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Periodontics > Unit 14 - Systemic Risk Factors That Amplify Susceptibilty to Peridontal Disease > Flashcards

Unit 14 - Systemic Risk Factors That Amplify Susceptibilty to Peridontal Disease Flashcards

1
Q

What are conditions or diseases that increase an individual’s susceptibility to periodontal disease by modifying or amplifying the host response to periodontal pathogens?

A

Systemic risk factors

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2
Q

What are the proven systemic risk factors?

A

Diabetes
Stress
Leukemia
Neutropenia
Metabloic syndrome
Hormonal variations
Down syndome
HIV
AIDS

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3
Q

Research is showing evidence for these other grade modifiers:

A

Obestity
Rheumatoid athritis
Alzheimer’s

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3
Q

What other systemic diseases have an impact on perdiodontal health?

A

Pnuemonia
Cardiovascular diseases
Alzheimer’s
Arthritis
Gastrointestional diseases
Thydroid diseases

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4
Q

What is the disease in which the body does not produce or properly use insulin?

A

Diabetes

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5
Q

What are the three types of diabetes?

A

Type I: 5 - 10% aused by damage to the pancreas
Type II: 90 - 95% develops when the body does not make enough insulin
Gestational: occurs during pregnancy

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6
Q

High susceptibility to infection occurs when the A1c glucose level is above

A

8%

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7
Q

What is the increased risk to infection range of a finger-stick test?

A

180 - 300mg/dL

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8
Q

What is the unacceptable range for a finger-stick test?

A

Greater than 300mg/dL

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9
Q

How is diabetes related to periodontal disease?

A

Studies have shown that diabetes leads to a hyperinflammatory response to dental biofilm which can lead to accelerated periodontal destruction

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10
Q

High glucose level = ________ function

A

Reduced PMN

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11
Q

What is defective neurtrophilic function?

A

Impairment of the immune response to infection

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12
Q

Hyperresponsive monocytes / macrophages leads to

A

Elevated production of proinflammatory cytokines in response to periodontal pathogens

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13
Q

What does AGE stand for?

A

Advanced glycation end products

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14
Q

What does RAGE stand for?

A

Receptor for advanced glycation end products

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15
Q

How are AGE and RAGE related to the periodontium by poorly / uncontrolled diabetes?

A

Excessive AGE modified proteins can be found in the oral cavity of a diabetic and interact with a cell receptor (RAGE) stimulating the release of proinflammatory cytokines. This can lead to exaggerated periodontal and systemic inflammation, insulin resistance and impaired tissue repair

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16
Q

What the symptoms of a poor response to periodontal therapy?

A

Reduced salivary flow
Burning mouth or tongue

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17
Q

What are signs of a poor response to periodontal therapy?

A

Inflammation
Extensive attachment loss
Progressive alveolar bone loss
Periodontal abscesses
Candidiasis

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18
Q

Prolonged periods of stress can cause

A

Supression of the immune system

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19
Q

What are the closely related metablic disturbances that occur together, increasing risk of heart disease, stroke, and diabetes?

A

High blood pressure
High blood sugar
Excess body fat around the waist
Abnormal cholesterol or triglyceride levels
Proinflammatory state
Increase tendency toward thrombosis

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20
Q

Having metabloic sydrome is associated with

A

A higher prevalence of periodontitis

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21
Q

What is metabolic syndrome?

A

Closely related metabolic disturbances that occur together, increasing risk of heart disease, stroke and diabetes

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22
Q

In the US _____ have metabloic syndrome

A

1 in 3 adults

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23
Q

How does metabloic syndrome have an impant on periodontal status?

A

Via chronic low-grade inflammation of prolonged duration

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24
Q

How does hypertension affect the periodontium?

A

Impairs blood flow that supplies the periodonitum

25
Q

Lifestyle modifications that should be suggested to improve the perdiontal risk of metabloic syndrome

A

Increase physical activity
Practice good nutrition

26
Q

Signs in the gingiva of leukemia-associated gingivitis

A

Swollen, glazed, spongy tissues
Red to deep purple in colour
Gingival enlargement

27
Q

Why does inflammation of oral mucous membranes when undergoing chemotherapy?

