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Chapters 7, 10-12
Risk Factors in Periodontal Disease
70
Other
Not Applicable
03/29/2013

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Term
What are disease sites?
Definition
specific tooth or surfaces of a tooth that have periodontal disease
Term
What are local contributing factors?
Definition
oral conditions that increase an individual's susceptibility to periodontal disease, increase risk
Term
What are some examples of local contributing factors?
Definition
-calculus
-faulty restorations
-dental decay
Term
Do local contributing factors initiate perio disease?
Definition
no, they contribut to the process already initiated by bacterial biofilm, increase the risk
Term
What are some ways in which local contributing factors increase the risk for periodontal disease?
Definition
1.increase biofilm retention
2.incease biofilm pathogenicity
3.cause direct damage to the periodomtium
Term
What are some local factors that increase biofilm retention?
Definition
-calculus
-tooth morphology
Term
Why does bacteria gather on the surface of calculus?
Definition
-surface is irregular
-rough surface harbors bacteria
Term
Is the surface of caculus always covered with bacteria?
Definition
yes, it is always covered with disease causing bacteria
Term
What are some factors that effect the calculus attachment to the tooth surface?
Definition
-aquired pellicle
-tooth irregularities
-direct contact to the tooth
Term
What are some tooth morphology factors that increase biofilm retention?
Definition
-developmental grooves
-root concavities
Term
What do root concavities harbor? What do they cause?
Definition
-harbor bacteria
-cause increase incidence of disease
Term
Where are root concavities usually found? Are they easy to clean?
Definition
-mesial, buccal concavities
-deep pockets
*no they are impossible for the patient to clean*
Term
Can flosses effectively remove the biofilm found in a concavity? If not what can?
Definition
no floss cannot effectively remove biofilm in concavities, interdental brushes are more effective
Term
What are some other anatomic factors? (3)
Definition
1.cervical enamel projections
2.enamel pearls
3.position of teeth in arch
Term
What are some dental related factors that can cause damage to the periodomtium?
Definition
-restorations
-untreated caries
-orthodontics
Term
What are some examples of restorations that can cause damage to the periodomtium?
Definition
-rough surfaces
-over contoured restorations
-overhangs
-trauma
Term
Why does untreated tooth decay cause periodontal disease?
Definition
because decay harbors periodontal pathogens, and if untreated the grow undisturbed
Term
What is an example of an orthodontic appliance that causes damage to the periodontium?
Definition
braces
Term
What are some things that cause direct damage to the periodontium? (4)
Definition
-food impaction
-patient habits
-faulty restorations
-occlusal forces
Term
What does food impaction do to the tooth?
Definition
-strips gingival tissues away from tooth surface
-alters gingival contour (resulting in interdental areas that are hard for the patient to clean)
Term
What are some patient habits that cause direct damage to the periodontium? (3)
Definition
-improper use of self-care aids (flossing too hard)
-misuse of toothpicks
-tongue thrusts
Term
How does damage from faulty restorations occur?
Definition
the encroach on the biological width- the margin of the crown is closer than 2 mm from the crest of the alveolar bone, causes resorption of bone
Term
What is the biological width?
Definition
the space inhabited by the JE and the connective tissue fibers
Term
What is the biological width?
Definition
the space inhabited by the JE and the connective tissue fibers
Term
What can bulky crowns result in? What happens to the papilla?
Definition
inadequate space between teeth, the papilla then enlarge because it is pushed up between the teeth
Term
What can faulty removable prosthesis cause?
Definition
-damage to the gingival tissues, thus promoting biofilm retention
Term
What are functional occlusal forces?
Definition
normal forces when chewing food
Term
What are parafunctional chewing forces?
Definition
forces not associated with chewing food
Term
What are some examples of some parafunctional occlusal forces?
Definition
-bruxism
-clenching
Term
What do parafunctional occlusal forces cause? What can be done to stop this?
Definition
-can cause damage to the periodontium
-thearpy or night guard
Term
What are some signs of trauma from occlusion?
Definition
-tooth mobility
-sensitivity to pressure
-migration of teeth
-enlarged funnel shaped PDL
-alveolar bone resorption
Term
What is some radiographic evidence of trauma from occlusion?
Definition
-loss of aveolar bone along the lateral surfaces
-widening of the PDL
Term
What are some things that can cause primary occlusal trauma?
Definition
-high restoration
-excessive force on abutement teeth from partial denture
Term
What does primary occlusal trauma cause?
Definition
-wider PDL, tooth mobility, pain
Term
Are the changes with primary occlusal trauma reversible?
