Edited by Alexander-Stamatios G. Antoniou and Cary L. Cooper
Chapter 22: The Role of Psychosocial Factors in the Development of Periodontal Disease
Alexander-Stamatios G. Antoniou, Diamanto Komboli, John Vrotsos and Zacharias Mantzavinos Introduction Periodontal diseases constitute infections related to speciﬁc pathogenic bacteria, which, in turn, attack and subsequently colonize the subgingival area. Several speciﬁc oral bacteria can be considered as representative for periodontal diseases and these include Actinobasillicus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis, Camphylobacter rectus and Fusobacterium nucleatum, all of which are associated with more severe forms of periodontal diseases (Genco et al., 1998). Periodontal diseases are now recognized as the bacterial infections which aﬀect a large proportion of the general adult population of 25–75-year-olds, causing great discomfort, pain and tooth loss (Hugoson and Jordan, 1982; Miller et al., 1987; Brown and Loë, 1993). A very important feature of the disease is that these speciﬁc bacteria are capable of colonizing the subgingival area and infecting it in spite of the protective mechanisms of the host (Baker et al., 1961). The initiation and progression of periodontal diseases is determined and modiﬁed by speciﬁc local and systemic conditions, which are identiﬁed as risk factors. Genco (1996) has divided risk factors into two categories: (a) local risk factors, which are related to an earlier stage of development including dietary factors, osteopenia/osteoporosis, AIDS and stress, and (b) systemic risk factors which can be modiﬁed, including factors such as tobacco smoking and diabetes mellitus. The fact that the systemic risk factors can be modiﬁed is very important for the management of the disease. Risk factors are considered...
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