Aetiology of Periodontal Disease: Systemic Factors

Cards (14)

  • What do systemic factors do?
    - Modify the presentation of periodontal disease
    - may also determine the susceptibility to periodontitis
  • What are some examples of systemic factors which increase the susceptibility of a patient developing periodontal disease?
    Smoking
    Diabetes
    Pregnancy
    Medications which cause gingival enlargement
    Genetic factors
  • What are smokers more likely to do?
    To develop periodontitis than non-smokers
    To experience greater bone loss
    To develop periodontal pockets
    To lose teeth
  • What does smoking mask?
    Gingivitis & the effects of periodontitis, so there's less bleeding (due to less blood flow in gingiva)
  • What is the effect of uncontrolled diabetes/poor glycaemic control on periodontal disease?
    It increases the risk of periodontal disease & disease progression
  • What do people with diabetes also have?
    Impaired immune response
    Impaired wound healing
    Recurrent/multiple periodontal abscesses
  • Why is pregnancy a systemic factor?
    Pregnancy increases gingival response to plaque
    Increased progesterone results in increased gingival blood flow
    Similar effects also seen at puberty & associated with contraceptive pill
  • Why is medication a systemic factor?
    Because drug induced gingival overgrowth increases plaque retention

    These drugs include:
    Ca channel blockers for hypertension (nifedipine, amlodipine, felodipine)

    Phenytoin for epilepsy

    Cyclosporin: immunosuppressant prescribed for some autoimmune disorders
  • How do genetic factors contribute to periodontal disease?
    There is evidence that genetics play an important role when determining susceptibility to periodontitis

    The evidence comes from:
    Familial tendency, especially in severe periodontal disease
    Racial predilection, especially in severe periodontal disease
    Twin studies
    Association with specific genetic polymorphisms
  • What are genetic polymorphisms?

    Normal variations in gene structure, may occur in regulatory or coding regions of gene
  • Are genetic polymorphisms common?
    Yes
  • Are hereditary neutropenic conditions common?
    No, they're rare
  • What do hereditary neutropenic conditions result from?
    Single point genetic mutations
  • What are some examples of hereditary neutropenic conditions?
    Papillon Lefevre syndrome
    Chediak Higashi syndrome
    Leukocyte Adhesion syndrome