Risk Factors For Periodontitis

1. Department of oral pathology
Risk factors for periodontitis
Presented by,
Shiji margaret
CRRI

2. Introduction
Historically, it was believed that
all individuals were uniformly
susceptible to developing
periodontal disease and that
accumulation of plaque, poor oral
hygiene and perhaps occlusal
trauma were sufficient to initiate
periodontitis.

3. classification
Risk factors
 smoking
Diabetes mellitus
Pathogenic bacteria
Risk derminants
Genetic factor
Age
gender

4. Risk indicator
osteoporosis
Risk markers
Previous history of periodontal disease
Bleeding on probing

5. Smoking
Smoking causes periodontitis

6. Smoking
 smoking is a well established risk factor of
periodontitis.
 smockers will be having less bleeding than
non smokers
With increased use of tobacco, patients
show higher periodontal probing depths,
increased clinical attachment loss, more
alveolar bone resorption, a higher
prevalence of gingival recessions, and a
higher risk for tooth loss

7. Diabetes mellitus
Diabetes is a modifiable factor in the sense
that though it cannot be cured, it can be
controlled.
Diabetes is a clear risk factor for periodontitis.
Prevelence and severity of periodontitis is higher
in patients with type1 and type2 diabetes

8. Diabetic parameters examined include
glycemic control, duration of disease, presence
of other diabetes-associated complications and
population studied. Periodontal parameters
examined have included gingivitis, clinical
attachment loss, and alveolar bone loss.
Studies have shown increased risk of
ongoing periodontal destruction in diabetics
as compared to nondiabetics
with an odds ratio of 4.2.

9. Finally, studies have been done which
suggest that poorly controlled diabetics
respond less successfully to periodontal
therapy relative to well-controlled and
non-diabetics

10. Micro-organims and periodontal disease
 Micro-organisms that colonize mouth
1. Tanerella forsythus
2. Porphyromonas gingivalis
3. Actinobaccilus actinomycetemcomitans

11.  the presence of periodontal pathogens, though
necessary to cause disease
 The presence of A. actinomycetemcomitans
confers no additional risk
of developing localized aggressive periodontitis in
adults
 It has been shown that Prevotella
intermedia, P gingivalis, and Fusobacterium
nucleatum may be risk indicators for periodontal
disease in a diverse population, though they are
not risk factors

12. Physiological factors
•stress

13.  individuals under psychological stress are
more likely to develop clinical attachment loss
and loss of alveolar bone
 One possible link in this regard may be
increases in production of IL-6 in response to
increased psychological stress
 individuals under stress are less likely to
perform regular good oral hygiene and
prophylaxis

14. Genetic factors
Although bacterial infection is the etiologic
agent in periodontal disease.
 studies of identical twins suggest 50% of
susceptibility to periodontal disease is due to
host factors (Michalowiczet al., 2000).
Similarly, indigenous and relatively isolated
populations have been shown to develop
periodontal disease that differ from group to
group (Dowsettet al., 2001; Ronderos et al., 2001).

15. Age
The aging process itself is suggested to be an
independent risk factor for periodontal diseases
The extent of severity of periodontal diseases
are shown to increase with age
increased level of periodontal
destruction observed with aging is the result of
cumulative destruction rather than a result of
increased rates of destruction.

17. Healthy gingiva
Pockets formed
between tooth and
gum
Can cause destruction
of bone support
Increase in pocket depth cause
Disease progression and lead to
surgery

18. Gender
Disease susceptibility may increased due to
hormone related alterations in women
• gingival blood flow
• composition of saliva
Men are found with worse periodontal health

19. Osteoporosis
Osteoporosis is a bone disease in which
bone loss occurs, so that bones become
weak and are more likely to break.

20. Without prevension or treatment,
osteoporosis can progress whithout pain or
symptoms until a bone breaks.
Fractures from osteoporosis commonly occurs
in the hip, ribs, spine, ribs and wrist.
Osteoporosis can occur in any age
It is more common in people above 50 years
of age

21. Anorexia ,Diets low in calcium,
phosohate and vitamin D are risk factors
for osteoporosis
Women are more likely to have
osteoporosis than men
People who are small and have thin
bones are at great risk.
If a persons parents are having
osteoporosis he or she may be at risk

22. conclusion
“ Measurement, Assessment,
Elimination or reducing as many risks
as possible will improve disease
prevention and treatment outcomes”

23. reference
 Journal of International Acadamy
of Periodontolgy. 2005 January ;
7(1): 3–7.
 Carranza 10th edision