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Risk and Modifying Factors for Periodontal Disease

Now that you’ve learned about predisposing factors in detail, we will now move on and discuss two other equally-important factors that contribute to the development of periodontal disease – risk and modifying factors. Again, these factors are systemic factors that are either a medical problem or a behavioral condition. They differ in the sense that a risk factor increases your chances of developing the disease, while modifying factor hastens disease progression by affecting the body’s immune response.

A certain condition can both be a risk and a modifying factor, and that’s what we will focus on in this article. Diabetes and tobacco use will be excluded, since their effects are discussed exclusively in separate articles.

Disorders that Affect Immunity:

Immune disorders contribute to periodontal disease via any of these two ways. First is by exaggerating the body’s immune response to bacteria in plaque and second by impairing the response itself, making the individual at high risk for infection.

Disorders that affect immunity include immune depressive, gastrointestinal, metabolic (i.e. diabetes), hematologic (a.k.a. blood), and genetic disorders. Genetic disorders, in particular, have been found to make an individual susceptible to periodontal disease despite having aggressive oral hygiene practices.

Identifying the disease through genetic tests even before it shows up allows for early intervention and help save the teeth that would otherwise be lost to periodontal disease.

Stress:

Stress is not a disease itself, but rather a serious condition that could lead to health problems such as high blood pressure and cancer to name a few. Recently, it also has been found to be linked to periodontal disease.

According to studies, stress depresses the body’s immune system, making it more difficult to fight off disease-causing organisms.

Medications:

Certain medications can impact periodontal health. These include birth control pills, calcium channel blockers, and antiepileptics to name a few. Birth control pills mess with periodontal tissues by exaggerating the body’s immune response to plaque, while calcium channel blockers and anti-epileptics cause gingival enlargement which makes plaque removal very difficult.

Periodontal inflammation caused by birth control pills tend to resolve once the individual stops the medication, while minor surgery may be needed to remove the enlarged tissue and restore the gums back to their normal form.

Malnutrition:

A diet that lacks in essential nutrients affects the health of the gums by compromising the body’s immune response. It can also worsen an existing periodontal problem. Vitamin C deficiency, otherwise known as scurvy, causes decreased collagen synthesis and poor wound healing.

In addition, studies have found that obesity increases one’s risk for periodontal disease. More can be learned about the association between these two in this article.

Endocrine Factors:

Endocrine conditions that could affect periodontal health are observed mostly in women. These are puberty, menstruation, pregnancy, and menopause. All of them cause an increase in estrogen and progesterone levels.

Some studies also mention that these hormones can encourage growth of bacteria that causes periodontal disease. Each one of these four endocrine-related conditions manifests as different periodontal problems, and you can learn more about them in detail by reading this article.