3. Risk Factors for Periodontal Disease
Heredity
Family history, PST-test
Smoking
Frequency, Current, Past
Diabetes
Duration, Control
Stress
Reported by patient
Medications
Calcium channel blockers
Dilantin
Cyclosporin
Known to cause dry mouth
Nutrition
Obesity
Poor oral hygiene
Plaque and calculus
Faulty dentistry
Overhangs, Subgingival margins
Hormonal variations
Pregnancy
Increased estradiol & progesterone
Menopause
Decreased estrogen, osteoporosis
Immunocompromise
HIV
Neutropenia
Connective tissue diseases
Previous history of periodontitis

4. Important Factors to Consider in Assessing the Periodontal Status of Patients with Diabetes
Degree of Metabolic Control
Duration of Disease
Presence of Other Long-term Complications
Retinopathy
Angiopathy
Nephropathy
Neuropathy
Delayed Wound Healing
Concurrent Risk Factors
Plaque
Smoking
Stress
Medications
Hormonal Variations
Adolescence
Pregnancy
Menopause

5. This schematic depicts the etiologic factors and cascade of events contributing to chronic adult periodontitis.
The periodontal breakdown cascade consists of both a bacterial component and a host component, which combine to result in the clinical sequelae of periodontitis including pocket formation, loss of attachment, tooth mobility, and tooth loss.
Notes:

12. Obesity An independent risk factor for periodontal disease
After statistical adjustment for other periodontal risk factors such as
Age
Gender
Socioeconomic status
Smoking
Diabetes
Plaque
Genco et al., Bissada et al.