It has been identified as a novel and potentially modifiable risk factor for CKD (Chambrone et al., 2013). In addition there are other factors such as bad nutrition or alcohol abuse that can also promote periodontitis. Signs and Symptoms. Studies that examined the effect of smoking on periodontal disease provide a clear association as follows: current and former smokers exhibit different risk profiles; in addition, the negative effect of smoking on periodontal health is cumulative and proportional to the amount of smoking. Understanding the clinical effects of various modifiable risk factors (MRFs) and nonmodifiable risk factors (NMRFs) is important in guiding proper treatment, yet there is limited evidence outlining the influence of MRFs and NMRFs on outcomes of PA resection. Inadequate oral hygiene is one of the key initiators of periodontal disease. There is no evidence to suggest that daily use of antiseptic agents should be part of the supportive periodontal therapy for aggressive periodontitis. Smoking has been associated with greater severity and more rapid rate of periodontitis with deeper periodontal pockets and more alveolar bone loss. Therefore, poor dental care and compromised physical health are some of the most significant periodontal disease risk factors. Although plaque biofilm is necessary for the onset of periodontitis, the tissue destruction mostly results from the abnormal host immuno-inflammatory response. Therefore, to prevent PD, the approach of controlling the common risk factors could be an effective strategy. But all risk factors are not created equal. Risk factors play an important role in an individual's response to periodontal infection. • A study (2017) reported a positive association between apical periodontitis and cardiovascular disease. Periodontal Risk Assessment (PRA) (Hexagonal Risk Diagram) (Lang & Tonetti 2003) The patient's risk assessment for recurrence of periodontitis may be evaluated on the basis of a number of clinical conditions whereby no single parameter displays a more paramount role. This review describes the current evidence published from January 2013 through March 2016 for “non-modifiable” risk factors for periodontitis and diabetes mellitus. potentially important modifiable risk factor causally as-sociated with exacerbation of periodontitis and other in-flammatory periodontal diseases. However, interproximal width and lack of adjacent tooth contacts are related to the likelihood of losing interproximal bone during periodontal maintenance, suggesting the need for restorative therapy. Tobacco smoking has been identified as the single most significant, modifiable risk factor for periodontal disease. If you are at a higher risk for this condition, it is important to be extra vigilant about your dental health. 8 The American Academy of Periodontology considers that postmenopausal osteoporosis is a risk factor for periodontal disease. Tobacco Smoking . The magnitude of the effects of smoking on periodontitis varies considerably among different studies. In patients who regularly smoke more than 10 cigarettes daily, it has been estimated that the relative risk of periodontitis may be as high as fivefold. While the control of most of the modifiable risk factors for periodontitis was not tested, some evidence suggested that smoking cessation may retard the progression of periodontitis. Risk factors for a disease are factors that increase the chance of developing the disease, that is, new onset or incidence. Risk Factors and Study Design. 2.1.2. Important risk factors for periodontitis can be grouped into four categories: microbial, systemic, behavioral and local. Prevention of poor oral hygiene practices involves the promotion of proper self-performed oral hygiene as well as professional maintenance at regular intervals depending on the individual patient’s risk. A risk factor can be defined as an occurrence or characteristic that has been associated with the increased rate of a subsequently occurring disease. Based on several meta‐analyses, systematic reviews, and recent studies, more than a dozen prospective, observational, and longitudinal studies have shown lower cognitive performance and an increase in the risk of dementia among individuals with diabetes; on balance, the association between diabetes and dementia appears strong, but not conclusive -. Multiple risk factors do not increase the risk in an additive manner, but rather in an exponential manner. There are a few well established modifiable risk factors for periodontitis, and numerous others that are under active research. There is also evidence that PD has several modifiable risk factors in common with cer- tain non-communicable chronic diseases like diabetes. In the short term, systemic and behavior factors are of limited value in identifying mild-moderate periodontitis patients on PM at increased risk of bone loss. This condition occurs when bacteria gather in pockets in your gums. Objective: Pituitary adenomas (PAs) are among the most common intracranial tumors. Most recent studies focusing on the periodontal health of ESRD patients on maintenance hemodialysis have reported the presence of poor oral hygiene and Many risk factors increase the likelihood of periodontal disease development, as well as the severity and speed at which it may occur. 19 Berlin-Broner Y, Febbraio M, Levin L. Association between apical periodontitis and cardiovascular diseases: a systematic review of the literature. 7 Overall, smoking is probably the single most significant, modifiable risk factor for periodontal diseases. In a multivariate analysis, smoking (odds ratio = 6.6) and a history of periodontitis (odds ratio of = 4.5) were significant risk factors16 Krennmair S, Hunger S, Forstner T, Malek M, Krennmair G, Stimmelmayr M. Implant health and factors affecting peri-implant marginal bone alteration for implants placed in staged maxillary sinus augmentation: A 5-year prospective study. Some of the most important risk factors are different systemic diseases such as diabetes, smoking and stress. Modifiable risk factors in periodontal disease Modifiable risk factors in periodontal disease Barros, Silvana P.; Offenbacher, Steven 2014-02-01 00:00:00 Epigenetic mechanisms Epigenetics is the study of heritable changes in gene expression that occur without changes in DNA sequence. There is also evidence that PD has several modifiable risk factors in common with cer- tain non-communicable chronic diseases like diabetes. 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