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 aeDology and pathogenesis of oral disease 1.10.1 Explain the principles of preve...

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 aeDology and pathogenesis of oral disease 1.10.1 Explain the principles of prevenDve care 1.10.2 Provide paDents with comprehensive and accurate prevenDve educaDon and instrucDon in a manner which encourages self-care and moDvaDon Intended learning outcomes DeIne 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 colonisa;on through plaque reten;on, thereby making it diOcult for the paDent to achieve opDmum plaque control. Where Plaque can Stagnate harbors in areas · How bacteria it can do. · Damage How may this exacerbate periodontal disease? Think about what may happen if the paDent who has suscepDbility cannot reach the area where plaque is building up… becomes Plaque is If not being removed gingiva disease if Left Inflammed Leading to periodontal. Image ref: bsperio.org.uk 7 List all of the secondary local factors that you can think of… Plaaue poor contact overhang restoration Partial dentures malpositioned teeth - 8  this - Like put there Image ref: www.bsperio.org.uk 9 Plaque reten;ve factors Developmental Natural Due to disease or trauma Iatrogenic by Relating disease and caused to examination o treatment. 10 Natural/developmental local factors  surface t pourus conta o creating years & - M Dental calculus urfaces to Refer to your Snorder calculus lecture Provides a large irregular surface area to which microorganisms can harbour and thrive Can hamper oral hygiene eJorts by the ( paDent Toxic substances can leach out of the plaque found calculus over a long period of Dme on calculus. Image ref: pockerdenDstry.com 12  Supragingival vs subgingival Image ref: en.wikipedia.org · Dentures On which other surfaces does calculus form? Image ref: researchgate.net SigniLcance? 13  Which other developmental Tooth anomalies anomalies may you see with lateral Root grooves/concavi;es incisors Palatal grooves- mainly found on upper lateral incisors ‘radicular grooves’ O Prognosis becomes worse the deeper the groove and the further apically that it extends - Hard to clean. 14 Image ref: rootcanalanatomy.blogspot.com  Malposi;oned teeth Image ref: medcraveonline.com Crowding Over-erupDon Poor contact point Poor posiDon in the arch · causes Plaque retention Image ref: presDge-dental-care.com.my 15 Malposi;oned teeth cont… Image ref: pocketdenDstry.com TilDng RotaDon Impacted teeth TraumaDc overbite Image ref: slideshare.net Image ref: www.implantperiocenter.com 16  enamel of Bead Enamel pearls - Usually associated with furca;ons. Present on approximately 5% of molars Image ref: pocketdenDstry.com 17  What is the Incomplete lip seal & mouth breathing role of saliva? Image ref: drmathursdental.com Image ref: tankonyvtar.hu LessSaliva Plaque build up · Dry mouth = 18 Due to disease/trauma  Think about what’s happening in the area Carious lesions and resorp;on cavi;es of resorp;on · Bacteria and plaque stagnation microscopically… G Og Image ref mitchmedical.us Image ref: dentalnotebook.com Image ref: drgennero.com 20 Previous periodon;;s, gingival recession , ac poor a build Plaque up recession Image ref: sweetcroWdental.co.uk Image ref: lowermydentalbills.com in Lesions 21 Oral Piercings… can accumulate on Plaque S oral piercing S can they exacerbate periodontal disease? How? Abrasion to gingiva Image ref: govanidental.com can cause recession Image ref: dentagama.com ⑧ 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 Dssues ‘caused’ by the clinician Therefore, any restoraDon or appliance that has areas where plaque can harbour Start thinking… Dentures Examples? ‘TAILOR’ the oral fillings hygiene! crowns vanners What is your role in helping the pa;ent to aUain and maintain op;mal plaque control? Teaching On 25  Image ref: mydentalgroup.com.au Dentures ParDal dentures, parDcularly acrylic types with substanDal coverage of the gingival margins. Where would the plaque accumulate? margins clasps, interproximal Image ref: thedenturecliniccanberra.com.au 26  What advice would Dentures cont… you give to this pa;ent? from p. Trauma 27 Dental restora;ons-amalgam/composite/GI/crowns Image ref: pocketdenDstry.com Image ref: pocketdentistry.com 28  · food trap accumulation · plaque Consequences…. O 29 Bridges Image ref :whitedental.com.sg ConvenDonal Adhesive Image ref: estheDcprofessionals.com Image ref: mydentalspecialist.co.uk 30  Oral hygiene for cleaning both teeth AND the Orthodon;c appliances appliance…. 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: advanceddenDstry.co.uk 32 The role of the dental therapist & dental hygienist E[cient assessment and recogni;on At paDents Lrst appointment and at reassessment Tailor OHI to individual Which methods will you use? Which BPE code will you record? 6 point pocket charting * 1/2/314 - 34 How may you eliminate or modify secondary local factors? What is YOUR main role? educator What does this depend on? Patient knowledge What else can you do to enable your paDent to manage op;mal plaque control? Demonstrate/Removal What if you cannot eliminate the local factor yourself? referal to required person 35 References/reading material BSP, Bri;sh Periodontology Society (2021) Available from: hUps://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