Risk Factors in Periodontal Disease - Smoking

Question 1

How does smoking contribrute to periodontal disease?

Answer 1

1. It contributes to the formation of dysbiotic film.
2. By affecting bacterial acquisition, colonisation, aggregation and higher levels of key pathogen colonisation.

Question 2

How much more likely is a smoker to get periodontitis than a non-smoker?

Answer 2

2.5-6x more likely.

Question 3

‘what cellular activities are influenced by chemicals from smoking?

Answer 3

1. impairs Tissue turnover (biological homeostasis)
2. impairs Healing and wound repair
3. impairs Immunological activity
4. increased Inflammatory cell activity

Question 4

How does smoking affect neutrophils?

Answer 4

Smoking reduced the number of neutrophils in an area and their ability to phagocyte.

Question 5

Why do smokers tend to bleed less from their gums and why is this bad?

Answer 5

1. Smoking (nicotine) causes a rise in blood pressure and vasoconstriction.
2. Gingivitis masked due to lack of bleeding to signify it.

Question 6

What is smoking’s effect on the inflammatory response?

Answer 6

Impairs it hence impairing the healing as well.

Question 7

Give 6 clinical oral features seen in smokers.

Answer 7

1. Increased keratinisation of the gingiva.
2. Less bleeding on probing.
3. Less gingival inflammation.
4. Increased probing depths.
5. Increased loss of attachment.
6. Increased bone loss.
7. acute nectrotizing ulcerative ginigivitis ANUG

Question 8

Other consideratons seen in smokers

Answer 8

staining
Haliotosis
ANUG more prevalent in smokers.

Question 9

How do smokers respond to periodontal treatment?

Answer 9

1. Smokers respond less favourably.
2. Dose of cigarettes also affects this.
3. Pocket depths deeper so further treatment commonly needed to avoid disease progression.

Question 10

How does the tooth loss rate differ with smokers and why?

Answer 10

1. Increased, strong relationship with molar extraction.
2. This is because there is a furcation area and therefore molars are more difficult to save.

Question 11

What is odds ratio?

Answer 11

The odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occuring in the absence of that exposure.

Question 12

How many years does it take for a former smoker to have the same odds ratio a non-smoker has?

Answer 12

13 years.