Modifiable systemic risk factors

Modifiable systemic risk factors

The main modifiable systemic risk factors for periodontitis are smoking and diabetes. Evidence is emerging on the role of other systemic factors which may modify the susceptibility to, or progression of, periodontitis including rheumatoid arthritis, obesity, nutritional deficiencies, and stress. Medications including calcium channel blockers and phenytoin predispose some patients to gingival enlargement. In addition, a large number of medications may cause reduced salivary flow (e.g. tricyclic antidepressants, beta blockers) leading to increased plaque growth and risk of disease. If medications are affecting periodontal health, this should be discussed with the patient. It may be appropriate, with the patient’s consent, to contact their doctor to request if alternative options are possible.

Current good practice is to address smoking and diabetes control. Other potential risk factors (e.g. stress, obesity) may be discussed as appropriate to the patient.