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Data. Family studies, twin studies, population studies and single nucleotide polymorphisms (SNP) have been done to find out the genetic basis of periodontal diseases. Certain medications 8. The book is usually delivered within one week anywhere in India and within three weeks anywhere throughout the world. These include genetic factors, host response, age, gender and socioeconomic status. In a review, it was concluded that most of the studies done to find out any association between osteoporosis and periodontitis concluded that systemic …………… Contents available in the book…………. Evaluation of social and psychological factors in periodontal disease. A previous history of periodontitis is a good predictor of future risk of periodontal disease. It has been demonstrated that the susceptibility of different individuals to periodontitis for the same amount of local factors is variable. Sources. Journal of the International Academy of Periodontology. Although, smokers have reduced clinical signs of periodontal inflammation as compared to non-smokers but they have an accelerated periodontal breakdown. Other mechanisms include altered monocyte-macrophage function, altered wound healing, increased oxidative stress and effects of the hyperglycemic state on cellular functions. In a study 66 on data obtained from NHANES III from 13,198 individuals which employed 20 years and older adults, it was observed that a linear relationship existed between a number of alcoholic drinks per week and log clinical attachment loss (P= 0.0001). The maintenance visits should be planned depending on the periodontal status of the patient and the presence of risk factors. Matrix metalloproteinases (MMPs) are responsible for the remodeling of connective tissue. Further-more, the advanced periodontal bone loss is less commonly observed in young individuals. A number of studies have discussed each factor’s relationship to disease progression. Clipboard, Search History, and several other advanced features are temporarily unavailable. However, it must be remembered that bleeding on probing does not indicate the severity of periodontal breakdown. 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 58, 59. 1. The treatment planning of the patient should be done taking into consideration the overall risk. 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. Risk determinants are those risk factors that cannot be modified. While it is accepted that the primary etiology of periodontitis is bacterial infection and a susceptible host response,15,16 the initiation and rate of destruction is affected by systemic and local risk factors. 1999 May;70(5):478-84. doi: 10.1902/jop.1999.70.5.478. Various mechanisms have been suggested to explain the effects of obesity on the severity of periodontal disease 62-64. Calculus. However, it has been demonstrated that absence of bleeding on probing is a good indicator of periodontal health 71, 72. Many studies and reviews have been published which support a relationship between periodontitis and diabetes, Psychological stress is another risk factor for periodontal diseases, Non-modifiable risk factors (Risk determinants), Present data strongly suggest that genetic factors are important risk factors for periodontal disease progression. 2018 Dec 30;49(4):280-287. doi: 10.25100/cm.v49i3.3919. Gene poly-morphisms have been shown to have a positive correlation with increased severity of periodontal disease. Global risk factors and risk indicators for periodontal diseases. 1998 Oct-Nov;65(5-6):362-9. Initiation and progression of periodontal infections are affected by local and systemic conditions. USA.gov. For optimal treatment results, systemic risk factors must be modified or eliminated. Initiation and progression of periodontal infections are clearly modified by local and systemic conditions called risk factors. Please enable it to take advantage of the complete set of features! 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 are also background determinants associated with periodontal disease including gender (with males having more disease), age (with more disease seen in the elderly), and hereditary factors.  |  Contents available in the book…………. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases. 2020 Sep 2;20(1):243. doi: 10.1186/s12903-020-01231-2. Rather, the disease has already occurred and the modifying factor alters the progression of the disease by modifying the body’s response to the disease itself or to the treatment. IL-1 and TNF-α gene polymorphism have been studied extensively and a positive correlation has been demonstrated between periodontitis and these polymorphisms 28-31. However, age is only one of the risk factors of periodontal disease. Save my name, email, and website in this browser for the next time I comment. Periodontal disease, smoking, cardiovascular complications and mortality in type 1 diabetes. The local factors include pre-existing disease as evidenced by deep probing depths and plaque retention areas