Podcast
Questions and Answers
Which of the following is a GDC (General Dental Council) learning outcome related to periodontal disease?
Which of the following is a GDC (General Dental Council) learning outcome related to periodontal disease?
- List three types of bacteria commonly found in periodontal pockets.
- Describe the surgical techniques for advanced periodontal regeneration.
- Outline the steps for performing a full periodontal charting on a patient.
- Explain the impact of a patient's periodontal and general health on their overall treatment plan and outcomes. (correct)
What is the primary focus of the intended learning outcomes regarding smoking and periodontal disease?
What is the primary focus of the intended learning outcomes regarding smoking and periodontal disease?
- To learn about the effects of smoking on the periodontium. (correct)
- To become proficient in prescribing nicotine replacement therapy.
- To understand the socio-economic factors contributing to smoking habits.
- To master advanced surgical techniques for treating periodontal disease in smokers.
According to the information, which of the following is considered a 'modifiable risk factor' for periodontitis?
According to the information, which of the following is considered a 'modifiable risk factor' for periodontitis?
- Gender
- Age
- Smoking (correct)
- Genetic predisposition
How does smoking typically affect the severity of periodontal disease?
How does smoking typically affect the severity of periodontal disease?
What is the correlation between smoking and periodontal tissues, based on the information provided?
What is the correlation between smoking and periodontal tissues, based on the information provided?
What percentage of adults smoked cigarettes in the UK according to the provided data?
What percentage of adults smoked cigarettes in the UK according to the provided data?
What is the impact of passive smoking on periodontitis?
What is the impact of passive smoking on periodontitis?
Which of the following is a clinical characteristic commonly observed in smokers compared to non-smokers?
Which of the following is a clinical characteristic commonly observed in smokers compared to non-smokers?
Why might smokers experience less gingival bleeding compared to non-smokers?
Why might smokers experience less gingival bleeding compared to non-smokers?
What is meant by the term “pack years” in the context of smoking and periodontal disease?
What is meant by the term “pack years” in the context of smoking and periodontal disease?
What effect does smoking have on periodontal treatment?
What effect does smoking have on periodontal treatment?
How does smoking impact implant failure rates?
How does smoking impact implant failure rates?
Which area in the mouth is typically the least affected by smoking?
Which area in the mouth is typically the least affected by smoking?
What is the effect of nicotine on blood vessels?
What is the effect of nicotine on blood vessels?
Which of the following represents one way that smoking leads to adverse effects on tissue repair?
Which of the following represents one way that smoking leads to adverse effects on tissue repair?
Of the chemicals found in tobacco smoke, which directly interferes with the blood's ability to transport oxygen?
Of the chemicals found in tobacco smoke, which directly interferes with the blood's ability to transport oxygen?
What is thought to be the effect of smoking on saliva production?
What is thought to be the effect of smoking on saliva production?
Besides cigarettes, what other form of tobacco consumption may also cause periodontal damage?
Besides cigarettes, what other form of tobacco consumption may also cause periodontal damage?
What is a characteristic that is more likely to be seen in the oral cavity of a smoker compared to a similar non-smoker?
What is a characteristic that is more likely to be seen in the oral cavity of a smoker compared to a similar non-smoker?
Why do smokers often exhibit an impaired host response in the context of periodontal disease?
Why do smokers often exhibit an impaired host response in the context of periodontal disease?
What direct effect does tar, a component of tobacco smoke, have on oral health?
What direct effect does tar, a component of tobacco smoke, have on oral health?
What is the likely outcome of smoking cessation regarding periodontal treatment?
What is the likely outcome of smoking cessation regarding periodontal treatment?
Which of the following is observed in smokers with periodontitis compared to non-smokers?
Which of the following is observed in smokers with periodontitis compared to non-smokers?
Which of the following mechanisms directly explains why smoking leads to increased alveolar bone loss?
Which of the following mechanisms directly explains why smoking leads to increased alveolar bone loss?
How have people tried to counteract dry mouth?
How have people tried to counteract dry mouth?
Flashcards
Smoking as a risk factor
Smoking as a risk factor
A modifiable risk factor that increases the susceptibility to periodontal disease.
Smoking and attachment loss
Smoking and attachment loss
Smoking is associated with a higher chance of periodontal attachment loss, periodontal pockets, and alveolar bone loss.
Dose-dependent effect
Dose-dependent effect
The negative impact of smoking on periodontal tissues increases with the number of cigarettes smoked daily and the duration of smoking.
Periodontitis prevalence
Periodontitis prevalence
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Smoking vs. Plaque
Smoking vs. Plaque
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Increased risk from smoking
Increased risk from smoking
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Smokers vs. Nonsmokers
Smokers vs. Nonsmokers
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Treatment effectiveness
Treatment effectiveness
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Smoker's gingivae
Smoker's gingivae
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Reduced bleeding in smokers
Reduced bleeding in smokers
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Rapid disease progression
Rapid disease progression
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Increased disease severity
Increased disease severity
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Smoking and dry mouth
Smoking and dry mouth
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Water pipes and gums
Water pipes and gums
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Reasons for adverse effects
Reasons for adverse effects
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Carbon monoxide
Carbon monoxide
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Smoking as a diagnostic factor
Smoking as a diagnostic factor
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Tar.
