Risk Factors For Periodontal Disease Flashcards
Characteristics that increase the probability that disease will occur
Risk Factors
Categories of Risk Factors
Unchanging risk factors/risk indicators: Race, gender
Changing risk factors: Poor oral hygiene, tobacco use
Contribute to periodontal problems. Risk factors do not change, even if
periodontal health is restored Example: conditions in which there is a
reduction of PMN numbers or function
Unchanging Risk Factors
Unchanging Risk Factors
- Sex
- Genetic Factors
- Congenital immunodeficiencies
- Past history of periodontal disease
- Past Hx of periodontal disease
- Congenital systemic diseases
Changing Risk Factors
- Poor OH
- Alcohol use
- Tobacco use
- Stress
- Nutritional Status
- Side effects of meds
- Dental restorations
- Some local contributory factors (ex. calculus)
Tobacco Use
- Users exhibit greater bone loss, increased
pocket depths, and calculus
-Nicotine and toxic substances reduce
neutrophil (PMN) effectiveness - Alters vasculature of periodontium
(reduces immunoglobulin levels and
antibody responses) - May exhibit less inflammation (Why?)
Vasoconstriction
Nutritional Status: Deficiencies of nutrients are associated with
wound healing may contribute to disease progression Nutrients are important for wound healing such as - Protein - Vitamin C - Folic Acid - Vitamin B12 - Vitamin A - Vitamin K - Iron - Zinc
Repairs tissue and increases resistance to infection
Protein
Promotes collagen formation, tissue synthesis, and wound
healing
Vitamin C
Enhances red blood cell maturation, tissue synthesis, and cell proliferation
Vitamin B12
Increases resistance to infection and promotes tissue
synthesis; deficiency affects integrity of epithelium
Vitamin A
Affects prothrombin formation
Vitamin K
Promotes red blood cell formation
Iron
Enhances connective tissue formation, wound healing, and protein synthesis
Zinc
Side Effects of Medications
severity of periodontal reaction to medication varies among patients examples: - gingival enlargement (hyperplasia) - Xerostomia - Altered host resistance - Abnormal bleeding
4 LOCAL CONTRIBUTORY FACTORS
- Calculus
- Anatomic Factors
- Iatrogenic Factors- something done in dentistry
- Traumatic Factors
Calculus is considered the most important __ ____ factor!
___ the cause of disease.
Always covered by plaque and retains toxic bacterial products -> contributes
local contributing
not
- Calculus is mineralized plaque. Precipitated salts that originate in saliva and GCF.
***- Inorganic content of calc. is mainly ____ ____, with lesser amts. of calcium carbonate and other organics - Minerals deposited within 24-72 hours of
plaque formation - Deposits are classified by location
calcium phosphate
Why is calculus tenacious at times
because it forms in layers
Supra gingival calculus
- Attaches coronally to gingival margin
- Chalky, creamy white or yellow
appearance - Mineralized by saliva
- Relatively easy to remove (about 30%
mineralized) - Common on max. molar buccal surfaces
and mand. Anterior linguals (why?) salviary glands
Sub gingival calculus
- Attaches apically to gingival margin
- Gray, brown, or black in color
- More difficult to remove than supra G
(about 60% mineralized) - Mineralized by sulcular fluid
Inflammatory periodontal diseases are
infections caused by ____
bacteria
Dental calculus is not a cause for
periodontal diseases, but an important
____ contributing factor
LOCAL
As a Clinician
Tx Plan
OHI-> Individualized for patient
Recall intervals
As a Clinician what is important for us to evaluate?
- Medical Hx
- Social Hx
- Habits
- OH self care
- Intraoral exam-> restorations , malpositioning
- periodontal exam-> any inconsistences
Traumatic Factors
- Trauma can result in loss of attachment apparatus, changes in local anatomy, and increased plaque accumulation - Toothbrush trauma -Factitious disease (scratching) - Food impaction - Chemical injury (aspirin or cocaine burn) - Occlusion - Oral piercings
Examples of tooth position that encourages plaque retentions!
Crowding
Tilting
Rotation
Open contacts->food impaction
Procedures, techniques, and materials
used in dentistry that directly or indirectly
contribute to initiation or progression of
periodontitis
Iatrogenic Factors
Iatrogenic Factors
Rough surfaced or over-contoured
amalgams, composites, crowns, bridges,
inlays, and onlays Overhanging margins Sub-gingival margins that invade the
biologic width Injuries to gingiva during procedure à
wedges, retraction cord Fixed crowns and bridges à pt must be
able to clean all surfaces
Extractions can affect adjacent teeth (if
their attachment app. is damaged or if
calculus remains) Patients stop chewing on ext. side and
stop brushing for a while Orthodontics: plaque retention!!!!
Traumatic Factors
-Trauma can result in loss of attachment
apparatus, changes in local anatomy,
and increased plaque accumulation
- Toothbrush trauma
- Factitious disease (scratching) - Food impaction
- Chemical injury (aspirin or cocaine burn)
- Occlusion
- Oral piercings
As a clinician what is imprortant for us to evaluate
- Medical Hx
- Social Hx
- Habits
- OH self care
- Intraoral exam à restorations,
malpositioning - Periodontal exam à any
inconsistencies?
-Tx Plan - OHI- indiviualized for patient
- recall intervals
Key Points
- Inflammatory periodontal diseases are infections caused by bacteria
- Certain secondary local and systemic risk factors can influence the initiation
and progression of the disease - Dental calculus is not a cause for periodontal diseases, but an important ___ contributing factor
LOCAL
