Smoking and Periodontal Disease
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Questions and Answers

What is a primary adverse effect of smoking on periodontal health?

  • White spots on teeth
  • Increased risk of periodontal disease (correct)
  • Decreased saliva production
  • Improved breath odor

Which of the following is NOT a harmful chemical found in tobacco?

  • Carbon monoxide
  • Nicotine
  • Fluoride (correct)
  • Tar

What potential reason explains why smoking negatively impacts periodontal health?

  • It weakens immune response and healing. (correct)
  • It leads to overproduction of saliva.
  • It reduces plaque buildup.
  • It enhances gum tissue regeneration.

How does the duration of smoking relate to periodontal health?

<p>Increased duration leads to more severe attachment loss. (D)</p> Signup and view all the answers

What risk factor does smoking increase in relation to periodontal tissues?

<p>Formation of periodontal pockets (C)</p> Signup and view all the answers

How prevalent is periodontitis in the context of global diseases?

<p>Sixth most prevalent disease (A)</p> Signup and view all the answers

What role does smoking play in risk assessment for periodontal health?

<p>It is a modifiable risk factor to consider. (B)</p> Signup and view all the answers

What is the relationship between the number of cigarettes smoked daily and periodontal health?

<p>Higher numbers correlate with worse periodontal health. (D)</p> Signup and view all the answers

Which aspect of general health is significantly linked to periodontitis?

<p>Overall general well-being (A)</p> Signup and view all the answers

What is the primary outcome of taking a social history from patients regarding smoking?

<p>Assessing their smoking habits for periodontal risks (D)</p> Signup and view all the answers

What is the implant failure rate in smokers compared to non-smokers over 10 years?

<p>15% (D)</p> Signup and view all the answers

Which clinical characteristic is typical of smokers with periodontal disease?

<p>More severe disease progression (A)</p> Signup and view all the answers

What effect does smoking have on saliva?

<p>Causes dry mouth (A)</p> Signup and view all the answers

What is one of the key reasons smoking adversely affects periodontal health?

<p>Direct damage by toxins (A)</p> Signup and view all the answers

Which of the following best describes the clinical appearance of gingiva in smokers?

<p>Fibrotic and tight gingivae with rolled margins (C)</p> Signup and view all the answers

How do nicotine and tar contribute to periodontal disease in smokers?

<p>By causing direct damage to tissue (D)</p> Signup and view all the answers

Which factor is linked to the poorer response to periodontal treatment in smokers?

<p>Destructive neutrophil effects (B)</p> Signup and view all the answers

What type of smoking device is also known for causing periodontal damage?

<p>Water pipe (Hookah) (C)</p> Signup and view all the answers

What is a common effect of smoking on the clinical severity of periodontal disease?

<p>Earlier onset of disease (B)</p> Signup and view all the answers

Which damaging substance in tobacco smoke is implicated in brown staining of teeth?

<p>Tar (D)</p> Signup and view all the answers

What percentage of adults aged 18 years and over in the UK smokes cigarettes?

<p>14.7% (A)</p> Signup and view all the answers

What is the highest smoking prevalence age group in the UK?

<p>25 to 34 years (C)</p> Signup and view all the answers

How does smoking influence periodontal attachment and bone loss?

<p>Increases the risk by 2- to 8-fold (A)</p> Signup and view all the answers

Which of the following conditions increases the severity of periodontal issues in smokers?

<p>Diabetes (C)</p> Signup and view all the answers

Compared to non-smokers, smokers typically experience what difference in periodontal bone loss?

<p>More bone loss (B)</p> Signup and view all the answers

Which periodontal treatment shows significantly less effectiveness in smokers?

<p>Non-surgical treatment (B)</p> Signup and view all the answers

What percentage improvement do smokers achieve compared to non-smokers in clinical parameters from surgical treatment?

<p>50-75% (C)</p> Signup and view all the answers

Which characteristic is commonly observed more in smokers than in non-smokers?

<p>Higher levels of calculus (C)</p> Signup and view all the answers

What is the outcome of passive smoking on periodontal health?

<p>Moderate risk increase (B)</p> Signup and view all the answers

Which of the following conditions is unrelated to periodontal outcomes in smokers?

<p>Less calculus (B)</p> Signup and view all the answers

What effect does smoking have on tissue vascularity?

<p>Decreases tissue vascularity and angiogenesis (A)</p> Signup and view all the answers

How does nicotine affect gingival bleeding in smokers compared to non-smokers?

<p>Smokers have less gingival bleeding (D)</p> Signup and view all the answers

What is the relationship between smoking exposure and alveolar bone loss?

<p>Increased smoking exposure leads to increased alveolar bone loss (B)</p> Signup and view all the answers

What are the consequences of tar in the mouth due to smoking?

<p>Stains teeth and is sticky (A)</p> Signup and view all the answers

How does carbon monoxide affect the blood's ability to transport oxygen?

<p>Binds to hemoglobin, preventing adequate oxygen carriage (C)</p> Signup and view all the answers

What is the effect of smoking cessation on periodontal treatment outcomes?

<p>Improves the prospects for a good outcome (A)</p> Signup and view all the answers

What does the term 'number of pack years' imply in relation to smoking risk?

<p>It quantifies the exposure to smoking (C)</p> Signup and view all the answers

Which factor contributes to smokers experiencing less gingival bleeding?

<p>Vasoconstriction caused by nicotine (C)</p> Signup and view all the answers

What is a significant impact of smoking on fibroblasts during tissue repair?

<p>Inhibits fibroblast growth and attachment (C)</p> Signup and view all the answers

Why is smoking considered a significant risk factor for periodontal disease?