A

Chemotherapy attacks and kills the rapidly dividing cells of the mucous membranes

28
Q

Sloughing of the mucosa from oral mucositis can be

A

Localized or generalized

29
Q

Reduced flow of saliva encourages growth of

A

Canadida albicans

30
Q

Increased growth of Candida albicans causes

A

Oral candidasis

31
Q

What should the dental hyienist look for in leukemia patients?

A

Spontaneous gingival bleeding and gingival enlargement for no apparent reason

32
Q

Does chemotherapy cause a sore and sensitive mouth that bleeds easily?

A

Yes

33
Q

How manage oral pain from oral mucositis

A

Topical anaesthetics have limited success
Prophylactic use of chlorhexidine may reduce frequency of oral mucositis and oral pathogens

34
Q

Periodontal and oral manifeatations of HIV infection

A

Hairy leukoplakia
Candidiasis
Herpes labialis
Herpes zoster
Recurrent aphthous ulcers
Kaposi sarcoma
Linear gingival erythema

35
Q

Manifestations of HIV infection are known as

A

Linear gingival erythema

36
Q

Linear gingival erythema is characterized by a

A

2 -3 mm marginal bane of intense redness in the free gingiva

37
Q

Is linear gingival erythema assosciated with pocketing?

A

No

38
Q

Does linear gingival erythema affect clinical attachment loss or alveolar bone levels?

A

No

39
Q

Is it safe to perform periodontal therapy on an HIV infected individual?

A

Yes, as long as the immune system is competent

40
Q

How is linear gingival erythema treated?

A

With standard periodontal procedures plus use of chlorhexidine gluconate

41
Q

Increase in hormone levels causes in creased blood circulation to the gingival tissues and may cause increased sensitivity to local irritants such as plaque biofilm in this disease.

A

Pubertal gingivitis

42
Q

What happens with pregnancy gingivitis?

A

Exaggerated response to small amounts of plaque due to increased estrogen levels and elevated progesterone levels.

43
Q

What is a pyogenic granuloma?

A

Pregnancy tumour which is the papilla reacting strongly to plaque

44
Q

What can be suggested for a pregnant client having frequent vomiting that is causing erosion?

A

Baking soda rinse

45
Q

What happens during menopause and postmenopause to the periodontium?

A

Decreased levels of circulating hormones in result in oral changes: dry mouth
burning sensation
altered taste
bone loss may worsen

46
Q

What is the effect of gingiva called during menopause or postmenopause?

A

Menopausal gingivostomatitis

47
Q

What are the characteristics of menopausal gingivostomatitis?

A

Gingiva bleed readily
Abnormally pale
Dry
Shiny
Erythematous

48
Q

Does osteroporosis intitate periodontitis?

A

No

49
Q

Can osteoporosis exacerbate the alveolar bone loss seen in preexisting periodonitits?

A

Yes

50
Q

What can be recommended to menopause clients?

A

Calcium supplements
Weight-bearing exercise
Meticulous self-care

51
Q

What are biphosphonates?

A

Most commonly prescribed medication to inhibit systemic bone resorption

52
Q

Biphosphonates cause a rare disorder called

A

MRONJ

53
Q

MRONJ is characterized by

A

Painful exposued bone in the mouth that fails to heal after extraction or oral surgery

54
Q

Neutropenia is

A

Abnormally few number of neutrophils in blood

55
Q

What does neutropenia lead to?

A

Increased susceptibilty for infection

56
Q

PMN abnormalities can lead to

A

Overwhelming bacterial infection and severe periodontal destruction

57
Q

Neutropenia is characterized by

A

The presence of abnormally few number of neutrophils in the blood which leads to increase susceptibilty to infection

58
Q

Why do people with down syndrome have a higher risk of periodontal disease?

A

Abnormal PMN function in about 50% of people with down syndrome

59
Q

How many medications have the potential to enlarge the gingiva?

A

20

60
Q

What are the three major classes of drugs that can englarge the gingiva?

A

Anticonvulsants
Immunosuppresives
Calcium channel blockers

Periodontics (15 decks)

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