Smoking Flashcards
leading cause of preventable disease and death in US
smoking
Smoking accounts for ____ deaths per year
480,000
% US adults smoking
15.1%-This means an estimated 36.5 million adults in the
United States currently smoke cigarettes.
Chemicals in smokeless “toe-bag-o”
just list some…
Polonium 210 (nuclear waste)
Formaldehyde (embalming fluid)
Cadmium (used in car batteries)
Lead (nerve poison)
Nitrosamines (cancer causing substances)
Arsenic
Cyanide
three types of smokeless tobacco
chewing
Snuff
Dry snuff
Concerns of e-cigs
- Each nicotine cartridge in an e-cig can provide 200 to 400 puffs, equivalent to two to three packs of cigarettes.
- may absorb higher concentrations of nicotine and other toxins
Results of smoking (5 main ones)
Discoloration -teeth, restorations, and dentures Mucosa -heat injury, melanossis, nicotine stomatitis, keratosis, black hair tongue, squamous cell carcinoma Bad Breath Sense of smell and taste Saliva -Periodontitis
flow rate of saliva of smokers
increased
pH of saliva in smokers
reduced
Buffering capacity of saliva in smokers
reduced
Bacteria response in smokers
reduced
Bacteria and fungi in smokers
increased
Support of smoking causing periodontitis/bone loss
both cross-sectional and longitudinal studies support higher prevalence
among smokers, ___% of their periodontitis was attributed to smoking
~75% it was found.
\_\_\_\_\_\_ is considered one of the strongest risk predictors for future periodontal breakdown (true risk factor)
smoking
Odds Ratio
defined as the odds of having a disease if one is exposed to the risk factor compared with the odds of having the disease if one is not exposed to the same factor
The odds ratio for periodontitis among smokers is in the range of __ to __
2-7
Heavy smokers have odds ratio that are over ______ times that of light smokers
two times
Effects of smoking on gingival inflammation
less clinical signs of inflammation and more supra-gingival calculus, gingival tissue appears
fibrotic with rolled margins, decreased inflammatory response to plaque accumulation compared to non-smokers
% of smokers aware that smoking causes gingival problems
~5%
smokers more or less calculus
more
primary sign of periodontitis
PD
Primary sign of gingavitis
bleeding
Smoking ___ the risk of attachment and/or bone loss in postmenopausal women, diabetics, and HIV-seropositive individuals.
increases
Smoking is associated with what types of gingavitis?
In young? Older?
Generalized aggressive periodontitis in young patients
Acute Necrotizing Ulcerative Gingivitis
Proposed mechanisms for the negative effects of smoking
(8)
- Vascular alterations
- Neutrophil function
- IgG production decre
- decreased lymphocyt
- incr periopathogens
- altered fibroblast attachment and function
- hard to clean
- negative local effects on cytokine and growth factor production
Smoking may alter the composition of bacterial plaque in favor of ____ bacteria
more virulent-may be a selective pressure
Lower oxygen tension in the periodontal pockets of smokers may favor ________
anaerobic species
Smokers may harbor greater numbers of periodontal pathogens such as _____(3 main perio bugs)
than non-smokers with comparable levels of periodontal disease
Porphyromonas gingivalis,
Tannerella forsythia (B. forsythus)
and Aggregatibacter actinomycetemcomitans
It may also be more difficult to eradicate P. gingivalis and T. forsythia from periodontal pockets in smokers using ______ techniques
non-surgical
Altered vasculature in smoking hosts
Vasoconstriction may lead to
decreased gingival blood flow,
decreased GCF
Wound healing in smokers
inhibit gingival fibroblast attachment and proliferation, dec collagen, impaired GF expression
How neutrophils are effected by smoking (3)
Decreased chemotaxis,
Decreased phagocytosis,
Decreased adhesion to vascular endothelium
Antibodies and smoking
decreased Ab production, dec levels of salivary IgA and serum IgG-may alter IgG subclass concentrations
T/F:African American smokers had lower IgG1 concentrations
True…
Next to ________, ______ is the strongest modifiable risk factor for periodontal disease.
bacterial plaque
Smoking
the more someone smokes the ____ viable PMNs are
less
Phagocytosis capacity _____ when smoking
decreases
smoking and oxidative stress
increased
Probing depth reduction and clinical attachment level improvements in smokers are ______those of non- smokers.
50-75%
Dose-response: heavy smokers vs light smokers response to therapy
heavy smokers (31 or more cigarettes) respond less favorably than light smokers (9 or less).
The difference in treatment outcome between
smokers and non-smokers is more pronounced
when
after surgical treatment
evidence for usefulness of antibiotic therapy with surgical periodontal therapy in smokers
not much-inconclusive
PD redcution in non smoker after graft vs in combo with combination therapy
Probing depth reduction is better in the non-smoker and the best in the non- smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone in Grade II Furcations
Enamel Matrix Derivative (EMD)
may provide increased defect fill and cementum formation in cigarrette smokers but was detrimental to new bone formation
Smoking and failure of dental implants-associated?
Failure rate?
Smoking is significantly associated with failure of dental implants
failure rates as much as 2x as high
Smoking affect on ridge augmentation procedures
negative affect
Impact of smoking on dental implant therapy is more dramatic in _______ with an odds ratio of 1.4-3.9.
grafted maxillary sinus
Implant rates for past smokers
Implant success rates for past smokers are similar to those who never
smoked.
In a group of patients who quit smoking 1 week before and 8 weeks
after implant placement, incidence of early implant failures was
similar
to that in nonsmokers
cover screw or abutment to cover tissue to reduce exposure on smokers and those with questionable oral hygiene
similar
to that in nonsmokers
Recession with smokeless tobacco location?
just localized
Effect of nicotine
May affect cells involved in periodontal repair
Gingival inflammatory response
Not clear what effects result from alterations in pro- inflammatory factors due to smoking
Gingival bleeding
in smokers
Less gingival bleeding, lower proportion of small blood vessels
Smoking proven risk factor?
yes
Increased risk to develop periodontitis Faster progression of periodontitis More susceptible to aggressive forms of periodontitis Not responding as favorable to periodontal treatment and implant placement as non-smokers
Scientific evidences support the negative effect of smoking on cells
and components of the immune and inflammatory system and
periodontal tissues.
The effect of smoking on the bacterial composition of plaque is not
clear
Smoking is a proven risk factor
