Certain conditions may predispose a patient to severe periodontitis. A patient with one of these conditions should be monitored more closely and instructed in preventive practices.



(1) diabetes mellitus, especially insulin-dependent juvenile

(2) Down's syndrome

(3) Papillon-Lefevre Syndrome (palmar and plantar hyperkeratosis with progressive periodontitis)

(4) Ehlers-Danlos Syndrome Type VIII

(5) leukemia, especially acute myeloid leukemia (AML)

(6) a disorder of neutrophilic and monocytic function

(6a) agranulocytosis

(6b) cyclical neutropenia

(6c) Chediak-Higashi Syndrome

(6d) Job's Syndrome (hyperimmunoglobulin IgE)

(6e) leukocyte adhesion deficiency (LAD)

(6f) chemotherapy-induced neutropenia (see above)

(7) severe iatrogenic immunosuppression

(8) HIV disease

(9) Crohn's disease

(10) pregnancy

(11) Wegener's granulomatosis

(12) glycogen storage disease type 1b

(13) sarcoidosis

(14) scurvy

(15) smoking or other use of tobacco products

(16) drug-induced gingival hyperplasia (phenytoin, cyclosporin, nifedipine)

(17) severe psychological stress

(18) severe oral neglect


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