Definition
yes, if the trauma is removed
Term
What is primary occlusal trauma?
Definition
injury to the periodomtium resulting from excessive occlusal forces
Term
What is secondary occlusal trauma?
Definition
injury to the periodontium from normal occlusal forces on a reduced periodontium (previously damaged)
Term
What may secondary occlusal trauma result in?
Definition
rapid bone loss and pocket formation
Term
What do lateral occlusal forces cause?
Definition
tipping of the tooth within the socket
Term
What does the "P" in lateral occlusal forces cause? The "T"?
Definition
P=area of pressure (the way the tooth is leaning)
T=area of tension (the tooth is leaning away from the area)
Term
What happens to teeth with reduced bone height?
Definition
-teeth with reduced bone height from perio disease get moved laterally from tooth next to it
Term
Smokers are BLANK to BLANK times more likely to have severe loss of attachment.
Definition
Smokers are 12 to 14 times more likely to have severe loss of attachment.
Term
What are smokers more likely to loose?
Definition
teeth!
Term
How likely are smokers to exhibit periodontal destruction?
Definition
2-6 times more likely
Term
Smokers are BLANK times more likely to be infected with periodontal pathogens.
Definition
18 times more likely
Term
What are smokers likely to clinically exhibit?
Definition
-more attachment loss and recession
-more alveolar bone loss
-more deep pockets
-more furcations
-more tooth loss
Term
What is one of the most important risk factors for periodontal disease?
Definition
smoking, causes an increased inflammatory response
Term
What does the tissue look like with smokers?
Definition
-reduced clinical inflammation(edema)
-fibrotic appearance
-reduced bleeding
Term
Does lack of bleeding upon probing or no signs of inflammation indicate health in smokers?
Definition
no
Term
What does tobacco smoke inhibit?
Definition
leukocyte(PMN) and macrophage defensive functions
Term
What does tobacco smoke increase?
Definition
the production of cytokins(inflammatory mediators)
Term
What does smoking impair?
Definition
healing--> less probing depth reduction or attachment gain
Term
When a cigarette is smoked, how many chemicals are released? How many of those are cancer casuing?
Definition
4,000 chemicals released, 60 of those are cancer causing
Term
What is the severity of periodontal attachment loss directly related to in smokers?
Definition
-# cigarettes smoked/day
-# of years the individual has smoked
Term
What is strongly recommended in periodontal therapy?
Definition
tobacco cessation
Term
What is the ADA's method for tobacco cessation?
Definition
Ask, Advise, Refer
Term
What are some systemic risk factors for periodontal disease?
Definition
-tobacco use
-diabetes
-leukemia
-AIDs
-osteoperosis
-hormonal variations
-down syndrome
Term
Genetics may account for BLANK percent of periodontal disease.
Definition
50%
Term
What is the genetic factor that can cause perio?
Definition
abnormalities in PMN function can lead to overwheling bacterial infection and severe periodontal destruction
Term
Are there genetic tests for periodontal disease?
Definition
-no, they are difficult to develop
-there is not a single gene responsible for it
Term
What can systemic medications do?
Definition
increase the risk of periodontal disease
Term
What does sugar do to the pH of your mouth?
Definition
decrease(increases acidic pH)
Term
What is sugar metabolized by?
Definition
bacteria which demineralizes enamel
Term
WHat are some drugs with Xerostomic effects?
Definition
-antihypertensives
-narcotics
-tranquilizers
-diruetics
-antimetabolites
-antihistamines
-sedatives
**more than 400 OTC & Rx drugs**
Term
What are the three major classes of drugs that cause gingival enlargement?
Definition
1.Anticonvulsants(phenytoin-Dilantin, seen with 50%)
2.immunosuppressive(autoimmune and transplant patients- cyclysporine, 25%)
3.Calcium channel blockers(anti hypertensive, angina, arrythmias, nifedipine- 38%)
Term
At least BLANK medications have the potential to enlarge the gingiva.
Definition
20
Term
What is the primary etiology of perio?
Definition
-bacteria!
-AA, Tanerella forsythesis, P. Gingivalis (mr.perio)
Term
What are some other risk factors?
Definition
-heredity(immune deficiency, genetic syndrome)
-systemic disease(diabetes)
-medications
Term
What are some habits that can increase the risk for periodontitis?
Definition
-self care(plaque control)
-professional care(recall)
-smoking
-alcohol
-diet
Term
What are some social atmosphere things that can increase the risk for periodonitits? (5)
Definition
-family/upbringing
-culture
-socioeconomic factors
-access to dental care
-dental insurance
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