11
Systemic risk factors for periodontal diseases
Table 11.1 Systemic risk determinants for periodontal disease.
| Systemic risk factors | Systemic risk indicators (potential risk factors) |
| Smoking | Low dietary calcium |
| Diabetes mellitus type 1 and type 2 | Postmenopausal osteoporosis and osteopenia |
| Race | Visceral obesity |
| Genetics | Stress and inadequate coping |
| Male gender | |
| PMN function | |
| SES (low educational level) | |
| Acquired systemic infections (e.g. HIV) | |
| Severe malnutrition (cancrum oris) | |
Systemic risk factors for periodontal disease are those conditions that affect most, if not all, tissues of the body. They are in contrast to the local risk factors described in Chapters 10 and 14 that influence periodontal tissues at the tooth or site level. Types of evidence required to establish risk factors in the causal pathway of a disease are discussed in Chapter 10.
Systemic risk factors and risk indicators for periodontal disease
• Systemic risk factors include smoking, diabetes mellitus, race, genetic factors, male gender, polymorphonuclear (PMN) functional abnormalities, low economic status, low educational level, acquired systemic infections such as human immunodeficiency virus (HIV), and severe malnutrition (Table 11.1).
• Systemic risk indicators or putative risk factors include low dietary calcium intake, postmenopausal osteoporosis and osteopenia, obesity, stress and inadequate coping, and decreased immunoglobulin 2 (IgG2) antibodies (Table 11.1).
• Regular dental visits, anaemia and anti-allergy medications protect against periodontal disease.
• Most of the risk factors for periodontal disease also affect risk for dental implant therapy.
Mechanisms by which systemic risk factors appear to be operating
Smoking
In the more than 4000 components of smoke, there are many that exaggerate the inflammatory responses to periodontal pathogens and others that s/>
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