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Chapter 6 - oral-systemic disease (Periodontal Diseases as Risk Factors…
Chapter 6 - oral-systemic disease
Genetics
Not equal for all people
Interleukin - 1 gene (IL-1) Occurs in 30% of the population. people with it are 7x more likely to develop perio
genetic factors that act on and modify host responses to the microbial challenge are major determinants of susceptibility to periodontitis
Stress
Long term stress increasses susceptibility to perio infection
Stress may depress immunie system
Hematologic System
several blood dyscrasias have been associated with uncommon forms of perio: agranulocytosis, neturopenia, and leukemia
Age, Gender, And race
incidence increases with age - likely due to result of cumulative effects of bacterial irritation of the tissues over many years
level of education has clear effect
males have greater incidence and severity
HIV/AIDS
Susceptible to NUP and NUG
Degree of immunodeficiency influences the prevalence and severity of periodontal diseases
Nutritional Status
deficiencies not been shown to cause periodontial diseases
Vitamin C plays important role in the function of fibroblasts, osteoblasts, and odontoblases
Vitamin D deficiency associated with periodontitis
Drug and Tobacco use
Tobacco
Most significant risk facotr for severe periodontal diseases
53% of periodontal diseases attributed to smoking
2-6x more likely to have periodontal destruction
Past effects of smoking cannot be reversed but cessation is beneficial
Smoking modulates subgingival microflora by favoring colonzation with pathogens
can impair chemotaxis and phagocytosis of neutrophils
products of cigarette smoke remain on the root surfaces and in the gingival crevicular fluid
Alcohol
Increased risk for periodontitis and tooth loss
Drugs
xerostomia
Gingival overgrowth
Obesity
associated with high plasma levels of TNF and may lead to a hyperinflammatory state
Endocrine system
Hormones
pregnancy
puberty
oral contraceptives
menopause/osteoporosis estrogen deficiency may play a role in the progression of periodontitis
Bisphosphonates - no osteoclasts to absorb necrotic bone resulting in osteonecrosis of the jaw
risk factors for ONJ: corticosteroid, diabetes, smoking, alcohol use, poor oral hygiene, chemotheraputic drugs
Periodontal Diseases as Risk Factors for Systemic Conditions
Diabetes
Untreated periodontitis can complicate glycemic control of patients with diabetes
more susceptible to periodontal disease
Severe attachment loss increased with decreased diabetic control
Control of infections may be essential to the establishment of good metabolic control
Cardiovascular disease
Heart disease is the most common condition shared by periodontitis patients
oral bacteria could enter the bloodstream which may trigger platelets to clump
Periodontitis and CVD are both associated with elevated levels of serum C-reactive protein
Adverse pregnancy outcomes
Women with periodontial disease may be 7-8x more likely to deliver premature
Prostaglandin E2 as a marker of current periodontal disease activity
Respiratory diseases
Bacterial found in the oral cavity can be taken up into the lung to cause respiratory diseases
Alzheimer's disease
gram-negative pathogens from the oral cavity can spread to the brain