Smoking affects the subgingival microflora in periodontitis. Bacterial species, including Porphyromonas gingivalis 1, Aggregatibacter actinomycetemcomitans 2, 3, Bacteroides forsythus 4, Prevotella intermedia 5, Peptostreptococcus micros 6, Fusobacterium nucleatum 7 and spirochetes 8, 9 have been specifically found to contain the virulence factors responsible for evasion of host response and periodontal breakdown. Subgingival margins of the restorations have been shown to have a positive correlation with the presence of gingival inflammation 68-70. Hormonal changes (sometimes caused by pregnancy or menopause) 2. However, it has been demonstrated that absence of bleeding on probing is a good indicator of periodontal health 71, 72. Furthermore, smokers have been observed to smoke more under stress which further deteriorates their periodontal status. Evaluation of social and psychological factors in periodontal disease. In fact, 70.1% of adults65 years and older have periodontal disease. Epub 2019 Jun 3. Heredity 6. The periodontal maintenance program should be planned, taking into consideration all the risk factors and determinants for a particular patient. References are available in the hard-copy of the website. Various longitudinal studies done on non-surgical and surgical periodontal therapy have demonstrated that patients who regularly visit the dental office for periodontal maintenance have a better periodontal status as compared to those who infrequently visit the dental office (more details in “Periodontal maintenance”). However, it has been demonstrated that absence of bleeding on probing is a good indicator of periodontal health, Periobasics A Textbook of Periodontics and Implantology, Text Book of Basic Sciences for MDS Students. Epub 2020 Aug 12. Further, it has been found that certain individuals mount an abnormal host response to the microbial challenge. The reason suggested for this difference is a better education level and more access to oral health care services by individuals with good socioeconomic status. Smoking 2. © 1996 American Academy of Periodontology. Albandar JM. Crooked teeth 7. Initiation and progression of periodontal infections are clearly modified by local and systemic conditions called risk factors. The information presented in this website has been collected from various leading journals, books and websites. These include anti-hypertensive drugs, narcotic analgesics, some tranquilizers and sedatives, antihistamines, and antimetabolites. The periodontal problems which are associated with HIV infection include specific forms of gingivitis and necrotizing periodontal diseases, as well as with possible exacerbation of pre-existing periodontal disease, Recent research has demonstrated a positive association between obesity and periodontitis and obesity can be considered as a risk factor for periodontal disease, Alcohol intake has been associated with an increased severity of clinical attachment loss in a dose-dependent manner. Various mechanisms have been suggested to explain the effects of obesity on the severity of periodontal disease 62-64. Systemic risk factors include poorly controlled diabetes mellitus and tobacco smoking. Keywords: A decreased salivary flow is associated with a decreased flushing effect of saliva in the oral cavity, which may contribute to the increased periodontal disease activity. Genco RJ. Inadequate nutrition 4. Objectives. Many studies and reviews have been published which support a relationship between periodontitis and diabetes 19-23. These include osteoporosis, HIV/AIDS, obesity, alcohol consumption, infrequent dental visits, drug intake associated periodontal disorders and iatrogenic factors.  |  Other risk factors include: 1. Diabetes 3. The local factors include dental plaque and plaque retentive areas such as dental calculus and defective restorations. (adsbygoogle = window.adsbygoogle || []).push({}); The risk factors for periodontal diseases can be classified broadly into two categories: modifiable risk factors and non-modifiable risk factors. Factors that can increase your risk of periodontitis include: 1. 2020 Oct-Dec;10(4):514-518. doi: 10.1016/j.jobcr.2020.07.020. Contents available in the book…………, The HIV infection is associated with a compromised immune response which predisposes the individual to various infections. However, it must be noted that the periodontal destruction observed in elderly individuals is a cumulative destruction over several years rather than a result of increased rates of destruction. Taking medications that cause dry mouth 10. At least two of these microorganisms, Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans, also invade the periodontal tissue and are virulent organisms. Various longitudinal studies done on non-surgical and surgical periodontal therapy have demonstrated that patients who regularly visit the dental office for periodontal maintenance have a better periodontal status as compared to those who infrequently visit the dental office (more details in. The local factors include pre-existing disease as evidenced by deep probing depths and plaque retention areas associated with defective restorations. Rough …………… Contents available in the book…………. Local risk factors could influence directly the periodontium, the most often involved local risk factors being dental calculus, malocclusions, improper or aged and degraded dental or prosthetic