difficult

false pocketing

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16
Q

what are the 2 most important behavioural risk factors?

A

poor OH

smoking

17
Q

what are pack years?

A

number of packs smoked per day x number of years patient smoked

18
Q

what are the stages of behavioural change in stopping smoking?

A
  • precontemplation
  • contemplation
  • preparation
  • action
  • maintenance
  • termination
19
Q

what are the 5 A’s of smoking cessation?

A 
ask
advice
asses
assist
arrange
20
Q

what are the 5 R’s in smoking cessation?

A 
relevance
risks
rewards
roadblocks
repetition
21
Q

what are lifestyle risk factors?

A

stress as a periodontitis risk factor

malnutrition as a periodontitis risk factor

22
Q

why is stress a risk factor?

A

link with NUG
stress reduces immune function
stress affects salivary function = increased plaque accumulation

23
Q

why might a vitamin c deficiency be a risk factor?

A

destruction of collagen

24
Q

what are some metabolic risk factors?

A

diabetes mellitus
pregnancy/OCP
crohns disease
sarcoidosis

25
Q

why is diabetes a risk factor for periodontitis?

A

poor controlled:

  • increase of periodontitis post puberty increases with age
  • the greater systemic complications of diabetes the more severe the periodontitis
  • the relationship between plaque and diabetes appears independent
26
Q

what is the relationship between type 1 diabetes and perio disease?

A

increased risk with age

increased risk with duration of diabetes

27
Q

what is the relationship between type 2 diabetes and perio disease?

A

3 x greater likelihood of LOA and bone loss

if glycaemic control is poor = 11 x risk of perio disease

28
Q

what factors contribute to the increased risk diabetic patients have to perio disease?

A

PMNL function - due to hypoglycaemia
collagen metabolism - less synthesised
wound healing - decreased in diabetics

29
Q

how may sarcoidosis affect the gingivae?

A

hyperplastic/granulomatous appearance with superficial ulceration

30
Q

why are haematological conditions a risk factor?

A

blood diseases don’t cause perio disease but alter the tissue response to plaque

Clinical Practice (22 decks)

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