Department of oral pathology

Risk factors for periodontitis

Presented by,Shiji margaret CRRI

Introduction

Historically, it was believed that all individuals were uniformly susceptible to developingperiodontal disease and that accumulation of plaque, poor oral hygiene and perhaps occlusaltrauma were sufficient to initiate periodontitis.

classification

Risk factors smokingDiabetes mellitusPathogenic bacteria

Risk derminantsGenetic factorAgegender

Risk indicatorosteoporosis

Risk markersPrevious history of periodontal diseaseBleeding on probing

Smoking

Smoking causes periodontitis

Smoking

smoking is a well established risk factor of periodontitis.

smockers will be having less bleeding than non smokers

With increased use of tobacco, patients show higher periodontal probing depths, increased clinical attachment loss, more alveolar bone resorption, a higher prevalence of gingival recessions, and a higher risk for tooth loss

Diabetes mellitus

Diabetes is a modifiable factor in the sense that though it cannot be cured, it can be controlled.

Diabetes is a clear risk factor for periodontitis.

Prevelence and severity of periodontitis is higher in patients with type1 and type2 diabetes

Diabetic parameters examined include glycemic control, duration of disease, presence of other diabetes-associated complications and population studied. Periodontal parameters examined have included gingivitis, clinical attachment loss, and alveolar bone loss.

Studies have shown increased risk of ongoing periodontal destruction in diabetics as compared to nondiabeticswith an odds ratio of 4.2.

Finally, studies have been done which suggest that poorly controlled diabetics respond less successfully to periodontal therapy relative to well-controlled andnon-diabetics

Micro-organims and periodontal disease

Micro-organisms that colonize mouth

1. Tanerella forsythus

2. Porphyromonas gingivalis

3. Actinobaccilus actinomycetemcomitans

the presence of periodontal pathogens, though necessary to cause disease

The presence of A. actinomycetemcomitansconfers no additional riskof developing localized aggressive periodontitis in adults

It has been shown that Prevotellaintermedia, P gingivalis, and Fusobacteriumnucleatum may be risk indicators for periodontaldisease in a diverse population, though they are not risk factors

Physiological factors

•stress

individuals under psychological stress are more likely to develop clinical attachment loss and loss of alveolar bone

One possible link in this regard may be increases in production of IL-6 in response to increased psychological stress

individuals under stress are less likely to perform regular good oral hygiene and prophylaxis

Genetic factors

Although bacterial infection is the etiologic agent in periodontal disease.

studies of identical twins suggest 50% of susceptibility to periodontal disease is due to host factors (Michalowiczet al., 2000).

Similarly, indigenous and relatively isolated populations have been shown to develop periodontal disease that differ from group to group (Dowsettet al., 2001; Ronderos et al., 2001).

Age

The aging process itself is suggested to be an independent risk factor for periodontal diseases

The extent of severity of periodontal diseases are shown to increase with age

increased level of periodontaldestruction observed with aging is the result of cumulative destruction rather than a result of increased rates of destruction.

Healthy gingiva

Pockets formed between tooth and gumCan cause destruction of bone support

Increase in pocket depth cause Disease progression and lead to surgery

Gender

Disease susceptibility may increased due to hormone related alterations in women

• gingival blood flow• composition of saliva

Men are found with worse periodontal health

Osteoporosis

Osteoporosis is a bone disease in which bone loss occurs, so that bones become weak and are more likely to break.

Without prevension or treatment, osteoporosis can progress whithout pain or symptoms until a bone breaks.

Fractures from osteoporosis commonly occurs in the hip, ribs, spine, ribs and wrist.

Osteoporosis can occur in any age

It is more common in people above 50 years of age

Anorexia ,Diets low in calcium, phosohate and vitamin D are risk factors for osteoporosis

Women are more likely to have osteoporosis than men

People who are small and have thin bones are at great risk.

If a persons parents are having osteoporosis he or she may be at risk

“ Measurement, Assessment,

Elimination or reducing as many risks

as possible will improve disease

prevention and treatment outcomes”

conclusion

reference

Journal of International Acadamyof Periodontolgy. 2005 January ; 7(1): 3–7.

Carranza 10th edision