Risk factors
1. Systemic risk factors factors that affect
Causes
Oral microorganisms
Porphyromonas gingivalis
Tannerella forsythensis
Treponema denticola.
Actinobacillus actinomycetemcomitans in
young adults
Pathology
Risk factors
1. Systemic risk factors factors that affect
Use of tobacco
Diabetes mellitus
Gingivitis, periodontitis, dental caries,
Use of tobacco
Heat from smoke attachment loss, calculus
Stress
biofilm plaque, gingivitis
Cardiovascular diseases
C-reactive protein -> myocardial
infarct, stroke
Poor oral hygiene
Biofilm plaque -> pathogenic bacteria of
periodontal disease
Risk assessment
Four levels
1. Patient level
2. Whole mouth level
3. Tooth level
4. Site level
American
academy of
periodontolo
gy selfassessment
tool
PSR codes
All parameters have their own scale for low, moderate and
high risk profiles
Gingival inflammation
GI - Loe and Silness (1967)
Plaque thickness at gingival margin
M/B/D/L
Gingival inflammation
Bleeding on probing index
M/B/D/L
Assessment of inflammation of
the periodontal tissue.
Plaque index:
Gingival index:
Le & Silness(1967)
Criteria
Visible plaque
Abundant plaque
periodontal
Criteria
Normal gingiva
color and
Ramfjord(1959)
Code
CPI
TN
Healthy
Bleeding on probing
II .
I+ calculus removal
Shallow pockets up to
5 mm
6mm
1959)
1997)
Sulcus Bleeding Index (Mhlemann & Major, 1958)
Bleeding Point Index
1962,Turesky 1970)
Shick and Ash Modification of Plaque Criteria ( Shick & Ash 1961)
1964)
Calculus component of PDI (Ramfjord, 1959)
Calculus severity index (Ennever &Radike 1961)