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In general, predisposing factors for these periodontal diseases can be defined as those factors which retain or hinder the removal of plaque and, depending upon the nature of the immune response to this plaque, the disease will either remain stable and not progress or it may progress and result in chronic periodontitis. In contrast, modifying factors can be defined as those factors that alter the nature or course of the inflammatory lesion. These factors do not cause the disease but rather modify the chronic inflammatory response, which, in turn, is determined by the nature of the innate and adaptive immune responses and the local cytokine and inflammatory mediator networks. Chronic inflammation is characterized by vascular, cellular and repair responses within the tissues. This paper will focus on how common modifying factors, such as smoking, stress, hormonal changes, diabetes, metabolic syndrome and HIV\/AIDS, influence each of these responses, together with treatment implications. As treatment planning in periodontics requires an understanding of the etiology and pathogenesis of the disease, it is important for all modifying factors to be taken into account. For some of these, such as smoking, stress and diabetic control, supportive health behavior advice within the dental setting should be an integral component for overall patient management.<\/jats:p>","DOI":"10.1111\/prd.12110","type":"journal-article","created":{"date-parts":[[2016,4,5]],"date-time":"2016-04-05T09:33:53Z","timestamp":1459848833000},"page":"22-51","source":"Crossref","is-referenced-by-count":131,"title":["Risk factors that may modify the innate and adaptive immune responses in periodontal diseases"],"prefix":"10.1111","volume":"71","author":[{"given":"Ellie T.","family":"Knight","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Seymour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Clovis M.","family":"Faggion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary P.","family":"Cullinan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2004.75.3.495"},{"key":"e_1_2_10_3_1","first-page":"15","article-title":"The significance of endocrine factors and microorganisms in the development of gingivitis in pregnant women","volume":"75","author":"Abraham\u2010Inpijn L","year":"1996","journal-title":"Stomatologiia (Sofiia)"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr029"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1994.tb00285.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2000.71.12.1874"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67402-8"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01858.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1258\/rsmsmj.54.2.41"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.55.02.06.db05-1201"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2006.P04039"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.20.7.1183"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2337\/diacare.28.suppl_1.S37","article-title":"Diagnosis and classification of diabetes mellitus","volume":"28","author":"American Diabetes Association","year":"2005","journal-title":"Diabetes Care"},{"key":"e_1_2_10_14_1","unstructured":"American Diabetes Association.Diabetes statistics. 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