Periodontal disease may be regarded as a range of different diseases for which certain individuals are at relatively high risk. Epidemiological and molecular studies of the oral microbial flora suggest, that although microbial factors are required for periodontal disease, they alone do not predict the presence or severity of periodontitis. So in high-risk patient groups, host factors appear to play an important role in susceptibility to periodontitis. In recent years elements of host susceptibility, such as immune response and systemic disease state, and other non-microbial environmental factors, such as smoking, have been shown to be important contributors to the disease expression. Thus, periodontitis represents a lifelong account of interactions between our genome, our behavior, and our environment.
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