Risk Assesment of Perio Disease Flashcards
what are the two types of risk factors?
- Local - local to oral cavity, factors which influence plaque accumulation.
- Systemic - host response
what are the 3 types of local risk factors?
anatomical risk factors
iatrogenic risk factors
trauma from occlusion
what are some anatomical risk factors?
furcation involvement
root morphology
localised gingival recession
dental anatomy and tooth arch relationships
why is furcation involvement a risk factor?
difficult area to clean = plaque stagnation area
why is root morphology a risk factor?
root grooves are associated with localised deep narrow pockets that do not respond to RSD - usually lateral upper incisors
what dental anatomy make cause perio problems?
enamel pearls
- close to CEJ, makes RSD difficult, can be removed
what are some iatrogenic risk factors?
overhangs poorly designed dentures ortho appliances defective crown margins defective bridge pontics
why are overhangs a risk factor?
interproximal area is very hard to clean and creates stagnation area
what are some systemic risk factors?
genetic/inherited factors environmental risk factors behaviuoural risk factors life style risk factors metabolic risk factors haematological risk factors
why is Downs syndrome a risk factor?
defects of PMNL chemotaxis and phagocytosis
why is chronic granulomatous disease a risk factor?
defect in killing ability of phagocytes
why is hypophosphotasia a risk factor?
poor mineralisation and formation of cementum - attachment compromised
why is Ehlers Danos a risk factor?
defects in collagen synthesis, hypermobility of joints and severe periodontal destruction
what drugs can cause issues in the periodontium?
anti epileptics - phenytoin - 50% have gingival overgrowth
Ca channel blockers - nifedipine/amlodipine overgrowth in 5-20%
immunosuppressants - cyclosporin - 30% overgrowth
why can gingival overgrowth cause issues?
makes OH difficult
false pocketing
what are the 2 most important behavioural risk factors?
poor OH
smoking
what are pack years?
number of packs smoked per day x number of years patient smoked
what are the stages of behavioural change in stopping smoking?
- precontemplation
- contemplation
- preparation
- action
- maintenance
- termination
what are the 5 A’s of smoking cessation?
ask advice asses assist arrange
what are the 5 R’s in smoking cessation?
relevance risks rewards roadblocks repetition
what are lifestyle risk factors?
stress as a periodontitis risk factor
malnutrition as a periodontitis risk factor
why is stress a risk factor?
link with NUG
stress reduces immune function
stress affects salivary function = increased plaque accumulation
why might a vitamin c deficiency be a risk factor?
destruction of collagen
what are some metabolic risk factors?
diabetes mellitus
pregnancy/OCP
crohns disease
sarcoidosis
why is diabetes a risk factor for periodontitis?
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
what is the relationship between type 1 diabetes and perio disease?
increased risk with age
increased risk with duration of diabetes
what is the relationship between type 2 diabetes and perio disease?
3 x greater likelihood of LOA and bone loss
if glycaemic control is poor = 11 x risk of perio disease
what factors contribute to the increased risk diabetic patients have to perio disease?
PMNL function - due to hypoglycaemia
collagen metabolism - less synthesised
wound healing - decreased in diabetics
how may sarcoidosis affect the gingivae?
hyperplastic/granulomatous appearance with superficial ulceration
why are haematological conditions a risk factor?
blood diseases don’t cause perio disease but alter the tissue response to plaque
