Periodontitis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 27 of 2022

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting periodontitis or death from periodontitis with the circumstances of a person's relevant service:

1. (1)
   having gingivitis involving the affected region of the periodontium for a continuous period of at least the 6 months before the clinical onset of periodontitis;
2. (2)
   having a foreign body in contact with the affected region of the periodontium, on more days than not for a continuous period of at least 6 months before the clinical onset of periodontitis, and where the foreign body has been removed before the clinical onset of periodontitis, then that onset occurred within 4 weeks of removal;

   Note: Examples of a foreign body in contact with the periodontium include an osseointegrated implant or dental prosthesis, a removable dental prosthesis and an orthodontic appliance such as a separator or elastic band.

3. (3)
   having an oral piercing adjacent to the affected region of the periodontium for a continuous period of at least the 6 months before the clinical onset of periodontitis;

   Note: oral piercing is defined in the Schedule 1 - Dictionary.

4. (4)
   having trauma to the affected region of the periodontium within the 6 months before the clinical onset of periodontitis;

   Note: trauma to the affected region of the periodontium is defined in the Schedule 1 - Dictionary.

5. (5)
   having surgery to the affected region of the periodontium within the 6 months before the clinical onset of periodontitis;
6. (6)
   having neutropenia or agranulocytosis at the time of the clinical onset of periodontitis;

   Note: Causes of neutropenia or agranulocytosis include having an autoimmune disease or infection such as human immunodeficiency virus infection, and taking drugs such as clozapine, sulfasalazine, ticlopidine, methimazole, carbimazole and propylthiouracil.

7. (7)
   having leukaemia at the time of the clinical onset of periodontitis;
8. (8)
   having infection with human immunodeficiency virus at the time of the clinical onset of periodontitis;
9. (9)
   having diabetes mellitus at the time of the clinical onset of periodontitis;
10. (10)
    being obese for a continuous period of at least the 3 years before the clinical onset of periodontitis;

    Note: being obese is defined in the Schedule 1 - Dictionary.

11. (11)
    having chronic renal failure at the time of the clinical onset of periodontitis;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

12. (12)
    having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical onset of periodontitis;

    Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.

13. (13)
    having smoked tobacco products: (a) in an amount of at least 2.5 pack-years before the clinical onset of periodontitis; and (b) if smoking has ceased before the clinical onset of periodontitis, then that onset occurred within 10 years of cessation;

    Note: one pack-year is defined in the Schedule 1 - Dictionary.

14. (14)
    having severe malnutrition at the time of the clinical onset of periodontitis;
15. (15)
    having severe vitamin C deficiency or vitamin D deficiency at the time of the clinical onset of periodontitis;

    Note: severe vitamin C deficiency and vitamin D deficiency are defined in the Schedule 1 - Dictionary.

16. (16)
    consuming an average of at least 200 grams of alcohol per week for a continuous period of at least the 2 years before the clinical onset of periodontitis;

    Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

17. (17)
    having gingivitis involving the affected region of the periodontium for a continuous period of at least the 6 months before the clinical worsening of periodontitis;
18. (18)
    having a foreign body in contact with the affected region of the periodontium, on more days than not for a continuous period of at least 6 months before the clinical worsening of periodontitis, and where the foreign body has been removed before the clinical worsening of periodontitis, then that worsening occurred within 4 weeks of removal;

    Note: Examples of a foreign body in contact with the periodontium include an osseointegrated implant or dental prosthesis, a removable dental prosthesis and an orthodontic appliance such as a separator or elastic band.

19. (19)
    having an oral piercing adjacent to the affected region of the periodontium for a continuous period of at least the 6 months before the clinical worsening of periodontitis;

    Note: oral piercing is defined in the Schedule 1 - Dictionary.

20. (20)
    having trauma to the affected region of the periodontium within the 6 months before the clinical worsening of periodontitis;

    Note: trauma to the affected region of the periodontium is defined in the Schedule 1 - Dictionary.

21. (21)
    having surgery to the affected region of the periodontium within the 6 months before the clinical worsening of periodontitis;
22. (22)
    having neutropenia or agranulocytosis at the time of the clinical worsening of periodontitis;

    Note: Causes of neutropenia or agranulocytosis include having an autoimmune disease or infection such as human immunodeficiency virus infection, and taking drugs such as clozapine, sulfasalazine, ticlopidine, methimazole, carbimazole and propylthiouracil.

23. (23)
    having leukaemia at the time of the clinical worsening of periodontitis;
24. (24)
    having infection with human immunodeficiency virus at the time of the clinical worsening of periodontitis;
25. (25)
    having diabetes mellitus at the time of the clinical worsening of periodontitis;
26. (26)
    being obese for a continuous period of at least the 3 years before the clinical worsening of periodontitis;

    Note: being obese is defined in the Schedule 1 - Dictionary.

27. (27)
    having chronic renal failure at the time of the clinical worsening of periodontitis;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

28. (28)
    having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical worsening of periodontitis;

    Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.

29. (29)
    having smoked tobacco products: (a) in an amount of at least 2.5 pack-years before the clinical worsening of periodontitis; and (b) if smoking has ceased before the clinical worsening of periodontitis, then that worsening occurred within 10 years of cessation;

    Note: one pack-year is defined in the Schedule 1 - Dictionary.

30. (30)
    having severe malnutrition at the time of the clinical worsening of periodontitis;
31. (31)
    having severe vitamin C deficiency or vitamin D deficiency at the time of the clinical worsening of periodontitis;

    Note: severe vitamin C deficiency and vitamin D deficiency are defined in the Schedule 1 - Dictionary.

32. (32)
    consuming an average of at least 200 grams of alcohol per week for a continuous period of at least the 2 years before the clinical worsening of periodontitis;

    Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

33. (33)
    having osteoporosis at the time of the clinical worsening of periodontitis;
34. (34)
    inability to obtain appropriate clinical management for periodontitis;

Aggravation-only factors: the factors in subsections 9(17) to 9(34) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.