<p>It decreases immune response to infection (A)</p> Signup and view all the answers

Flashcards

Smoker's Implant Failure Rate

Smokers have a significantly higher implant failure rate (15%) over 10 years compared to non-smokers (4%).

Smoker's Gingiva

Smokers often exhibit fibrotic, 'tight' gums with reduced redness and bleeding.

Smoker's Periodontal Disease

Smokers tend to have more severe, widespread periodontal disease, with earlier onset and progression compared to non-smokers.

Smoking and Implant Treatment

Smokers typically have a poorer response to non-surgical and surgical periodontal treatments, with higher recurrence rates within a year.

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Tobacco Smoke Chemicals

Tobacco smoke contains thousands of chemicals, including nicotine and tar, that can harm periodontal health.

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Dry Mouth and Smoking

Smoking can cause a dry mouth by affecting saliva production, making the mouth more susceptible to disease.

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Water Pipes/Hookah/Shisha

Smoking water pipes (hookah or shisha) can cause periodontal damage in a similar way to other forms of tobacco smoking.

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Smoking and Host Response

Smoking can negatively impact the body's immune response, hindering the battle against periodontal pathogens.

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Smoking and Periodontal Bacteria

Smoking may promote the growth of periodontopathic bacteria, increasing the level and severity of periodontal disease.

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Smoking and Oxidative Damage

Smoking can increase oxidative damage to tissues, which contributes to the worsening of periodontal bone loss and tissue destruction.

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Smoking's effect on tissue vascularity

Smoking decreases blood vessel growth (angiogenesis) and blood supply to tissues, impacting healing.

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Smoking's effect on fibroblast growth

Smoking inhibits fibroblasts, the cells responsible for collagen production and tissue repair.

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Smoking and gingival bleeding

Smokers often experience less gingival (gum) bleeding than non-smokers, seemingly due to nicotine's vasoconstrictive effects.

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Alveolar bone loss and smoking

Studies show a direct relationship between smoking exposure and alveolar bone loss in the mouth.

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Tar's effect in the mouth

Tar in cigarette smoke stains teeth and is harmful to oral tissues.

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Carbon Monoxide's effect

Carbon monoxide reduces blood's oxygen-carrying capacity by binding to hemoglobin.

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Smoking Cessation and periodontal treatment

Quitting smoking improves the success of periodontal treatments.

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Pack Years

A measure of smoking exposure, calculated by multiplying the number of packs smoked per day by the number of years smoked.

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Periodontal Disease Risk Factors

Smoking is now recognized as a risk factor in periodontal disease diagnosis.

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Nicotine and Vasoconstriction

Nicotine causes blood vessels to narrow, potentially affecting blood flow.

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Smoking's Effect on Periodontium

Smoking increases the risk of periodontal disease, leading to attachment loss and bone loss.

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Periodontal Disease Risk

Smoking significantly increases the susceptibility to periodontal disease, making it more severe and progressing faster.

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Smoking and Attachment Loss

Smoking is correlated with increased periodontal attachment loss.

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Smoking and Pocket Formation

Smoking is linked to the formation of periodontal pockets, spaces between teeth and gums where bacteria can grow.

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Smoking and Bone Loss

Smoking contributes to alveolar bone loss, crucial for supporting teeth.

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Smoking and Treatment Outcomes

Smokers often have poorer responses to periodontal treatments, with higher recurrence rates.

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Smoking as Modifiable Risk

Smoking is a factor that can be impacted through interventions to mitigate its effect on periodontal health.

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Tobacco Chemicals and Periodontal Health

Tobacco smoke contains harmful chemicals that negatively impact periodontal health.

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Smoking and Periodontal Pocket Depth

Smoking is associated with increased periodontal pocket depth, adding to the severity of the disease.

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Periodontitis Prevalence

Periodontal disease, a major global oral health problem, is significantly related to overall well-being. It's the 6th most prevalent disease globally.

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Smoking's Impact on Periodontium

Smoking significantly increases the risk of periodontitis, a gum disease, by 2-8 times. It leads to accelerated attachment and bone loss, worse with higher smoking frequency.

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Smoking & Periodontal Treatment

Smoking significantly reduces the effectiveness of periodontal treatments, both surgical and non-surgical. Improvement is often less than 50% compared to non-smokers.

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Smoking and Disease Severity

Smoking worsens periodontal disease, especially for those already predisposed, like diabetics. The effect depends on how much and how long one smokes (Pack Years).

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Smoking and Periodontal Pocketing

Smokers typically have deeper pockets (spaces between teeth and gums) compared to non-smokers, due to the progressive nature of gum disease.

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Smokers and Bone Loss

Smokers commonly experience more periodontal bone loss than non-smokers, impacting the support of teeth and overall oral health.

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Smoking and Missing Teeth

Advanced gum disease in smokers often leads to the loss of teeth, especially molars, due to significant bone and gum damage.

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Passive Smoking and Periodontitis

Indirect exposure to smoke (passive smoking) is linked to increased risk of periodontitis, though to a lesser degree than active smoking.

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Smoking and Cumulative Effects

The harmful effects of smoking on periodontium build up over time, and are closely related to the 'pack years' of smoking habits.

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Smoking and Calculus

Smokers tend to have more calculus (tartar) buildup, independent of plaque levels, compared to non-smokers.

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Smoking and Gums

Smokers often have fibrotic (thickened) gums, which may be less red and bleed less frequently, despite having more severe underlying 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.
  • 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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Smoking and Periodontal Disease PDF

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.

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