Smoking and Periodontitis Quiz

Smoking and Periodontitis

• Smoking significantly increases the risk of periodontitis, influencing prevalence, extent, and severity.
• Clinical outcomes for both surgical and non-surgical treatments may be adversely affected by smoking.
• The long-term success of dental implants is compromised in smokers.
• Tobacco smoke contains harmful compounds like carbon monoxide, hydrogen cyanide, and nicotine, which may modify the host response in periodontitis.

Classification of Smokers

• Current smokers: Individuals who have smoked 100 or more cigarettes in their lifetime and continue to smoke at the time of the assessment.
• Former smokers: Individuals who have smoked 100 or more cigarettes but have quit smoking.
• Non-smokers: Individuals who have never smoked 100 or more cigarettes.
• Light smokers: Individuals who smoke fewer than 19 cigarettes daily.
• Heavy smokers: Individuals who smoke 19 or more cigarettes daily.

Forms of Tobacco

• Smoking tobacco: Includes cigarettes, cigars, pipes, hookah, and beedis.
• Smokeless tobacco: Comprises products like guthka, pouch, khaini, and snuff.

Nicotine and Its Local Effects

• Nicotine, an alkaloid in tobacco, makes up about 0.6-3.0% of tobacco's dry weight.
• It causes vasoconstriction, impairing blood flow to the gums, which negatively impacts healing in periodontal procedures.

Effects of Smoking on Periodontal Disease

• Gingivitis: Smokers exhibit reduced inflammatory response to plaque, leading to less gingival bleeding.
• Gingival blood flow: Smokers show less bleeding on probing due to nicotine’s vasoconstrictive effects.
• Periodontitis: Increased severity and prevalence of periodontal issues like pocket depth, attachment loss, and alveolar bone loss in smokers compared to non-smokers.

Notable Impacts of Smoking

• Gingivitis leads to decreased gingival inflammation and probing bleeding.
• Periodontitis results in a higher rate of periodontal destruction, increased pocket depth, attachment loss, and tooth loss.
• Severity of periodontal disease correlates with the amount smoked daily.
• Smoking cessation leads to a decrease in the prevalence and severity of periodontal disease.

Pathogenesis and Etiology of Periodontal Disease

• Smoking alters host-bacterial interactions, causing more aggressive periodontal breakdown.
• Changes in subgingival plaque composition or host responses contribute to this increased destruction.

Effects on Plaque Development

• Smokers typically have higher dental plaque prevalence, correlating with more severe periodontal disease.
• Smoking may lower the resting flow rate of gingival crevicular fluid (GCF), impacting periodontal health.

Microflora Changes in Smokers

• Research indicates that smokers have a distinct subgingival microflora, potentially contributing to their increased periodontal disease risk.