chapter 10- risk factors for periodontal disease

what determines oral health

-disease and condition status

-physiological function

-psycho-social function

disease and condition status

-number of dental implants, crowns, and bridges

-total # of fillings and cavities

-number of missing teeth

-classification of periodontal experience

physiological function

-ability to chew tough food

-how do you perceive your ability to chew?

-physical pain

-functional limitation

psycho-social function

-social disability

-psychological disability

-handicap

-physical disability

-psychological discomfort

risk factors for periodontal disease

-pathogenic microorganisms

-heredity

-habits

-social factors

-psychological factors

pathogenic microorganisms

modified by:

-oral hygiene

-plaque-retentive niches/ factors

-diet

heredity 

-immune deficiency

-genetic syndromes

-systemic diseases (diabetes, etc.)

-viruses (immune modulation) 

habits

-general attitude toward health

-smoking

-alcohol

-diet

-medications

social factors

-family

-up bringing

-job/profession

-socioeconomic factors

-culture

-political attitude/ affiliation

psychological factors

-negative stress

-immune modulation

periodontal pathogens

-A. actinomycetemcomitans

-Tannerella forsythia

-Porphyromonas gingivalis

modifiable local acquired risk factors

-plaque and calculus

-partial dentures

-open contacts

-overhanging and poorly contoured restorations

modifiable local anatomical risk factors

-malpositioned teeth

-furcations

-root grooves and concavities

-enamel pearls

modifiable systemic risk factors

-smoking

-diabetes

-poor diet

-certain medications

-stress

emerging evidence of modifiable systemic risk factors

-nutrition

-alcohol

-obesity/ overweight

non-modifiable systemic risk factors

-socioeconomic status

-genetics

-adolescence

-pregnancy

-age

-leukemia 

balance between health and disease: disease

-risk factors

-overproduction of proinflammatory or destructive mediators and enzymes

-underactivity or overactivity of aspects of host response

-poor compliance, poor plaque control

-subgingival bioburden

balance between health and disease: health

-reduction of risk factors

-expression of host derived antiinflammatory or protective mediators

-host modulatory therapy

-resolution of inflammation

-OHI, SRP, surgery, antiseptics, antibiotics to reduce bacterial challenge

host response definition

how well an individual’s immune system can effectively deal with a mouthful of periodontal pathogens

host response characteristics

-systemic risk factors that increase susceptibility

-patient’s home care

-remove obstacles that can be removed

-smoking? stop!

-if genetic risk factor that is unchangeable, assist patient by maintaining health by increasing appt.

gingivitis in the presence of biofilm

in people with low susceptibility to periodontitis, gingivitis may never progress to periodontitis