Tar.
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Chemicals in tabbaco
Chemicals in tabbaco
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Water-pipes
Water-pipes
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Study Notes
- Smoking is a modifiable risk factor increasing susceptibility to periodontal disease
- The adverse effects of smoking on periodontal tissues are dose-dependent
- The daily number of cigarettes and the duration of smoking are related to periodontal disease impact
GDC Learning Outcomes
- Explain general and systemic diseases and their relevance to oral health
- Explain and account for 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
- Identify harmful chemicals in tobacco
- Explain possible reasons why smoking has adverse effects on periodontal health
Smoking and Periodontitis
- Smoking tobacco links to an increased risk of periodontitis
- Periodontitis ranks as the 6th most prevalent disease worldwide
- Periodontitis is significantly linked to general well-being
- In the UK, 14.7% of those aged 18 and over smoke, equating to 7.2 million people
- The 25-34 age group has the highest proportion of current smokers at 19.0%
Periodontal Effects
- Smoking is second only to bacterial plaque as a modifiable risk factor for periodontitis
- Smoking increases the risk for periodontal attachment and bone loss by 2-8 times
- The increased risk depends on the definition of disease severity and smoking dose
- Passive smoking is mildly associated with periodontitis
- Smoking worsens periodontal conditions in susceptible individuals, like diabetics
Smoker Characteristics Compared to Non-Smokers
- Smokers have deeper pockets
- Smokers have more CAL (Clinical Attachment Loss)
- Smokers have more periodontal bone loss
- Smokers have more furcation involvement
- Smokers have more infra-bony defects
- Smokers have more missing teeth, particularly molars
- Smokers have more recession
- Smokers have more fibrotic gingivae
- Smokers have less BOP (Bleeding on Probing)
- Smokers have higher levels of calculus, independent of plaque levels
Treatment Efficacy in Smokers
- All types of periodontal treatment are less effective in smokers
- Non-surgical periodontal treatment efficacy is reduced
- Surgical periodontal treatment efficacy is reduced
- Muco-gingival (recession coverage) treatment is less effective
- Implants are less successful
- Smokers experience 50-75% of the clinical improvement seen in non-smokers after surgical and non-surgical treatment
- Implant failure rates are higher in smokers; 15% over 10 years, compared to 4% in non-smokers
Clinical Appearance of Smokers
- Smokers’ Gingivae is fibrotic and "tight" with rolled margins
- Smokers often exhibit less gingival redness and bleeding
- Smokers experience more severe and widespread disease for the same age compared to non-smokers
- Smokers often have nicotine staining
- Smokers often have calculus
- Smokers’ Worst affected areas include the anterior, maxilla, and palate
Clinical Characteristics of Smokers
- Smokers have an early onset of periodontal issues
- Smokers have rapid disease progression
- Smokers have increased severity and extent of disease, including pockets, CAL (Clinical Attachment Loss), and bone loss
- More tooth loss occurs in smokers
- Smokers have poorer response to Non-Surgical Periodontal Treatment (NSPT)
- Smokers experience recurrence within one year of surgery
- Increased rates of smokers are refractory to treatment
Smoking and Dry Mouth
- Smoking causes dry moth
- Tobacco affects saliva
Water Pipes (Hookah/Shisha)
- Water pipes, also known as hookahs or shishas, may cause periodontal damage
- Water pipes are single or multi-stemmed instruments heating/vaporizing and smoking tobacco, cannabis, or hashish
Chemicals in Tobacco Smoke
- There are 4000 chemicals in tobacco smoke
- Nicotine causes addiction and increases heart rate
- Tar stains teeth
- Carbon monoxide reduces blood's ability to transport oxygen
Deleterious Effects of Tobacco and Tar
- Tar is sticky and stains teeth
- Carbon monoxide binds to haemoglobin, reducing the blood's oxygen-carrying capacity
Adverse Effects of Smoking on Periodontal Health
- Direct damage occurs from toxins
- More periodontopathic bacteria?
- Impairment of innate and adaptive host response
- Decrease in IgG production
- Destructive neutrophil effects and oxidative damage
- Negative effects on cytokine and growth factor production
- Effects on tissue repair and healing
- Decrease in tissue vascularity and angiogenesis
- Inhibition of fibroblast growth; attachment and collagen production
Smoking & Periodontium Affect
- Smokers have less gingival bleeding than non-smokers, which is dose-dependent
- Reduced gingival bleeding may be linked to the vasoconstriction caused by nicotine
Pack Years
- Level of risk is based on "pack years"
- Pack years = (number of packs smoked per day) x (number of years smoked)
- There is a direct linear relationship between smoking exposure and alveolar bone loss
- Smoking is now one of the diagnosis terms in risk factors
Smoking Cessation
- Smoking cessation improves prospects for good periodontal treatment outcomes
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