August 2014

Risk Assessment

Health promotion, defined by the World Health Organization (WHO) as 'the process of enabling people to increase control over their health and its determinants, and thereby improve their health', is the cornerstone of good medical and dental practice.

When formulating a treatment plan, health promotion and prevention have a huge part to play in its success - patients need to be informed that they have a key role in the outcome. This is why a proper risk assessment is so important before you embark on a course of action. With the full co-operation of your patient, this begins by looking at the various factors that may affect a successful long-term outcome. These will include the individual's general standard of oral hygiene, their daily home-care routine, if they smoke, if they are overweight and whether there are any other systemic conditions that need to be taken into consideration, such as diabetes or heart problems.

Gathering all the appropriate information together in the first instance means that together you can prepare a personalised programme based on individual needs and risk factors, to not only treat your patient successfully, but also to help prevent an infection and/or reinfection in the future.

Systemic & Environmental Risk Factors

Implant placement is a good example of how systemic disease can affect the outcome of treatment. Before implants are placed, or indeed any treatment is commenced, several risks will need to be assessed - patients need to be aware of the infection risks and possible complications or even failure. For example, implant patients who smoke are at a heightened risk of peri-implantitis compared with non-smokers and this is increased further if they have diabetes or poor glycemic control. There is an extensive body of evidence to indicate that people with diabetes are more likely to develop periodontal disease than those without; and periodontitis has a systemic inflammatory burden that negatively affects glucose control. Should they need implant treatment, this risk needs to be adequately addressed.

As with any kind of recovery following a medical procedure, patients with a poor general standard of health will heal slower. By going back to basics as part of your risk assessment, and discussing the importance of a healthy diet, reduced stress and an effective oral hygiene regime, they will be better prepared for long-term success.

Genetics: A Non-Modifiable Risk Factor

Mapping of the genome to assess genetic risk factors for dental disorders is an exciting area. In the case of periodontitis, the genetic marker IL-1 plays a role in its onset, how aggressive it is and a patient's response to treatment. A study found severe periodontal disease in non-smokers who were also genotype positive, which is an explanation for patients who seem to lack risk factors, yet have an exaggerated response to biofilm and unexplained periodontal breakdown. In the future, this might become an important aspect to the risk assessment process, as adjunctive protocols and dental regimes can be put in place to help prevent the development of certain oral health problems for patients most at risk.

Clinically Proven Solution to Improve Oral Hygiene

Poor oral hygiene is a modifiable risk factor, yet can be challenging for patients of all ages.  Keep it simple and effective.   Enough said!

Complete Care - All your brushing and flossing needs in one place
Cordless Plus - Great for bathrooms without a shaver socket
Nano™ - Ideal for small bathrooms and travel
Ultra - State-of-the-art water flossing