Non-Microbial Factors and Periodontal Disease PDF

24/06/2021 Introduction to NON-microbial factors in the aetiology of periodontal disease Intended Learning Outcomes By the end of this session students should be able to: Define a non-microbial factor in relation to aetiology of periodontal disease. Name several systemic diseases/conditions th...

24/06/2021 Introduction to NON-microbial factors in the aetiology of periodontal disease Intended Learning Outcomes By the end of this session students should be able to: Define a non-microbial factor in relation to aetiology of periodontal disease. Name several systemic diseases/conditions that may modify the host response to periodontal pathogens. Give brief explanations for why these factors may contribute to periodontal disease or disorders. 2 1  24/06/2021 Please ensure you have watched these videos  https://youtu.be/bHMTgMKPFG8  https://youtu.be/RhrLOVN5_8E  https://youtu.be/br-iMGi6fYI 3 Useful Websites  https://www.efp.org/gum-disease-general-health/perio-diabetes/  https://www.efp.org/gum-disease-general-health/oral-health- pregnancy/ 4 2  24/06/2021 More in depth discussion about each of these in Year 2 Applied Clinical Practice Dental Specialities 5 BSP Periodontal Diagnosis Flowchart 6 3  24/06/2021 Increase susceptibility to periodontal disease Modify or amplify host response 7 Quantify risk factors / Risk factor - influences condition Modifiable vs Nonmodifiable # 8 Stress Females have higher rate of progression in some cases -not a risk factor in diagnosis 4  24/06/2021 Non-microbial factors include: Sex Family history Genetic Systemic hormones Factors disorders Stress Smoking (own Medications topic) Can impact immune system and drug induced gingival overgrowth 9 Not single factors - well connected factors Directional or multidirectional relationships Sheilman and Watt 2000 10 5  24/06/2021 11 Diabetes Mellitus Leukemias Stress 01 Neutropenia Down Pregnancy Syndrome 06 02 05 03 DIGO HIV/AIDS 04 Poor nutrition can exacerbate Can you think of HIV/AIDS Osteoporosis Diabetes anymore? Osteoporosis 6  24/06/2021 Linked to Endocrine Disease lecture Taking a medical history Diabetes Prevalence (diagnosed & undiagnosed) Out of 100 of us have diagnosed or undiagnosed diabetes Data from PHE: https://fingertips.phe.org.uk/ profile/diabetes-ft/data Diagnosed by blood sugar levels 14 7  24/06/2021 Diabetes - endocrine system cannot regulate how blood sugar is processed - sugars circulate the blood - impacts responses and delays healing High sugar diet - also higher caries risk Diabetes, the oral cavity & the dental professional What can you see in the mouth? Diabetes Control Medical emergencies risk What is poor control? Risk factor for diabetes Oral implications Diabetes & You Casanova, L., Hughes, F. & Preshaw, P. Diabetes and periodontal disease: a two- Management of appointment way relationship. Br Dent J 217, 433–437 (2014). https://doi.org/10.1038/sj.bdj.2014.907 Motivation Control of oral & general health? Predicting risk now & in future or family members 15 Diabetes - impacts inflammatory mediators, increased caries and periodontal risk, delayed healing. Liaise with GP/dietican Pregnancy & Hormone related factors 16 Diabetes during birth - Gestational diabetes 8  24/06/2021 Sex - hormone linked Puberty Contraception Pregnancy Menopause HRT 17 Bobetsis YA, Barros SP, Offenbacher S. Exploring the relationship between periodontal Pregnancy disease and pregnancy complications. J Am Dent Assoc. 