34 - Tobacco and Alcohol Flashcards

1
Q

____% of alcohols are heavy smokers compared to ____% in the general population

A

70%

10%

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2
Q

Smokers are ____X more likely to consume alcohol than nonsmokers

A

1.3X

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3
Q

Smokers is a risk factor for what systemic conditions

A
Cardiovascular disease
COPD
Cancer
Atherosclerosis
Stroke
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4
Q

Smoking and alcohol effect on oral/throat/esophageal cancer

A

Smoking 7X
Drinking 7X
Drinking + smoking 38X

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5
Q

Smoking as a risk factor for periodontitis (2 sources)

A

Grossi - dose dependent CAL/bone loss. OR 3.0

Martinez - effects seen w/ 10+ cigarettes. Risk of severe ChP 2.8X

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6
Q

1 extra cigarette smoked daily increases gingival recession by _____%, pocket depth _____%, and CAL _____%

A
  1. 3%
  2. 3%
  3. 5%
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7
Q

Effect of alcohol on periodontium (2 sources)

A

Sakki - Finnish who drank 3.5+ more likely to have PD 3+

Tezal - 5+ drinks a week 65% more likely to have gingival bleeding and 36% more likely to have severe CAL

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8
Q

Longitudinal studies on alcohol

A

Erie County
NHANES III

Significant relationship between alcohol consumption and severe attachment loss and gingival bleeding

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9
Q

Smoking effect on innate immunity

A

Neutrophil motility/chemotaxis/phagocytosis are reduced

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10
Q

Smoking effect on adaptive immunity

A

AB production (IgG) and immune regulatory T-cells are reduced

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11
Q

Smoking effect on bacteria (source)

A

Zambon & Grossi

AA 3.1X
TF 2.3X
PG 1.5X

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12
Q

Cytokines that are increases w/ smoking

A

PGE2
TNFa
MMP8
IL-1B

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13
Q

Metabolite of nicotine

A

Cotinine

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14
Q

What causes increase in pathogenic organisms?

A

Peripheral vasoconstriction that leads to decreased oxygen tension

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15
Q

Smoking effect on NST (source)

A

Grossi

  • Reduced reduction in PD (0.8mm less) and gain in CAL
  • No difference in smokers who quit 1 year ago
  • Less reduction in periodontal pathogens
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16
Q

Systemic ABC + NST in smokers. Effects? (2 sources)

A

Palmer - 7 days of Metronidazole, reduction in improvement compared to non-smokers (more supported)

Ryder - subgingival doxycycline, no difference between smokers + nonsmokers

17
Q

Smoking + MWF (source)

A

Preber
-Less reduction in PD and less gain in bone levels
Difference of 1mm in 7+mm sites

18
Q

Smoking + grafting w/ FDBA (2 sources)

A

Rosen & Tonneti

-Less gain in CAL up to 5 years

19
Q

Smoking + furcation treatment (source)

A

Rosenberg

-80% failure rate in treatment of furcation defects

20
Q

Smoking + root coverage (source)

A

Miller

  • Less root coverage after grafts
  • 57% (smoker)
  • 78% (nonsmoker)
21
Q

Dental implants success

A

93%
Anterior maxilla
-Smokers 17% failure
-Nonsmokers 3.6% failure

22
Q

Failures after uncovering

A

Smokers 2.6X more likely to have failure between time of uncovering and restorative loading

23
Q

ITI SLA implants success (source)

A

Kumar
-Smokers 97%
Nonsmokers 98.4%

24
Q

Graft wound healing in smokers (source)

A

Jones

-Implant + graft have 80% prevalence of impaired wound healing in smokers compared to 10% non-smokers

25
Q

Smoking and periodontal maintenance (2 sources)

A

Kaldahl - dose response to successful therapy

MacFarlane - 90% of RF patients were smokers

26
Q

5 A’s of smoking (source)

A
Glynn & Manley
Ask (do you smoke?)
Advise (you should quit)
Assess (do you want to quit)
Assist
Arrange (follow-ups)
27
Q

___ years of nonsmoking have same response to treatment as never smoker

A

11 years

28
Q

6 mechanisms of smoking increasing risk for periodontitis

A

1) 2550 toxins
2) Affect innate + adaptive immunity
3) Increases bacterial adhesion and is selective for gram negatives
4) Decreased oxygen tension in sulcus
5) Increased cytokines from NP/MP
6) Nicotine reduces fibroblast activity

29
Q

NHANES III data (source)

A

Tomar & Asma

  • Smokers 4X more likely to have periodontitis
  • OR 2.79 (<9)
  • OR 5.88 (>31)
  • OR 1.15 (quit for 11 years)
30
Q

For every ____ pack year increase = ____mm increase in LoA

A

10 pack year

1mm increase LoA

31
Q

Smokers and gingivitis (source)

A

Danielsen & Manji

  • Same rate of plaque accumulation
  • Slower development of gingivitis
  • Faster recovery from gingivitis (with supervised OH)
32
Q

Smokers and periodontitis (source)

A

Bergstrom & Eliasson

-Dental hygienists, bone loss associated w/ higher smoking