Podcast
Questions and Answers
Which of the following conditions is primarily associated with upper lateral incisors?
Which of the following conditions is primarily associated with upper lateral incisors?
What prognosis is indicated with deeper grooves in lateral incisors?
What prognosis is indicated with deeper grooves in lateral incisors?
Which of the following anomalies is associated with molars and occurs in about 5% of cases?
Which of the following anomalies is associated with molars and occurs in about 5% of cases?
What is a common consequence of malpositioned teeth?
What is a common consequence of malpositioned teeth?
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Which of the following is NOT typically a feature of malpositioned teeth?
Which of the following is NOT typically a feature of malpositioned teeth?
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What can exacerbate periodontal disease from oral hygiene practices?
What can exacerbate periodontal disease from oral hygiene practices?
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What are iatrogenic factors typically associated with in dental practices?
What are iatrogenic factors typically associated with in dental practices?
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In what area is plaque likely to accumulate with the use of partial dentures?
In what area is plaque likely to accumulate with the use of partial dentures?
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Carious lesions and resorption are associated with which dental condition?
Carious lesions and resorption are associated with which dental condition?
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What should clinicians consider to optimize plaque control for their patients?
What should clinicians consider to optimize plaque control for their patients?
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Which of these is likely to be a result of previous periodontitis?
Which of these is likely to be a result of previous periodontitis?
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What is a common characteristic of acrylic partial dentures regarding hygiene?
What is a common characteristic of acrylic partial dentures regarding hygiene?
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Which of the following is NOT an example of iatrogenic factors in dentistry?
Which of the following is NOT an example of iatrogenic factors in dentistry?
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What best defines a secondary local factor in periodontal disease?
What best defines a secondary local factor in periodontal disease?
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Why do local factors exacerbate periodontal disease?
Why do local factors exacerbate periodontal disease?
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Which of the following is considered a naturally occurring (developmental) local factor?
Which of the following is considered a naturally occurring (developmental) local factor?
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What are iatrogenic local factors?
What are iatrogenic local factors?
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How can dental hygienists or dental therapists modify secondary local factors?
How can dental hygienists or dental therapists modify secondary local factors?
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Which of the following best describes the impact of dental calculus on oral hygiene?
Which of the following best describes the impact of dental calculus on oral hygiene?
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What effect do toxic substances leaching from dental calculus have over time?
What effect do toxic substances leaching from dental calculus have over time?
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Which of the following is NOT a local factor affecting periodontal disease?
Which of the following is NOT a local factor affecting periodontal disease?
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What is the primary role of dental therapists and hygienists at a patient's first appointment?
What is the primary role of dental therapists and hygienists at a patient's first appointment?
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How should dental professionals approach the elimination of secondary local factors affecting oral health?
How should dental professionals approach the elimination of secondary local factors affecting oral health?
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Which of the following is a method of plaque control that dental professionals can encourage for their patients?
Which of the following is a method of plaque control that dental professionals can encourage for their patients?
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What does the BPE code record help assess in a dental context?
What does the BPE code record help assess in a dental context?
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What should be done if a dental professional cannot eliminate a local factor affecting a patient’s oral health?
What should be done if a dental professional cannot eliminate a local factor affecting a patient’s oral health?
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In the context of dentures, what key advice should be given to patients?
In the context of dentures, what key advice should be given to patients?
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What is one key function of a bridge in dental restoration?
What is one key function of a bridge in dental restoration?
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What is a primary difference between conventional and adhesive bridges?
What is a primary difference between conventional and adhesive bridges?
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Study Notes
Secondary Local Factors in Periodontal Disease
- Secondary local factors are things that increase the risk of periodontal disease by providing areas for microorganisms to colonise through plaque retention, making it hard for the patient to achieve optimum plaque control.
- Plaque retentive factors can be developmental, due to disease or trauma, or iatrogenic.
- Developmental local factors are naturally occurring, like dental calculus, tooth anomalies, and incomplete lip seal & mouth breathing.
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Dental Calculus:
- Provides a large irregular surface area for micro-organisms to thrive.
- Hampered oral hygiene efforts.
- Toxic substances can leach out over time.
- Can form supragingivally or subgingivally.
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Tooth Anomalies:
- Root grooves/concavities, palatal grooves, mainly found on upper lateral incisors, also known as ‘radicular grooves’.
- Root grooves create areas where plaque can build up easily and cause inflammation.
- The deeper and further the groove, the worse the prognosis.
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Malpositioned Teeth:
- Crowding, over-eruption, poor contact points, poor position in the arch, tilting, rotation, impacted teeth, traumatic open bite.
- Make it hard to clean properly, leading to plaque accumulation.
-
Enamel Pearls:
- Usually associated with furcations.
- Present on approximately 5% of molars.
- Plaque can easily build up around enamel pearls, leading to inflammation.
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Incomplete lip seal & mouth breathing:
- Contributes to dryness of the mouth, which can lead to plaque retention.
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Disease or Trauma Local Factors:
- Can contribute to plaque retention, making it harder for the patient to maintain good oral hygiene.
- Examples include:
- Carious lesions and resorption
- Previous periodontitis and gingival recession
- Oral piercings
- Oral jewelry
-
Iatrogenic Local Factors:
- Damage or disease to tissues caused by the clinician.
- Any restoration or appliance that has areas where plaque can harbour is a potential iatrogenic local factor.
- Examples include:
- Dentures
- Dental restorations (amalgam/composite/GI/crowns)
- Bridges
- Orthodontic appliances
- Implants
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Dental Hygienists' and Therapists' Role:
- Efficently assess and recognize local factors at the first appointment and at reassessments.
- Methods used for assessment:
- Thorough examination (including probing depths and bleeding on probing)
- Oral hygiene instructions
- Plaque disclosure
- Radiographs
- Periodontal charting
- Ensure patients know about the impact of local factors and their role in preventative care.
- Ensure patients can achieve optimal plaque control.
- If a local factor cannot be eliminated, refer patient to a specialist for further advice.
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