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Questions and Answers
What is a primary adverse effect of smoking on periodontal health?
What is a primary adverse effect of smoking on periodontal health?
Which of the following is NOT a harmful chemical found in tobacco?
Which of the following is NOT a harmful chemical found in tobacco?
What potential reason explains why smoking negatively impacts periodontal health?
What potential reason explains why smoking negatively impacts periodontal health?
How does the duration of smoking relate to periodontal health?
How does the duration of smoking relate to periodontal health?
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What risk factor does smoking increase in relation to periodontal tissues?
What risk factor does smoking increase in relation to periodontal tissues?
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How prevalent is periodontitis in the context of global diseases?
How prevalent is periodontitis in the context of global diseases?
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What role does smoking play in risk assessment for periodontal health?
What role does smoking play in risk assessment for periodontal health?
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What is the relationship between the number of cigarettes smoked daily and periodontal health?
What is the relationship between the number of cigarettes smoked daily and periodontal health?
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Which aspect of general health is significantly linked to periodontitis?
Which aspect of general health is significantly linked to periodontitis?
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What is the primary outcome of taking a social history from patients regarding smoking?
What is the primary outcome of taking a social history from patients regarding smoking?
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What is the implant failure rate in smokers compared to non-smokers over 10 years?
What is the implant failure rate in smokers compared to non-smokers over 10 years?
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Which clinical characteristic is typical of smokers with periodontal disease?
Which clinical characteristic is typical of smokers with periodontal disease?
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What effect does smoking have on saliva?
What effect does smoking have on saliva?
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What is one of the key reasons smoking adversely affects periodontal health?
What is one of the key reasons smoking adversely affects periodontal health?
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Which of the following best describes the clinical appearance of gingiva in smokers?
Which of the following best describes the clinical appearance of gingiva in smokers?
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How do nicotine and tar contribute to periodontal disease in smokers?
How do nicotine and tar contribute to periodontal disease in smokers?
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Which factor is linked to the poorer response to periodontal treatment in smokers?
Which factor is linked to the poorer response to periodontal treatment in smokers?
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What type of smoking device is also known for causing periodontal damage?
What type of smoking device is also known for causing periodontal damage?
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What is a common effect of smoking on the clinical severity of periodontal disease?
What is a common effect of smoking on the clinical severity of periodontal disease?
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Which damaging substance in tobacco smoke is implicated in brown staining of teeth?
Which damaging substance in tobacco smoke is implicated in brown staining of teeth?
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What percentage of adults aged 18 years and over in the UK smokes cigarettes?
What percentage of adults aged 18 years and over in the UK smokes cigarettes?
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What is the highest smoking prevalence age group in the UK?
What is the highest smoking prevalence age group in the UK?
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How does smoking influence periodontal attachment and bone loss?
How does smoking influence periodontal attachment and bone loss?
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Which of the following conditions increases the severity of periodontal issues in smokers?
Which of the following conditions increases the severity of periodontal issues in smokers?
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Compared to non-smokers, smokers typically experience what difference in periodontal bone loss?
Compared to non-smokers, smokers typically experience what difference in periodontal bone loss?
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Which periodontal treatment shows significantly less effectiveness in smokers?
Which periodontal treatment shows significantly less effectiveness in smokers?
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What percentage improvement do smokers achieve compared to non-smokers in clinical parameters from surgical treatment?
What percentage improvement do smokers achieve compared to non-smokers in clinical parameters from surgical treatment?
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Which characteristic is commonly observed more in smokers than in non-smokers?
Which characteristic is commonly observed more in smokers than in non-smokers?
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What is the outcome of passive smoking on periodontal health?
What is the outcome of passive smoking on periodontal health?
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Which of the following conditions is unrelated to periodontal outcomes in smokers?
Which of the following conditions is unrelated to periodontal outcomes in smokers?
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What effect does smoking have on tissue vascularity?
What effect does smoking have on tissue vascularity?
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How does nicotine affect gingival bleeding in smokers compared to non-smokers?
How does nicotine affect gingival bleeding in smokers compared to non-smokers?
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What is the relationship between smoking exposure and alveolar bone loss?
What is the relationship between smoking exposure and alveolar bone loss?
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What are the consequences of tar in the mouth due to smoking?
What are the consequences of tar in the mouth due to smoking?
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How does carbon monoxide affect the blood's ability to transport oxygen?
How does carbon monoxide affect the blood's ability to transport oxygen?
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What is the effect of smoking cessation on periodontal treatment outcomes?
What is the effect of smoking cessation on periodontal treatment outcomes?
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What does the term 'number of pack years' imply in relation to smoking risk?
What does the term 'number of pack years' imply in relation to smoking risk?
