smoking, stress, genetic susceptibility

?
how do we estimate how much someone has smoked in their lifetime
pack years. 1 packet of 20 cigs per day= 1 packet times how many years they smoked = pack years
1 of 31
What are pack years what does it assess
tobacco dosage from cigs- the number of packs smoked per day times the number. of years the subject has smoked
2 of 31
how many cigs in a small cigar and in a normal cigar and in 1g of pipe tobacco
1 small cigar = 3 cigs 1 cigar= 5 cigs and 1g of pipe tobacco = 1 cig. pack years provide an estimation of life time exposure/ dose to smoking
3 of 31
describe the response/ relationship between the number of pack years and the risk of smoking related diseases such as lung cancer and periodontitis
the more a patient smokes, the higher the chance they will have periodontal disease, it is also more likely to be more severe, progress more quickly and respond less well to perio treatment compared to a never smoker. reduced treatment outcomes
4 of 31
what is high level of nicotine dependency shown by
smoking at least 15-20 cigs per day and or smoking within 30 mins of waking
5 of 31
What are the positive effects of smoking cessation
the longer the patient has stopped smoking their tissue response to treatment will be more like a never smoker
6 of 31
what is the 5 A's approach
ask- about the smoking use status, advice- about the advantages and value of stopping, assess-how motivated a patient is to stop, assist-those who wish to stop, arrange- monitoring, follow up and referral
7 of 31
what are the 5 Rs if the patient does not want to stop
relevance- of smoking to the individual, risks- associated with smoking, rewards- of cessation to be stressed, road- blocks must be identified , repetition
8 of 31
how does smoking affect the periodontium? general- oral mucosa
smoking has been. clearly implicated in the aetiology of various oral lesions, including oral cancer. important carcinogens in smoke are polycyclic aromatic hydrocarbons and n nitroso compounds
9 of 31
how else does smoking affect the periodontium - general
staining- black/ brown. if surface is rough, plaque retention may be increased which may be sufficient to raise plaque levels above the patient's disease threshold. smokers have more calculus than non smokers . smoking causes increased salivary flow
10 of 31
continued
rate as a response to the irritant particulate matter in smoke. increased parotid flow has raised pH, raised calcium concentration and increased precipitation of calcium phosphate thus calculus deposition occurs
11 of 31
how does smoking affect the periodontium? general - gingiva
results in a reduced inflammatory response and vascularity which can make the gingiva appear healthy, even though there is sig active periodontal disease present
12 of 31
what are the biological effects of smoking on the periodontal tissues
reduced vascularity, reduced inflammatory and immune response, more pathogenic plaque biofilm, direct toxic effects on various cell types- fibroblasts and thermal damage
13 of 31
what is the effect of smoking on vascularity
smoking impairs the vasculature of periodontal tissues as fewer large blood vessels and more smaller blood vessels in smokers gingiva. inflammatory response in smokers seems to produce less increase in vascularity than in non smokers . results in
14 of 31
continued. what happens
less gingival redness and less bleeding on probing.
15 of 31
what happens the gingiva of smokers react when they stop smoking
there's a rapid recovery of both the inflammatory response and vascularity of the perio tissues- rebound effect. increased BOP and increased bleeding when brushing, flossing
16 of 31
how is the inflammatory and immune response affected by Smoking
the responses are reduced. reduced neutrophil function with impaired chemotaxis, phagocytosis and bacterial killing. reduced production of salivary IgA. reduced IgG levels and reduced number of helper T lymphocytes
17 of 31
what inflammatory mediators present in smokers cause tissue breakdown
prostaglandins E2- PGE2 and matrix metalloproteinases MMPs
18 of 31
smoking causes reduced gingival crevicular fluid flow rate .. what is the effect of this
reduces the ability of immunoglobulins and other defence molecules to reach the periodontal pocket. reduces the flushing out of the gingival crevice/ preriodontal pocket which helps to remove bacteria and their waste
19 of 31
how's the sub gingival plaque biofilm in smoker s
more diverse with higher levels of pathogenic species and is more anaerobic in nature
20 of 31
what are the 3 factors that cause non smokers to have a depth reduction following scaling
reduction in inflammatory swelling, improved tissue resistance, small possible gain in attachment
21 of 31
how is healing. impaired in smokers
in smokers, inflammatory swelling makes up less of the pocket depth. the reduction of inflammatory swelling following treatment cannot contribute as much to pocket depth reduction in smokers . also lower numbers of fibroblasts and reduced epithelial
22 of 31
continued
cell function in addition to the reduced host response. and reduced vascularity
23 of 31
what're the two theories of stress and periodontium
psychoneurogenic model and behaviour orientated model
24 of 31
what happens in the first theory
poor coping behaviour to chronic stress results in activation of the hypothalamus- pituitary- adrenal HPA axis and sympathetic nervous system -this activation leads to complex interactions between hormones, neurotransmitters and cytokines-
25 of 31
continued
this reduces the efficiency of the immune system resulting in chronic disease
26 of 31
what are the oral effects of stress
stress is known to: decrease salivary flow, increase glycoprotein content= increase salivary viscosity and increase salivary acidity . this favours plaque formation and some evidence stress could influence the nature and composition of the subgingivq
27 of 31
continued
sub gingival biofilm and promote perio disease
28 of 31
what to look at in order to assess someone genetic susceptibility
age, level of oral hygiene, extent of previous perio disease - bone loss , loss of attachment
29 of 31
genetic susceptibility to perio disease if not accounted by ..
oral hygiene and levels of perio pathogens
30 of 31
what genetic conditions cause destruction to perio tissues
Down syndrome, Ehlers danlos syndrome, papillon-lefevre, chediak higashi syndrome
31 of 31

Other cards in this set

Card 2

Front

What are pack years what does it assess

Back

tobacco dosage from cigs- the number of packs smoked per day times the number. of years the subject has smoked

Card 3

Front

how many cigs in a small cigar and in a normal cigar and in 1g of pipe tobacco

Back

Preview of the front of card 3

Card 4

Front

describe the response/ relationship between the number of pack years and the risk of smoking related diseases such as lung cancer and periodontitis

Back

Preview of the front of card 4

Card 5

Front

what is high level of nicotine dependency shown by

Back

Preview of the front of card 5
View more cards

Comments

No comments have yet been made

Similar Dentistry resources:

See all Dentistry resources »See all periodontology resources »