Incorporating Periodontal Medicine into Clinical Practice Maria Emanuel Ryan D.D.S., Ph.D. State University of New York at Stony Brook School of Dental Medicine

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Risk Factors for Periodontal Disease

• Heredity
• Family history, PST-test
• Smoking
• Frequency, Current, Past
• Diabetes
• Duration, Control
• Stress
• Reported by patient
• Medications
• Calcium channel blockers
• Dilantin
• Cyclosporin
• Known to cause dry mouth
• Nutrition
• Obesity

• Poor oral hygiene
• Plaque and calculus
• Faulty dentistry
• Overhangs, Subgingival margins
• Hormonal variations
• Pregnancy
• Increased estradiol progesterone
• Menopause
• Decreased estrogen, osteoporosis
• Immunocompromise
• HIV
• Neutropenia
• Connective tissue diseases
• Previous history of periodontitis

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Important Factors to Consider in Assessing the
Periodontal Status of Patients with Diabetes

• Degree of Metabolic Control
• Duration of Disease
• Presence of Other Long-term Complications
• Retinopathy
• Angiopathy
• Nephropathy
• Neuropathy
• Delayed Wound Healing
• Concurrent Risk Factors
• Plaque
• Smoking
• Stress
• Medications
• Hormonal Variations
• Adolescence
• Pregnancy
• Menopause

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Obesity

• An independent risk factor for periodontal
  disease
• After statistical adjustment for other
  periodontal risk factors such as
• Age
• Gender
• Socioeconomic status
• Smoking
• Diabetes
• Plaque

Genco et al.,Bissada et al.
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