Chapter 5 Local Contributory Factors for Periodontal Disease
Local Contributory Factors
Considered the most important local contributing factor.
Essentially calcified dental plaque
Porous and can provide a reservoir of bacteria and endotoxin.
Removal of calculus promote healing and prevent further loss of attachment
Mineralization process occurs separately from supragingival and subgingival
calculus are associated most frequently with sites that are adjacent to salivary sources, such as
Parotid gland (maxillary molar areas) or
floor or the mouth (Whartons duct)
calculus is derived from gingival crevicular fluid and any inflammatory exudates
Reflection: The linguals of my mandibular anterior teeth easily forms calculus if I do not floss after every meal and at night before going to bed.
knowledge, supplemented by radiographs and the patient's dental history, is needed to identify dental anomalies
Anomaly is defined as a deviation from normal tooth development or function
Cervical enamel projection- manifested enamel in the furcation area of the root surface
Palatogingival Grooves- presented on about 5% to 8% of maxillary incisors, tend to accumulate plaque, and can become the focus of a narrow, deep pocket.
May influence plaque accumulation and access for oral hygiene therapy
Crowding, tilting, rotations. Open contacts allow for food impaction.
Reflection: I have a few open contacts where food is easily impacted. I need to floss a lot to remove the food that is caught.
Rough surfaces and over-contoured amalgrams, composites, crowns, bridges have been associated with increased gingival inflammation and periodontal disease
Reflection: I have overhangs of composites that was previously done and it's easy for plaque to build up.
can completely destory a narrow band of attached gingiva and result in extensive recession.
- patients may persistently gouge or scratch their gingiva with their fingernails or other devices, resulting in exposure of root surface
is one of the more common local factors that many contribute to initiation and progression of inflammatory periodontal disease
- Lip piercing may cause dental/periodontal injury on the facial aspect of the mandibular incisors. Tongue piercing affects the lingual aspect of mandibular incisors
Reflection: Before knowing the proper way of brushing my teeth, I was definitely doing a lot of damage to my gingiva with the scrubbing brushing technique.
do not themselves initiate gingival inflammation, but foster increased or longstanding plaque accumulation and make plaque removal more difficult