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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Periodontal Disease, continued

Risk Factors for Periodontal Disease

  • Poor oral hygiene resulting in plaque and calculus formation
  • Gingivitis or gingival recession
    Gingivitis: Inflammation of the gums.
    • Can be triggered by abrasions from oral piercings
  • Systemic conditions:
    • Down syndrome
    • Immunodeficiency (e.g., cyclic neutopenia, leukocyte adhesion deficiency)  
    • Metabolic diseases (e.g., diabetes, hypophosphatasia)
    • Oncologic (e.g., leukemia, Langerhans cell histiocytosis)  
  • Tobacco or marijuana use
  • Pregnancy and hormonal contraceptives  
  • Oral trauma 

Periodontal Link to Systemic Disease

  • Periodontitis may be an independent risk factor for:
    • Cardiovascular disease (stroke and coronary heart disease)
    • Diabetes (glycemic control, diabetes complications, and development of type 2 diabetes)
    • Adverse pregnancy outcomes (i.e., low-birth weight, premature birth)
  • Association with multiple other systemic diseases (cancer, arthritis,
    obesity, metabolic syndrome, chronic kidney disease) has been
    studied, but study size, limitations, and confounders prohibit
    statement of causal connection at this time.
    • Additional studies are warranted to investigate these associations.

Periodontal Disease Prevention and Treatment

  • Reinforce the importance of good oral hygiene, encourage brushing
    and flossing.  
  • Discourage all forms of tobacco and other drug use.  
  • Discuss the risks of oral piercings.
  • Promote regular preventive dental visits. 
  • Maintain vigilance regarding the oral health of adolescents with
    special health care needs.  
  • Incorporate an evaluation of hard and soft oral tissues into every
    routine physical examination.  
  • Refer patients with abnormalities to a dental professional and
    continue close monitoring.
Fast Facts
Periodontal disease is very common among adolescents.
Periodontitis is the number one cause of tooth loss in adults.
Pubertal hormonal changes, hormonal contraceptives, and pregnancy all increase the risk of developing periodontitis.
Tobacco use significantly increases the risk for development of periodontal disease.
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