Risk Assessment of the Periodontal Patient Flashcards
What is “risk assessment?”
A statistical evaluation to determine how much you would like to gamble
(Given the facts that you KNOW… what do you think the odds are for disease progression or treatment outcome)
A risk assessment:
- contains ______ components
- is the _______ of contracting a disease
- ______ between individuals
numerous
probability of contracting disease/having unfav. outcome
VARIES
What are the four levels of evidence-based assessment of risk?
- Case Reports
- Cross-Sectional Analysis
- Longitudinal Studies
- Intervention Studies
Describe the process for risk assessment:
- Identify risk factors
- Develop a risk-assessment model (look at evidence)
- Assess the population (specific, ethnicity, etc)
- Target a prevention program or intervention
A polymorphism in which gene has been associated with an increased risk for periodontitis in certain populations?
IL-2
What did Perio Predict use as its basis for assessing risk of periodontitis? What is wrong with this?
based on 6 Snps that were highly associated with perio disease.
there are ethnic differences for which this technology (these 6 Snps) was irrelevant and completely wrong
What are “risk FACTORS?”
environmental, behavioral, or biological factors that are part of the CAUSAL CHAIN toward disease occurrence.
What kind of evidence is required in order to establish risk factors?
Longitudinal Evidence is required…must show exposure precedes disease onset
How many risk factors exist for perio disease?
Two:
smoking and diabetes
True or False: Smoking is a risk factor, tobacco is not a risk factor.
True
The “odds ratio” is a way of comparing whether the probability of a certain event is _________.
the same for two groups
The odds ratio for both “smoking” and “diabetes” is approximately _____.
4
“Extreme” smoking puts patients at a ____ times greater risk for perio disease.
16
What is a “risk DETERMINANT?”
considered to be a substitute term for a risk factor; however, DETERMINANTS are reserved for those factors that cannot be modified
What are some examples of risk determinants?
age (older>younger) gender (men>women) ethnicity socioeconomic status (poor>rich) genetic predisposition (IL-1beta for example)
What are “risk INDICATORS?”
a probable or putative risk factor that is NOT confirmed by longitudinal studies (if it were it would be a “factor”)
Risk indicators are identified via ______ studies; risk factors or determinants are identified via ______ studies
indicators = cross-sectional factors/determinants = longitudinal
What are some examples of risk determinants?
obesity inflammation stress osteoporosis HIV/AIDS Microbiota
Risk determinants are _____ but not _____ to cause disease.
necessary
sufficient
What are “risk PREDICTORS?”
increases risk for disease but is NOT part of the causal chain
Risk _______ could be a consequence of the disease that would then put you at risk for future problems or disease.
predictors
predicting the future?
Risk predictors are useful for predicting who is _______ but not in identifying likely _______.
at risk
interventions
Situation: Two patients of the same age present without either risk factor (smoking/diabetes), both also lack risk indicators (inflammation) and both have good oral hygiene. However, patient A has 6 mm pockets and patient B has 1 mm pockets. Which patient has a risk “predictor?”
Patient A…. predicting the future….you could say that he/she is at higher risk for severe bone loss or attachment loss
What are some examples of risk predictors?
bleeding on probing
previous perio history
remaining teeth
What is a “prognostic factor?”
an environmental, behavioral, or biologic factor that directly affects the probability of positive outcomes when therapy is rendered
(if treated, how sure are we that there will be success?)
What are some examples of prognostic factors in the periodontium?
extent and severity of presenting disease
level of oral hygiene
frequency of dental visits
smoking
What are the four clinical components of the risk assessment?
- Demographic Data (male or female?)
- Medical History
- Dental History (show up for cleanings?)
- Clinical Examination
True or False: Once an at-risk patient is identified and a diagnosis is made, their treatment plan may be modified.
True….sometimes even by a third party (annoying)
Steps in the risk assessment are:
- Determine ______
- Modification of ________
- Modification of _______ plan
- Patient _______
determine risk
modification of prognosis
modification of treatment plan
patient education
What is an “etiological factor?”
a variable contributing to the cause of the disease (ex. bacteria)
What is the difference between etiology and risk?
etiology is the CAUSE…without this factor, disease will not occur
risk influences the CHANCE of developing the disease
_______ postulates differ between different diseases.
Koch’s
True or False: Caries and LAP are both caused by single bacterial species and therefore should have similarity in Koch’s postulates.
False