2006 Oct;137 https://doi.org/10.14219/jada.ar chive.2006.0403 Adverse Hormones Inflammatory Appointment Hard tissues pregnancy mediators management outcomes 18 LA safest in 2nd or 3rd trimester Immune response effected Increase recall 9  24/06/2021 Sex hormones Puberty / Contraception Menopause Taichman LS, Sohn W, Kolenic G, Sowers M. Depot medroxyprogesterone acetate use and periodontal health in 15- to 44- year-old U.S. females. J Periodontal. 2012;83:1008–1017. 19 Winkler JR, Robertson PB. Periodontal disease associated with HIV infection. Oral Surg Oral Med Oral Pathol. 1992 Feb;73(2):145-50. doi: 10.1016/0030-4220(92)90186- t. PMID: 1532235. 20 10  24/06/2021 Immunosuppressed patients - more common 21 Immune Disorders 22 11  24/06/2021 Examples – please refer to Immune Disorders Lecture Leucocyte adhesion deficiency (LAD) Diabetes associated 23 HIV Associated Early child/birth - short immune system - low life expectancy- involved both B and T cells - inability of leukocytes to migrate to site of infection Drug induced gingival overgrowth DIGO 24 12  24/06/2021 High blood pressure Differential diagnosis Epilepsy 25 Refer back to GP to reassess medications Immune response - increase in cortisol Major factor in multi factorial response Stress Immuno- suppression Clenching Motivation Diet 26 13  24/06/2021 Osteoporosis Calcium depletion Bone disease Long term steroids - influence immune response Age? Bisophosphonates Gender? Oral VS IV - IV much higher risk and duration also increases risks. Diet? Seeing more in younger patients - more common in females due to hormonal aspect and calcium dependency higher 27 Hyperlipidaemia High Cholesterol Lipids in the blood - causes narrowing of the blood vessels Impacts on host response Found periodontal pathogens involved within plaques in blood vessels 28 14  24/06/2021 WATEVS - I just came to scale teeth 29 In both oral and general health Detection Delivery Assessing Re-assessment Communication/ Support Education Motivation Monitor & Coaching 30 15  24/06/2021 Supporting material 31 Making Every Contact Count (MECC) Trying to influence behaviour change 32 16  24/06/2021 New knowledge? Thoughts? Empowered? Part of a pyramid or a circle? 33 Recommended Reading  Casanova, L., Hughes, F. & Preshaw, P. Diabetes and periodontal disease: a two-way relationship. Br Dent J 217, 433–437 (2014). https://doi.org/10.1038/sj.bdj.2014.907  Bobetsis YA, Barros SP, Offenbacher S. Exploring the relationship between periodontal disease and pregnancy complications. J Am Dent Assoc. 2006 Oct;137 https://doi.org/10.14219/jada.archive.2006.0403  Winkler JR, Robertson PB. Periodontal disease associated with HIV infection. Oral Surg Oral Med Oral Pathol. 1992 Feb;73(2):145-50. doi: 10.1016/0030-4220(92)90186-t. PMID: 1532235.  Taichman LS, Sohn W, Kolenic G, Sowers M. Depot medroxyprogesterone acetate use and periodontal health in 15- to 44- year-old U.S. females. J Periodontal. 2012;83:1008–1017 34 17  24/06/2021 Image References  https://www.sanofi.com/en/our-responsibility/my-daily-life-with-diabetes  https://www.parents.com/pregnancy/signs/symptoms/a-pregnancy-symptom-timeline/  https://www.everydayhealth.com/menopause/perimenopause-symptoms/  https://www.irishtimes.com/life-and-style/health-family/why-are-young-women-giving-up- on-the-contraceptive-pill-1.3800390  https://www.womenshealth.gov/hiv-and-aids/hiv-and-aids-basics  https://www.osmosis.org/learn/Leukocyte_adhesion_deficiency  https://spectrum.diabetesjournals.org/content/24/4/195  https://www.zavamed.com/uk/amlodipine.html  https://www.gnhindia.com/products/phenytoin-sodium-milpharm-phenytoin-uk/  https://www.canr.msu.edu/news/strategies_to_cope_with_family_stress  Chance To Change stock image. Image of attitude, ability - 144397939 (dreamstime.com) 35 18