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Which factor contributes to smokers experiencing less gingival bleeding?
Which factor contributes to smokers experiencing less gingival bleeding?
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What is a significant impact of smoking on fibroblasts during tissue repair?
What is a significant impact of smoking on fibroblasts during tissue repair?
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Why is smoking considered a significant risk factor for periodontal disease?
Why is smoking considered a significant risk factor for periodontal disease?
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Study Notes
Smoking and Periodontal Disease
- Smoking is a modifiable risk factor increasing susceptibility to periodontal disease.
- Smoking is associated with a 2-8 fold increased risk of periodontal attachment and/or bone loss, depending on the severity and smoking dose.
- Passive smoking is mildly associated with periodontitis.
- Smoking worsens periodontal conditions in those already susceptible (e.g., diabetics).
- Smoking is second only to bacterial plaque as a modifiable risk factor for periodontitis.
GDC Learning Outcomes
- Explain general and systemic disease and their relevance to oral health.
- Explain and take account of the impact of the patient's periodontal and general health on the overall treatment plan and outcomes.
Intended Learning Outcomes
- Describe the adverse effects of smoking on the periodontium.
- List harmful chemicals in tobacco.
- State possible reasons why smoking has adverse effects on periodontal health.
Links to Associated Lectures
- Smoking Cessation (lecture date TBC)
- Periodontal disease
- Gingival histology
- Immunology
Dental Relevance
- Taking social history (risk assessment).
- Discussing impact on periodontal outcomes with patients.
- Encouraging smoking cessation.
Compared with Non-Smokers
- Smokers have deeper pockets, more bone loss, furcation involvement, infra-bony defects (especially molars), more recession, more fibrotic gingivae, less bleeding on probing (BOP), and higher calculus levels (independent of plaque levels).
Periodontal Treatment Effectiveness
- All types of periodontal treatment are less effective in smokers.
- Smokers have 50-75% of the improvement in clinical parameters compared to non-smokers.
- Implant failure rate is higher in smokers (15% compared to 4% in non-smokers).
Smoker - Clinical Appearance
- Fibrotic "tight" gingivae, rolled margins.
- Less gingival redness and bleeding.
- More severe, widespread disease for similar age controls.
- Nicotine staining.
- Calculus.
- Worst affected areas: anterior, maxilla, palate.
Smoker - Clinical Characteristics
- Early onset.
- Rapid disease progression.
- Increased severity & extent of disease (pockets, CAL, bone loss).
- More tooth loss.
- Poorer response to non-surgical periodontal treatment (NSPT).
- Recurrence within one year of surgery.
- Increased refractory to treatment.
Smoking and Dry Mouth
- Smoking causes a dry mouth due to the effect of tobacco smoke on saliva.
Water Pipes (Hookah/Shisha)
- Water pipes may also cause periodontal damage.
- Known as hookahs or shishas.
- Single or multi-stemmed instruments used to heat or vaporize and then smoke tobacco, cannabis, or hashish.
Why?
- Why do smokers have more severe periodontal disease?
- Why are smokers more susceptible to periodontal disease?
- Why do smokers have a poorer response to surgical and non-surgical treatment?
- Why are smokers more likely to have increased implant failure?
4000 Chemicals in Tobacco Smoke
- Nicotine (addictive drug, increases heart rate).
- Tar (causes brown staining).
- Carbon monoxide (poisonous gas, lowers blood's oxygen-carrying capacity).
Reasons Why Smoking May Have Adverse Effects on Periodontal Health
- Direct damage by toxins.
- Increased periodontopathic bacteria.
- Impairs innate and adaptive host response (decreased IgG production, negative effects on cytokines/growth factors).
- Effects on tissue repair and healing (decrease in tissue vascularity, angiogenesis, collagen production).
Affect of Smoking on Periodontium
- Smokers have less gingival bleeding compared to non-smokers; this is dose-dependent.
- Possible link to vasoconstriction of nicotine.
Level of Risk = Number of Pack Years
- Calculating pack years: (average # packs smoked/day) x (# years smoked) = pack years.
- Direct linear relationship between smoking exposure and alveolar bone loss.
Answers to Questions
- Tar: sticky, stains teeth.
- Carbon monoxide: binds to haemoglobin preventing sufficient oxygen carriage (lowers blood's ability to carry oxygen).
Smoking Cessation
- Smoking cessation improves the prospects for a good periodontal treatment outcome.
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Description
This quiz explores the relationship between smoking and periodontal disease, highlighting how smoking increases the risk of periodontal issues. Participants will learn about harmful chemicals in tobacco and their adverse effects on oral health. Understand how smoking influences treatment outcomes for patients with existing periodontal conditions.
