RISK ASSESSMENT OF RECURRENCE OF DISEASE DURING SUPPORTIVE PERIODONTAL CARE - EPIDEMIOLOGIC CONSIDERATIONS

Although it is accepted that the primary cause of periodontitis is bac terial infection of long duration, there are a number of risk factors which may increase the probability of recurrence of periodontal diseas e during supportive periodontal care. The risk may in such cases be ca used by other factors than poor oral hygiene measures per se. Cross-se ctional and longitudinal studies show conflicting results concerning a ge as a risk factor for periodontal disease. The effect of smoking on the periodontal tissues has been discussed for decades and only lately has it been possible to demonstrate that smokers definitely have more periodontal problems than non-smokers. Another important risk factor for periodontitis relates to the insulin dependent and non-insulin dep endent forms of diabetes mellitus. Poorly-controlled long-duration dia betics have more periodontitis and tooth loss than well-controlled or non-diabetics. Finally, the issue of compliance deserves attention. Th e medical literature has suggested that patients with chronic illnesse s tend to comply poorly, especially if the disease is not perceived to be particularly threatening, if the therapy is time-consuming, or if the symptoms are non-disturbing. Suggestions for improved compliance a re called for.