Risk Assessment new Flashcards
Define “Risk.”
Risk is the probability that an individual will get a specific disease in a given period.
Define “Risk Assessment.”
Risk Assessment is the act of determining the likelihood of a disease occurring in the future, based on the balance between risk factors and protective factors.
What is the purpose of Risk Assessment?
The purpose of Risk Assessment is to develop or modify the treatment plan, educate the patient about their own risk factors and oral health problems, provide factual information, relate oral health findings to behavioral habits, and educate on behavioral modification methods.
Where can a dental hygienist find and document risk factors?
A dental hygienist can find and document risk factors in the patient’s medical history, dental history, social/behavioral history, clinical examination, radiographs, and by considering the patient’s perception of their health.
Define and differentiate between risk factors, risk determinants, risk indicators, and risk markers.
- Risk factors are exposures, behaviors, lifestyles, genes, or conditions that increase the likelihood of a disease.
- Risk determinants are non-modifiable risk factors, intrinsic to the individual, such as age or genetics.
- Risk indicators are probable risk factors like exposures, behaviors, lifestyles, gene and conditions but with less conclusive evidence.
- Risk markers are predictors for disease occurrence, such as a history of periodontitis.
What is the difference between modifiable and non-modifiable risk factors?
- Modifiable risk factors can be changed (e.g., smoking, diet, oral hygiene).
- Non-modifiable risk factors are intrinsic to the individual and cannot be changed (e.g., age, genetics).
What are the two major risk factors and indicators for periodontal disease?
- The two major risk factors for periodontal disease are smoking and diabetes.
- Risk indicators include pathogenic bacteria, microbial tooth deposits, and local contributing factors.
Give examples of risk factors, risk indicators, risk determinants, and risk markers associated with periodontal disease.
- Risk factors: Smoking, diabetes.
- Risk indicators: Specific pathogenic bacteria, microbial tooth deposits, alcohol, nutrition, osteoporosis, stress, socioeconomic status.
- Risk determinants: Age, sex/gender, race/ethnicity, genetics, stress, socioeconomic status.
- Risk markers: Bleeding on probing, history of periodontitis.
What areas of risk assessment are covered in dentistry?
Areas include caries risk, oral hygiene, dietary habits, restorative susceptibility, bacteria, oral cancer risk, periodontal disease risk, and systemic diseases like diabetes and heart disease.
What is the relationship between Dental Hygiene Process of Care (DHPC) and treatment planning?
DHPC involves assessment, diagnosis, planning, treatment implementation, evaluation, and documentation.
Risk assessment informs the treatment plan by identifying potential risks and tailoring the treatment approach to minimize them.
Define SOAP documentation.
- S (Subjective): Patient’s reported symptoms and concerns.
- O (Objective): Clinical examination findings.
- A (Analysis): Diagnosis and treatment decisions based on findings.
- P (Procedures): Specific treatment performed and plans for further care.
What is the purpose of a risk assessment in dental hygiene?
To develop or modify a treatment plan, educate the patient about their oral health, and provide factual, behavior-related advice.
What sources are used to select risks for a dental risk assessment?
Sources include medical history, dental history, social/behavioral history, clinical examination, radiographs, and the patient’s own health beliefs and values.
How does smoking contribute to periodontal disease?
Smoking increases the risk of periodontal destruction by up to 6 times, leads to greater attachment loss, deeper probing depths, and reduced response to periodontal therapy.
What are the effects of smoking on the periodontium?
Smoking leads to pale, fibrotic tissue with reduced bleeding, more calculus, impaired immune response, and impaired healing after periodontal therapy.
lack of BOP does not equate to healthy tissues
heat and dryness
smokers enhibit no difference in plaque levels
What are the effects of diabetes on periodontal health?
Uncontrolled diabetes can result in more severe periodontitis, increased susceptibility to infections, poor wound healing, and other complications like xerostomia and burning tongue.
What are the effects does smokeless tobacco has on the periodontium?
- Increased inflammatory response at placement site
- Abrasive= gingival recession
- Mandibular buccal areas
- Contribues to periofontal disease and cancerous changes
- Success rates of implants are reduced in smokers
What is the difference between well-controlled and poorly-controlled diabetics in relation to periodontal disease
Well-controlled diabetics have no greater risk of periodontal disease than non-diabetics, while poorly controlled diabetics are at higher risk for severe periodontitis and poor healing outcomes.
What is the effects of hyperglycemia?
- Suppress the host immune response- diminished neutrophil function
- Leads to poor wound healing
- Recurrent infections
- Glucose rich environmnet may alter bacterial composition in plaque and influence development of disease
What are some oral manifestations of diabetes?
- Common complaints of uncontrolled diabetics: reduced salivary flow, burning tongue, xerostomia (candida albican growth)
What is the relationship between diabetes and periodontal therapy?
