Potential impact of subject-based risk factor control on periodontitis

Aims: To assess the potential impact of the control of subject-based modifiable risk factors on periodontitis. Background: Cross-sectional and longitudinal data from epidemiological research indicate that risk factors can be identified and, if modified, may improve both periodontal conditions and the outcome of treatment. Material and Methods: A search was conducted to identify factors involved in the etiology and pathogenesis of periodontal diseases. The factors identified were separated into modifiable and non-modifiable, and control of the subject-based modifiable risk factors were further analyzed. Results: The analysis was limited to the influence of the control of the remaining modifiable subject-based risk factors. It was observed that most of the subject related risk factors were hitherto not validated in controlled intervention studies. Therefore, the evidence for the efficacy of risk factor control had to be based on results from cohort studies. While the control of most of the modifiable risk factors for periodontitis was not tested, some evidence suggested that smoking cessation may retard the progression of periodontitis. Conclusions: Although only limited evidence was available, it appeared reasonable to suggest that second to the removal of the bacterial biofilm, smoking cessation was the most important measure in the management of periodontitis.