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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 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 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.