Risk Factors Flashcards
What determines periodontal health?
The balance between bacterial biofilm (dental plaque) and the host immune system.
Name two genetic conditions that impair the immune system and increase susceptibility to periodontal disease.
Papillon-Lefèvre syndrome,
Chediak-Higashi syndrome.
Which bacteria are associated with periodontal disease?
Key pathogens: Porphyromonas gingivalis, Treponema denticola, Tannerella forsythensis.
Why doesn’t gingivitis always progress to periodontitis?
Because host immune response and environmental factors determine disease progression.
Differentiate between acquired and anatomical local risk factors for periodontal disease.
• Acquired: Plaque, calculus, overhanging restorations, orthodontic appliances, occlusal trauma.
• Anatomical: Malpositioned teeth, root grooves, concavities, enamel pearls, furcations.
Name non-modifiable systemic risk factors for periodontitis.
Age, gender (males), genetic disorders (e.g., Down syndrome, Papillon-Lefèvre syndrome).
List three modifiable systemic risk factors for periodontitis.
Smoking, poorly controlled diabetes, stress.
How does occlusal trauma contribute to periodontal health?
It may cause bone loss but does not initiate periodontitis.
How does smoking increase periodontal disease risk?
• Alters oral microbiota.
• Enhances immune system activation.
• Reduces healing due to decreased blood flow.
What is the effect of diabetes mellitus on periodontitis?
• Hyperglycemia increases inflammation (via RANKL/OPG imbalance).
• Advanced glycation end-products (AGEs) stimulate pro-inflammatory cytokines.
• Poor glycemic control exacerbates disease severity.
How does vitamin C deficiency impact periodontal health?
It causes scorbutic gingivitis (scurvy), impairing immune function.
Name a drug that causes gingival enlargement and explain its mechanism.
Phenytoin (anticonvulsant)—stimulates fibroblast proliferation and connective tissue deposition.
How do calcium channel blockers like amlodipine affect the periodontium?
They cause gingival hyperplasia by increasing fibroblast activity and vascular permeability.
How does osteoporosis contribute to periodontal disease?
Decreased bone density can lead to increased alveolar bone loss.
How does psychological stress impact periodontal disease?
• Increases cortisol levels, which suppress immune response.
• Enhances inflammatory cytokine production.
How is periodontal disease linked to cardiovascular disease (CVD)?
• Shared risk factors (smoking, diabetes, inflammation).
• Periodontal pathogens found in atherosclerotic plaques.
• Chronic inflammation contributes to endothelial dysfunction.
What is molecular mimicry and how does it relate to periodontitis & CVD?
Cross-reactivity between bacterial antigens and host endothelial cells triggers inflammation.
What was the key finding of the Randomized Controlled Trial on Periodontitis & Hypertension?
Intensive periodontal therapy significantly reduced systolic blood pressure by 11.1 mmHg.
How does periodontitis increase the risk for preeclampsia?
By triggering systemic inflammation and immune activation, which affects vascular function.
Explain the bidirectional relationship between periodontitis and diabetes.
• Diabetes → Periodontitis: AGEs and inflammation worsen periodontal destruction.
• Periodontitis → Diabetes: Bacterial toxins & cytokines impair insulin signaling, increasing insulin resistance.
What bacterial enzyme is linked to rheumatoid arthritis via periodontitis?
PPAD (peptidyl arginine deiminase) from Porphyromonas gingivalis, which induces citrullination of host proteins.
What role does P. gingivalis play in Alzheimer’s disease?
• Can colonize the brain.
• Increases production of β-amyloid (a key component of amyloid plaques).
• Enhances immune activation leading to neurodegeneration.
How does periodontitis impact respiratory diseases?
• Periodontal bacteria impair respiratory epithelial immunity.
• Increases susceptibility to pneumonia and chronic obstructive pulmonary disease (COPD).
What are the four levels of disease prevention?
Primordial prevention – Prevents risk factor development.
Primary prevention – Reduces risk exposure (e.g., oral hygiene).
Secondary prevention – Early diagnosis & treatment.
Tertiary prevention – Reducing disease complications.
What are diseases leading to impairment of immune system?
Leukaemia
Arganulocytosis
Neutropenia
HIV
