Chapter 10 Risk Factors

any attribute, characteristic, or exposure associated with increased liklihood of developing disease or injury

risk factor

disease

risk factor - condition that increases the possibility of a ____________

any attribute, characteristic, or exposure known to cause disease

etiologic factor

etiologic

pathogenic bacteria are the primary ______________ factors in the initiation of periodontal disease

1. plaque and calculus 2. partial dentures 3. open contacts 4. overhanging and poorly contoured restorations

acquired local factors

1. malpositioned teeth 2. furcations 3. root grooves and concavities 4. enamel pearls

anatomical local factors

1. smoking 2. uncontrolled diabetes 3. poor diet 4. certain medications 5. stress 6. hormonal changes 7. systemic bone disorders 8. neutrophilic disorders that manifest as periodontitis

systemic factors

1. Socioeconomic Status

2. Genetics

3. Adolescence

4. Pregnancy

5. Age

6. Leukemia

non-modifiable factors

nonmodifiable

risk factors for periodontal disease can be classified as modifiable or _________________ factors

nature

modifiable risk factors are usually environmental or behavioral in _______________

changed

nonmodifiable risk factors are usually intrinsic to the individual and therefore cannot be ______________

periodontitis

tobacco use is the most significant known risk factor for ?

response

tobacco use has profound impact on periodontitis development and treatment ______________

NOT

smoking does ________ increase risk of caries

1. calcium channel blockers 2. anticonvulsants 3. immunosuppressants

what medications cause enlargement of gingiva?

calcium channel blockers enlargement

phenytoin enlargement

physiologic mechanism that functions to maintain state of balance in internal environment of body; homeostasis

biologic equilibrium

state of biologic equilibrium within oral cavity between biofilm bacteria and host

periodontal health

host

for periodontium to remain healthy - bacterial challenge must be contained at level tolerated by __________

balance

no disease progresion if sides in ____________, like a scale

factors

equilibrium occurs when there is a balance between disease-promoting factors and health-promoting _____________

tip

periodontal disease - presence of certain risk factors can _______ balance, leading to disease

individual

periodontal disease - risk factor in one individual may not be risk factor for another ______________

diabetic patient with poor glycemic and plaque control at higher risk than diabetic patient with good glycemic and plaque control

what's an example of a risk factor for one patient not being a risk factor for another

to return oral cavity to state of biologic equilibrium

when active periodontal disease sites present in mouth what is the goal?

periodontitis

patients with a low susceptibility to periodontitis may remain in the gingivitis state and never progress to ___________________

biofilm

individual patients respond to plaque __________

periodontitis

many patients exhibit gingivitis without clinical signs of progression to ________________

biologic

some patients may have no systemic or acquired risk factors that disrupt ____________ equilibrium

periodontitis

in some individuals, gingivitis progresses to ________________

variables

some individuals possess systemic risk factors that significantly increase susceptibility (genetic ___________ or systemic disease)

The immune/inflammatory response to bacteria, which can cause destruction of connective tissue and alveolar bone

What is theorized to be responsible for tissue destruction in periodontal disease?

plaque

may patients unable or unwilling to perform thorough self-care necessary to control __________ biofilm

care

with patients unwilling to do self-care you must increase frequency of professional _________ to compensate, can be effective in restoring balance between health and disease

periodontitis

in susceptible individuals, the body's immune response (host response) results in damage to the periodontal tissues and progression from gingivitis to _____________

correcting faulty restoration

what is an example of eliminating a local risk factor ?

using tufted dental floss around abutment teeth of fixed bridge

may be able to compensate by improving self-care or increasing frequency of professional care example ?

working with physician to keep diabetes controlled, smoker stops smoking

may be able to control or eliminate if patient is willing to do so?

Increase the protective/health side of the scale by providing more preventive and professional dental care to help maintain periodontal health

What should be done when a contributing periodontal risk factor cannot be controlled?

They have contributing risk factors that increase susceptibility to periodontal disease, so increased professional care and monitoring may be needed

Why are patients with Down syndrome at increased risk for severe periodontal disease?

increasingly important in periodontal treatment planning and should be part of every comprehensive dental and periodontal evaluation

periodontal risk assessment

factors

periodontal risk assessment - process of identifying risk ________ that increase individual's probability of disease

Systemic disease, genetics, and personal habits are considered to classify patients as higher- or lower-risk for periodontal disease

What factors are considered when assessing an individual's risk for periodontal disease?

Smoking — smokers have a higher risk of periodontal disease than nonsmokers

Give an example of a personal habit that increases periodontal disease risk

Demographic data, medical and dental histories, and a comprehensive periodontal clinical examination.

What information is used during risk assessment to help prevent periodontal disease?

1. age 2. duration of exposure to risk factors 3. self-care/plaque control 4. frequency of professional care 5. male gender 6. dental awareness 7. socioeconomic status

What demographic and personal factors are considered in a clinical risk assessment for periodontal disease?

1. tobacco use 2. diabetes 3. osteoporosis 4. HIV/AIDS 5. genetic predisposition to aggressive perio disease

What medical history factors are considered when assessing periodontal disease risk?

1. frequency of professional care 2. family history of early tooth loss 3. previous history of periodontal disease

What 3 factors are considered in a patient's dental history when assessing periodontal disease risk?

1. plaque biofilm 2. microbial composition 3. calculus 4. BOP 5. attachment loss 6. plaque-retentive areas 7. anatomic factors 8. restorative factors

What clinical findings are evaluated when assessing a patient's periodontal disease risk?

1. DentoRisk 2. Two-Stage Web-Based Risk Assessment 3. Lang and Tonetti's Periodontal Risk Assessment (PRA) 4. PreViser Periodontal Risk Calculator

What are some examples of periodontal disease risk assessment systems?

They help identify individuals at high risk for periodontal disease and help hygienists discuss periodontal risk factors with patients.

What are risk assessment questionnaires used for?