This summary is based on the article published in the New York State Dental Journal: The relationship between smoking and periodontal disease. Review of the literature and case report (November 2013)
Gene B. Sherwon, DDS; Diana Nguyen, DDS; Yaakov Friedman, DDS; Mark S. Worlff, DDS, PhD
Context
Cigarette smoking has been associated with tooth loss from periodontal disease for a long time. Smoking cessation has been shown to reverse these effects.
Periodontal disease is the most common cause of tooth loss among adults. Risk factors include smoking, genetic predisposition, probably psychological stress, diabetes, and several uncommon systemic diseases. Of all the environmental factors known to be associated with periodontitis, cigarette smoking may be the most important as it has been shown to significantly increase the risk of tooth loss.
A review of the literature over the past 20 years has demonstrated a positive correlation between cigarette smoking and a higher risk for periodontal disease.
Key Findings
- Cigarette smoking has been shown to be associated with a greater increase in probing depth and attachment loss as well as greater tooth loss at an earlier stage.
- Evidence shows that environmental exposure to cigarette smoking has been associated with two- to three-fold increases in the odds of developing clinically detectable periodontitis.
- The noxious effect of smoking gas been shown to be dose dependent and to be particularly marked in younger individuals.
- Current literature identifies the harmful effects of smoking, including interference with the vascular and immunological reactions. This results in a destruction of the supportive functions of the periodontal tissues.
- The periodontal status and oral mucosa are better in those who have quit compared to current smokers.
- There is evidence that smoking has a negative effect on host response, such as neutrophil function and antibody production.
- Periodontal disease progression slows in patients who quit smoking and that these individuals have a similar response to periodontal therapy as non-smokers.
- There is very strong evidence of more severe dose-related periodontal destruction among smokers and a return to a healthier status once periodontal therapy and smoking cessation counseling have been given and accepted.
- The existing evidence shows that individuals with a smoking habit will eventually damage their periodontium and immune systems.
- Implementation of periodontal treatment, home-care instruction and smoking cessation guidance can overcome and reverse the destructive effects of smoking.
- During their dental school education, dental and dental hygiene students should be taught these skills in order for them to be better equipped to provide optimum care in dental practice.
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