Personal risk factors for generalized periodontitis
This paper proposes a model for the etiology of periodontal disease that focuses on the essential role of personal factors such as compromised general wellness, optimal responses of the defensive cells and the immune system, diet and lifestyle, and psychosocial interaction together with the necessary bacterial agent. An intense search continues for the possible role of bacteria in the pathogenesis of periodontal disease. Various forms of periodontitis have been associated with, and are widely believed to be caused by, specific bacterial groups. However, distribution of periodontopathic bacteria is far wider than the distribution of periodontitis, indicating that the association between periodontitis and bacteria is weak.
In this paper a model is described in which the interaction of personal factors with the social environment provides the potential for the initiation of periodontitis. Biological variation is significant, and the combination of factors that cause generalized periodontitis or any other chronic disease in one individual may not result in dental or any other chronic disease in another. [M.O.]
Clarke, N., and R. Hirsch, J Clin Periodont, 22:136,1995