Secondary Local Factors

Question 1

What is a secondary local factor?

Answer 1

Something which may increase the risk of periodontal disease due to providing areas of microorganism colonisation through plaque retention.

Question 2

What do secondary local factors cause to patients?

Answer 2

Difficultly in maintaining optimum plaque control

Question 3

What are anatomical secondary local factors?

Answer 3

Malpositioned teeth
Furcations
Root grooves and concavities
Enamel pearls

Question 4

What are acquired secondary local factors?

Answer 4

Plaque and calculus
Partial dentures
Open contact points
Overhangs and poorly contoured restorations
Carious and resorption lesions

Question 5

3 categories of plaque retentive factors

Answer 5

Developmental/natural
Due to disease or trauma
Iatrogenic (caused by clinician)

Question 6

How is calculus a secondary local factor

Answer 6

• Rough and large surface area which allows for plaque and bacteria to harbour.
• Hamper oral hygiene efforts due to creating different contours on teeth.
• Toxic substances can leach out of calculus over long periods.

Question 7

What’s the name of palatal grooves mainly found on upper lateral incisors?

Answer 7

Radicular grooves

Question 8

How are tooth abnormalities/malpositioned teeth secondary local factors?

Answer 8

• Root grooves and concavities
• Crowding
• Over-eruption
• Poor contact points
• Misalignment
• Tilting
• Rotation
• Impaction
• Overbite
  ALL harbour bacteria and plaque and cause stagnation due to difficult to clean areas.

Question 9

What is present on approximately 5% of molars?

Answer 9

Enamel pearls

Question 10

How are enamel pearls identified

Answer 10

Radiographs or debridement

Question 11

How are incomplete lip seals and mouth breathing secondary factors?

Answer 11

• Causes dry mouth (xerostoma)
• Saliva has natural antibacterial properties and washes away plaque and dilutes bacteria.
• More plaque and bacteria build up due to decrease in saliva.

Question 12

Self inflicted secondary factors

Answer 12

Oral piercings/jewellery

Question 13

What is an iatrogenic factor

Answer 13

Disease or damage caused by the clinician
(Restorations and appliances)

Question 14

What should each oral hygiene plan be?

Answer 14

Tailored to the patients needs and oral cavity.

Question 15

Examples of iatrogenic secondary local factors?

Answer 15

Restorations
Crowns/bridges
Implants
Dentures
Orthodontic appliances fixed or removable.

Question 16

What is it essential to do during an examination appointment relating to secondary risk factors

Answer 16

Identify them!
Plan to either correct them or educate patient how to best clean them.

Question 17

What BPE score is given for plaque retentive factors/secondary local factors?

Answer 17

2

Question 18

What method is important when dealing with secondary local factors?

Answer 18

Tailoring instructions/oral hygiene to each individual patient for their specific needs.

Question 19

Example of disease/trauma secondary local factors

Answer 19

Carious/resorption lesions
Previous periodontitis
Gingival recession
Oral piercings/jewellery