- Well controlled diabeteics: similar response to NST as non diabetics
- Poorly Controlled diabetics: poorer response to non surgical and surgical therapy, more rapid recurrence of deep pockets, less favorable long term response to treatment.
- Add smoking= greater than 45 years i 20 times more to experience severe periofontitis than non-diabetic, non smoker.
Name three specific pathogenic bacteria associated with periodontitis.
Aggregatibacter actinomycetemcomitans
Porphyromonas gingivalis
Tannerella forsythia
Treponema denticola (mod)
How is malnutriton related to periodontal disease?
- Compromised host resposne and defense mechanisms
- Increased susceptibility to infection
- Exacerbate gingival response to plaque
Name the vitamins that are associated with periodontal disease when deficiencies occur?
A B C
How does chronic alcohol intake affect periodontal health?
Chronic alcohol intake can suppress the immune system, impair neutrophil function, lead to malnutrition, and increase the risk of bleeding and cancer.
Poor OH due to neglect
What are some sts about tobacco and alcohol use?
- 70% of alcoholics are heavy smokers
- smokers are 1.3 times more likely to drink alcohol than non smokers.
The risk for esophageal and other oral cancer increases with heavy use, list the highest to least.
Smokeless 50x
Smokers and drinkers 15x
Smokers 7x
Drinkers 6x
Cigar 4-6x
What are the periodontal implications of HIV/AIDS?
Patients with HIV/AIDS may experience disproportionate plaque-related inflammation, candidiasis, Kaposi’s sarcoma, linear gingival erythema, periodontitis and necrotizing gingivitis or periodontitis.
How does osteoporosis impact periodontal health?
Osteoporosis can lead to decreased bone density, which may exacerbate alveolar bone loss in periodontitis, especially when coupled with sufficient plaque stimulus.
This is a disorder characterized by the loss of bone mineral
Which population of people does osteroporosis affect?
postmenopausal women
sedentary or bedridden people
long term steriod therapy
What causes osteoporosis in postmenopausal women?
- cessation of estrogen production
- porous bone
- less trabeculation
- thin cortical plate
Osteoporosis and periodontitits risk is link to?
- linked between the skeletal osteoporosis and alveloar bone loss
- significant correctation between the mandibular bone and hip bone mineral density.
What can aggravate progression of periodontitisit in patients with osteoporosis?
- It doe not initiate tissue destruction
- loss of alveolar bone density can exacerbate bone resorption
- sufficent plaque stimulus= can lead to severe periodontitis
- HRT- can lessen inflam and slow progression
How can hormone alterations affect the periodontium?
Changes in hormone levels during puberty, pregnancy, or menopause can increase sensitivity, inflammation, and gingival enlargement in response to local irritants.
What occurs durin a increase or decreased level of hormones?
- Elevated estrogen and progesterone= vessel dialation and permeability (sensitivity), increase inflammation, exaggersted response to local irritants.
- Decreased levels of circulating hormones: dry mouth, altered taste and burning mouth.
Name some medications that may induce gingival enlargement.
Medications like calcium channel blockers (nifedipine), immunosuppressants (cyclosporine), and antiseizure drugs (e.g., phenytoin) may cause gingival enlargement.
oral contraceptives
What are some local contributing factors?
overhangs
subgingival margins
orthodontics
removable partials dentures
malposititioning
piercings
calculus
attached gingiva amount
trauma
How does stress affect periodontal health?
tress depresses immune function, increases susceptibility to periodontal disease, and may lead to behavioral changes like poor self-care, smoking, and bruxism.
What are non-modifiable risk determinants for periodontal disease?
Non-modifiable risk determinants include age, sex/gender, race/ethnicity, and genetics.
How does age affect the risk for periodontal disease?
The prevalence and severity of periodontal disease increase with age due to degenerative changes and prolonged exposure to other risk factors.
How does sex/gender affect the risk for periodontal disease?
Males tend to have more bone loss, attachment loss, and tooth loss compared to females. They also tend to have poorer oral hygiene, with higher levels of plaque and calculus
How does race/ethnicity affect the risk for periodontal disease?
African Americans are more likely to experience periodontitis, although socioeconomic status (SES) plays a significant role in the risk associated with race.
How does genetics influence the risk for periodontal disease?
Genetic factors, such as the IL-1 genotype, increase susceptibility to periodontal disease. About 30% of the population carries the IL-1 gene, and those with this genotype are 7 times more likely to develop severe periodontal disease.
What is the significance of bleeding on probing?
Bleeding on probing is a clinical indicator of gingival inflammation but not necessarily a predictor for future clinical attachment loss (CAL).
Previous History of periodontisits is a good?
clincial predicotr for future disease
severe loss at greater risk for future loss
free of disease have decreased risk fo development of CAL than current.
How does the Dental Hygiene Process of Care (DHPC) relate to treatment outcomes?
DHPC guides the assessment, diagnosis, planning, treatment, evaluation, and documentation of care, ensuring treatment goals are met and reducing the risk of malpractice.
