Secondary Local Factors in Periodontal Disease PDF

Secondary local factors in Periodontal Disease Oral and Dental Sciences Aim To have knowledge of and to recognise the various local risk factors which may exacerbate periodontal disease. GDC LLOs: 1.1.4 Explain the aetiology and pathogenesis of oral disease 1.10.1 Explain the principles of prev...

Secondary local factors in Periodontal Disease Oral and Dental Sciences Aim To have knowledge of and to recognise the various local risk factors which may exacerbate periodontal disease. GDC LLOs: 1.1.4 Explain the aetiology and pathogenesis of oral disease 1.10.1 Explain the principles of preventive care 1.10.2 Provide patients with comprehensive and accurate preventive education and instruction in a manner which encourages self-care and motivation Intended learning outcomes Define secondary local factors Explain why local factors may exacerbate periodontal disease List and describe naturally occurring (developmental) local factors List and describe local factors occurring through disease or trauma List and describe iatrogenic local factors Discuss how a dental hygienist/dental therapist may eliminate or modify secondary local factors Risk Factors  What is a secondary local factor in periodontal disease? A secondary local factor is something which may increase the risk of periodontal disease due to it providing areas of microorganism colonisation through plaque retention, thereby making it difficult for the patient to achieve optimum plaque control. How may this exacerbate periodontal disease? Think about what may happen if the patient who has susceptibility cannot reach the area where plaque is building up… Image ref: bsperio.org.uk 7 List all of the secondary local factors that you can think of… 8 Image ref: www.bsperio.org.uk 9 Plaque retentive factors Developmental Due to disease or trauma Iatrogenic 10 Natural/developmental local factors Dental calculus Refer to your calculus lecture Provides a large irregular surface area to which microorganisms can harbour and thrive Can hamper oral hygiene efforts by the patient Toxic substances can leach out of the calculus over a long period of time Image ref: pockerdentistry.com 12  Supragingival vs subgingival Image ref: en.wikipedia.org On which other surfaces does calculus form? Significance? Image ref: researchgate.net 13  Which other developmental anomalies may Tooth anomalies you see with lateral incisors Root grooves/concavities Palatal grooves- mainly found on upper lateral incisors ‘radicular grooves’ Prognosis becomes worse the deeper the groove and the further apically that it extends Image ref: rootcanalanatomy.blogspot.com 14 Malpositioned teeth Image ref: medcraveonline.com Crowding Over-eruption Poor contact point Poor position in the arch Image ref: prestige-dental-care.com.my 15 Malpositioned teeth cont… Image ref: pocketdentistry.com Tilting Rotation Impacted teeth Traumatic overbite Image ref: slideshare.net Image ref: www.implantperiocenter.com 16 Enamel pearls Usually associated with furcations. Present on approximately 5% of molars Image ref: pocketdentistry.com 17  What is the role of Incomplete lip seal & mouth breathing saliva? Image ref: drmathursdental.com Image ref: tankonyvtar.hu 18 Due to disease/trauma  Think about what’s happening in the Carious lesions and resorption cavities area of resorption microscopically… Image ref mitchmedical.us Image ref: dentalnotebook.com Image ref: drgennero.com 20 Previous periodontitis, gingival recession Image ref: sweetcroftdental.co.uk Image ref: lowermydentalbills.com 21 Oral Piercings… can they exacerbate periodontal disease? How? Image ref: govanidental.com Image ref: dentagama.com 22 Oral jewellery https://www.pinterest.com/pin/760263980831433229/ www.amazon.co.uk/Gold Tooth Grill $_10.JPG (1000×1000) (ebayimg.com) 23 Iatrogenic factors Iatrogenic factors Disease or damage to tissues ‘caused’ by the clinician Therefore, any restoration or appliance that has areas where plaque can harbour Start thinking… ‘TAILOR’ the oral hygiene! Examples? What is your role in helping the patient to attain and maintain optimal plaque control? 25  Image ref: mydentalgroup.com.au Dentures Partial dentures, particularly acrylic types with substantial coverage of the gingival margins. Where would the plaque accumulate? Image ref: thedenturecliniccanberra.com.au 26  What advice would you give Dentures cont… to this patient? 27 Dental restorations- amalgam/composite/GI/crowns Image ref: pocketdentistry.com Image ref: pocketdentistry.com 28 Consequences…. 29 Bridges Image ref :whitedental.com.sg Conventional Adhesive Image ref: estheticprofessionals.com Image ref: mydentalspecialist.co.uk 30  Oral hygiene for cleaning both teeth AND the appliance…. Orthodontic appliances Image ref:researchgate.net Image ref: piercedmd.com Image ref: en.wikipedia.org Image ref: researchgate.net 31 Implants Image ref: mdpi.com Image ref: elegantdentcare.com Image ref: advanceddentistry.co.uk 32 The role of the dental therapist & dental hygienist Efficient assessment and recognition At patients first appointment and at reassessment Which methods will you use? Which BPE code will you record? 34 How may you eliminate or modify secondary local factors? What is YOUR main role? What does this depend on? What else can you do to enable your patient to manage optimal plaque control? What if you cannot eliminate the local factor yourself? 35 References/reading material §BSP, British Periodontology Society (2021) Available from: https://www.bsperio.org.uk/assets/downloads/BSP_BPE_Guidelines_2019.pdf [Accessed 23rd May 2021|] Kornman K.S. and Loe H. (1993), The role of local factors in the etiology of periodontal diseases. Periodontology 2000, Val. 2, 1993, 83-97. Available from: https://doi.org/10.1111/j.1600-0757.1993.tb00222.x [Accessed 10th June 2021] The Root Canal Anatomy Project: Radicular Groove (2014). Available from: The Root Canal Anatomy Project: Radicular Groove: Maxillary Incisors [Accessed 10th June 2021] Kaminagakura ,E. Salmon, C. Fonseca D.C. Lopes M.C.A and Tango, R.N. (2011), Prevalence and microscopic features of enamel pearls from permanent human molars. Brazilian Journal of Oral Sciences. 10(4):268-271. Available from: DOI: https://doi.org/10.20396/bjos.v10i4.8641613 [Accessed 15th June 2021]. 36