In a dental practice, a dentist will see
several smokers on a regular basis. Although smoking causes 1 in 5 deaths in
the United States every year, as well as being the single greatest preventable
cause of morbidity and mortality in the United States, people still do it. The
incidence of smoking also increases, with thousands of teens starting the
habit. Cigarettes contain approximately 600 ingredients, and 4,800 chemicals of
which around 70 are known to cause cancer. Some of the chemicals found in
cigarettes are used in our daily lives and are not suitable for the human body,
such as acetone, ammonia, carbon monoxide, formaldehyde, and lead among others.
Several of the well-known risks of smoking are cancer (of the head and neck,
lung, stomach, etc.), stroke, blindness, pneumonia, heart disease, chronic lung
disease, asthma, including several other effects on the smoker’s health. One of
the effects less talked about in the media is the effect of smoking on the
patient’s oral health; especially with periodontal disease.
Anyone could suffer from periodontal
disease, but smokers have a higher prevalence and severity. In addition,
smoking affects the response to the treatment of periodontal disease, making it
progress faster. Several studies have shown that smokers have greater
frequencies of periodontally involved teeth and disease sites when compared to
nonsmokers, thus making smoking a risk factor for chronic periodontal disease.
Studies also demonstrate that smokers have more plaque and/or more virulent
types of plaque bacteria. Bacteria that is normally found in the oral flora are
found to have a higher prevalence amongst smokers when compared to non-smokers.
This in turn leads to greater probing depth (more than 3.5 mm pockets) and the
impairment of the host in fighting this infection. Furthermore, smoking also
affects the treatment aspect of periodontal disease with smokers showing less
pocket depth reduction after scaling and root planning, and a decrease on the
regeneration of clinical attachment levels.
As health care professionals, it is
impossible for us to have a smoking-free patient pool. We have the option to
educate our patients and provide them with the necessary means to quit if they
so desire. The ADA provides us with several “Tobacco Cessation Strategies” that
could aid the dental professional when helping a patient. The health care
provider has at their disposal the latest counseling techniques and drug information
for treating tobacco dependence. In addition, we can be trained to use
pharmacotherapy to further help our patients. Additionally, there are self-help
tobacco cessation tools that can be brought to the attention of the patient, as
well as literature to educate and help guide our patients to a better
lifestyle. It is important to remember that smoking slowly deteriorates the
overall health of the individual. It not only affects the lungs; it has a
systemic effect on the human body. It is important to make it our
responsibility to educate and support the patients that are willing to make the
changes for a healthy life.