Risk factors for periodontitis

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Periodontal disease refers to a group of inflammatory conditions that affect the tissues around the teeth.

The mildest form of periodontal disease is gingivitis.

If left untreated, gingivitis can progress to periodontitis, which can lead to destruction of the supporting structures around the teeth.

Now, etiologic factors in periodontal disease are subdivided into two main groups, primary and secondary etiologic factors.

The primary, or initiating etiologic factor is the dental plaque or dental biofilm, which is a sticky collection of bacteria, salivary proteins, and dead cells from the oral mucosa.

On the other hand, secondary, also known as contributing etiologic factors, enhance the ability of dental plaque to cause periodontitis.

Secondary etiologic factors are further subdivided into local factors, which make the dental plaque more resistant and difficult to remove; and systemic factors, which include conditions like diabetes that could impair the host’s immune response and increase the risk of periodontitis.

Local factors include calculus, caries, tooth position, anatomical features, iatrogenic factors, and trauma.

First, let’s focus on calculus, which is defined as a calcified dental plaque.

Supragingival calculus is located above the gingiva while subgingival is below the gingiva.

Supragingival calculus is visible upon oral examination and it’s composed of organic and inorganic components.

Organic components include bacterial cells, salivary proteins, and lipids.

The inorganic component mainly consists of calcium phosphate.

In contrast to supragingival calculus, subgingival calculus is not visible upon oral examination and it’s harder to remove.


Periodontal disease refers to a group of inflammatory conditions that affect the supporting tissues around the teeth. The mildest form of periodontal disease is gingivitis and if left untreated, it can progress to periodontitis.

Risk factors for periodontitis include dental plaque, dental caries, trauma, and systemic factors that may impair the host's immune defense like HIV infection, poor oral hygiene, smoking, and stress. By being aware of these risk factors, individuals can take steps to reduce their risk of developing periodontitis, such as practicing good oral hygiene, quitting tobacco, and seeking treatment for any underlying medical conditions. Regular dental check-ups are also important for detecting and treating periodontal diseases in their early stages.


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