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Smoking and Periodontal Disease

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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.