associated with defective restorations. Similarly, in another study, it was shown that subjects who had quit smoking during the entire study period had significantly reduced alveolar bone loss as compared to smokers 18. These include stress and coping behaviors, and osteopenia associated with estrogen deficiency. The presence of faulty restorations and overhanging margins of crowns facilitate the accumulation of food particles and debris at the tooth-soft tissue interface. Systemic conditions associated with reduced neutrophil numbers or function are also important risk factors in children, juveniles, and young adults. Periodontal risk assessment is the overall evaluation of the patient to assess the risk for the development of periodontitis. Heredity 6. In a study, Adhering strictly to the periodontal maintenance protocol has been shown to have a beneficial effect on the overall dentition and periodontium of the patients. In a study, it was observed that adolescents (11-18 years old) have a reduced intake of raw fruits and non-potato vegetables, which are sources of vitamin C. Furthermore, an increased intake of soft drinks and non-citrus juices were observed in this age group. It has been observed that stressed, anxious, or depressed persons tend to neglect their oral hygiene. References are available in the hard-copy of the website. Various studies done around the globe have highlighted this finding 44-47. Health conditions that decrease your immunity 9. Subgingival margins of the restorations have been shown to have a positive correlation with the presence of gingival inflammation 68-70. A detailed description of stress as a risk factor for periodontitis has been given in chapter “Stress as a risk factor for periodontal diseases”. For example, if the patient is a smoker, the smoking cessation protocol should be included in the treatment plan. Because these altered immune responses are genetically determined and cannot be altered with our present strategies, the altered host response can be considered as a non-modifiable risk factor. Stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. Anatomical features. Local Risk Factors for Periodontal Diseases. Gingival overgrowth has been shown to be associated with the intake of drugs such as anticonvulsants, calcium channel blocking agents, and cyclosporine. Crooked teeth 7. 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. Effects of probiotic bacterium Weissella cibaria CMU on periodontal health and microbiota: a randomised, double-blind, placebo-controlled trial. Poor oral health habits 6. three primary mechanisms by which local factors can increase the risk of developing periodontal disease or increase the severity of existing periodontal disease. Risk indicators are probable or putative risk factors that have been identified in cross-sectional studies, but not confirmed through longitudinal studies. It may alter the pH of the oral cavity, thus affecting plaque composition, The presence of faulty restorations and overhanging margins of crowns facilitate the accumulation of food particles and debris at the tooth-soft tissue interface. Contents available in the book…………. Albandar JM. 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. Furthermore, smokers have been observed to smoke more under stress which further deteriorates their periodontal status. Inadequate nutrition 4. 2005 Oct;39(1):118-31. Certain drugs which are in a chewable form, commonly have sugar as one of their constituents. These include anti-hypertensive drugs, narcotic analgesics, some tranquilizers and sedatives, antihistamines, and antimetabolites. Fraenal attachments. Multiple risk factors do not increase the risk in an additive manner, but rather in an exponential manner. Genetics 10. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Sheiham A, Nicolau B. Calcium intake was also found to be reduced in this age group. Family studies, twin studies, population studies and single nucleotide polymorphisms (SNP) have been done to find out the genetic basis of periodontal diseases. A decreased estrogen production following menopause is associated with a decreased mineral density of bones 56. Controlling Systemic Risk Factors.Several risk factors have well established associations with both periodontal and systemic diseases, such as diabetes, smoking, stress, immunodeficiency, medications, obesity, hormones, and nutrition. These areas become inaccessible for cleaning by the patient and promote the formation of a periodontal pocket. Alcohol intake has been associated with an increased severity of clinical attachment loss in a dose-dependent manner. The patient may have a single or multiple risk factors or determinants. Certain factors increase the risk for periodontal disease: 1. Contents available in the book…………. The information presented in this website has been collected from various leading journals, books and websites. Patients having existing severe attachment loss are at a higher risk for future attachment loss. 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