treatments, orthodontic appliances, affecting also the masticatory, esthetical and phonetical function consequently decreasing the quality of life. There is strong evidence available today suggesting a multifactorial etiology of periodontal diseases. Local risk factors for periodontal disease 21. Smoking or chewing tobacco 4. However, the relationship between socioeconomic status and periodontitis is less direct as compared to gingivitis 42, 48-50. Smoking cessation has been shown to improve periodontal health. It has been observed that stressed, anxious, or depressed persons tend to neglect their oral hygiene. Family studies, twin studies, population studies and single nucleotide polymorphisms (SNP) have been done to find out the genetic basis of periodontal diseases. Recent studies also point to several potentially important periodontal risk indicators. These two risk factors markedly affect the initiation and progression of periodontitis, and attempts to manage these factors are now an important component of prevention and treatment of adult periodontitis. There are five key concepts that an oral health provider should know about periodontitis risk factors. A number of studies have discussed each factor’s relationship to disease progression. 1996 Oct;67:1041-9. A periodontal exam and assessment of both new and current patients in the dental practice is more important than ever. In the upcoming articles, we shall read in detail various risk factors and determinants associated with periodontal diseases and the mechanisms of their association. Poor oral health habits 3. J Periodontol. Certain drugs which are in a chewable form, commonly have sugar as one of their constituents. Further, it has been found that certain individuals mount an abnormal host response to the microbial challenge. Journal of the International Academy of Periodontology. Certain drugs have been shown to be associated with decreased salivary flow. 2020 Sep 2;20(1):243. doi: 10.1186/s12903-020-01231-2. Certain drugs which are in a chewable form, commonly have sugar as one of their constituents. Local Risk Factors for Periodontal Diseases. Certain medications 8. This disorder has been shown to be positively associated with periodontal bone loss 51-55. Periodontology 2000. Anatomical features. Adhering strictly to the periodontal maintenance protocol has been shown to have a beneficial effect on the overall dentition and periodontium of the patients. USA.gov. Investigation of the levels of different salivary stress markers in chronic periodontitis patients. In other words, it can be said that periodontal risk assessment involves identifying elements that either may predispose a patient to develop periodontal disease or may influence the progression of the disease that already exists. Periodontal risk assessment is the overall evaluation of the patient to assess the risk for the development of periodontitis. 2020 Aug 27;12(9):2614. doi: 10.3390/nu12092614. The treatment planning of the patient should be done taking into consideration the overall risk. 2019 Sep;33(9):603-609. doi: 10.1016/j.jdiacomp.2019.05.025. Local risk factors can increase the risk of development and progression of periodontal disease by acting as plaque retention factors. Contents available in the book…………. To reiterate, modifying factors are also systemic factors like risk factors. Osteoporosis is characterized by a decreased bone-mineral density throughout the skeletal system, including the jaws. In a 12 month study, it was demonstrated that patients who had continuously refrained from smoking for the entire study period had a significant reduction in probing depths as compared to smokers 17. These areas become inaccessible for cleaning by the patient and promote the formation of a periodontal pocket. Mt Sinai J Med. Poor oral health habits 6. Other risk factors play important roles as well. Relationship between the presence of certain bacterial pathogens and periodontal status of urban Thai adults. Risk factors which we know today as important include diabetes mellitus, especially in individuals in whom metabolic control is poor, and cigarette smoking. Recent research has demonstrated a positive association between obesity and periodontitis and obesity can be considered as a risk factor for periodontal disease 60, 61. However, it should be noted that this association is not reliable as it entirely depends on the maintenance of oral hygiene and not on gender. Local factors Dental plaque Tobacco … Genetic factors also play a role in periodontal disease and allow one to target individuals for prevention and early detection. Systemic risk factors recently have been identified by large epidemiologic studies using multifactorial statistical analyses to correct for confounding or associated co-risk factors. While these cannot be modified, recognizing them can help oral health professionals determine the most appropriate interventions. Modifiable risk factors are usually environmental or behavioral in nature, whereas non-modifiable risk factors are usually intrinsic to the individual and therefore can not be easily changed. Systemic conditions associated with reduced neutrophil numbers or function are also important risk factors … Omega-3 Polyunsaturated Fatty Acids EPA and DHA as an Adjunct to Non-Surgical Treatment of Periodontitis: A Randomized Clinical Trial. 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