Smoking and periodontitis Flashcards
How does smoking influence periodontal disease?
Smoking increases the prevalence and severity of periodontal disease.
What is the relative risk for periodontal destruction in smokers compared to non-smokers?
The relative risk ranges from 2.8 to 6.0, meaning smokers are 2.8 to 6 times more likely to experience periodontal destruction.
What does a relative risk (RR) of 1.0 indicate?
It indicates no difference in risk between the exposed group and the non-exposed group.
How does the number of cigarettes smoked per day affect the severity of attachment loss?
1 cigarette/day → 0.5% increase in attachment loss.
10 cigarettes/day → 5% increase.
20 cigarettes/day → 10% increase
How does smoking affect microbial flora in the mouth?
Smokers exhibit early and sustained pathogenic colonization, with increased plaque levels and enrichment of periodontal and respiratory pathogens.
What were the findings of the Erie County Study regarding microbial flora in smokers?
The study found an increased presence of A. actinomycetemcomitans, P. gingivalis, B. forsythus, and T. forsythia in smokers, with a higher relative risk associated with smoking amount.
How does smoking affect pathogen levels post-therapy?
Smokers have less reduction in pathogen levels after periodontal therapy.
What is the impact of smoking on the host immune response?
Neutrophil dysfunction (impaired chemotaxis, phagocytosis, and oxidative burst).
Altered macrophage function (immunosuppressive effects, altered cytokine release).
Increased CD8+ cell counts, reduced CD4+/CD8+ ratio, and reduced NK cell activity.
Lower serum immunoglobulin levels and decreased antibody responses.
Increased collagenase release and impaired fibroblast attachment.
How does smoking contribute to long-term vascular impairment in periodontal disease?
Smoking causes chronic impairment of vasculature, resulting in lower BOP (bleeding on probing) and less gingival redness.
What chemicals in tobacco smoke damage cells?
Tobacco smoke contains reactive oxygen species that can damage cells.
What is the risk for periodontal involvement in young adult smokers?
Young adult smokers have a 3x higher risk for periodontal involvement compared to non-smokers.
How does the probing depth (PD) of >5mm compare between current smokers, former smokers, and non-smokers?
Current smokers: 10.4% ± 13.9%
Former smokers: 6.8% ± 11.6%
Non-smokers: 4.0% ± 8.1%
How does attachment loss (AL) >5mm compare between current smokers, former smokers, and non-smokers?
Current smokers: 26.0 ± 25.2
Former smokers: 18.0 ± 20.9
Non-smokers: 11.1 ± 14.7
What is the relative risk for severe bone loss (>4 mm apical to CEJ) in smokers?
The relative risk is 4.7 in current and former heavy smokers (more than 30 pack years).
What are the 10-year relative risks for bone loss in smokers?
Greater vertical bone lose in heavy smokers
Light smokers: 2.3-fold higher risk.
Heavy smokers: 5.3-fold higher risk.
How long does it take for smoking cessation to reduce tooth loss due to periodontitis (TLP) risk to non-smoker levels?
It takes about 15 years for the risk to reduce to non-smoker levels.
How much does the risk of tooth loss due to periodontitis (TLP) decrease per year of smoking cessation?
The TLP risk decreases by 6% per year of smoking cessation.
How does smoking influence periodontal health?
Smoking influences population prevalence, severity, attachment loss, bone loss, disease progression, and response to treatment & maintenance.
What is the relative risk for attachment loss in moderate smokers (15-30 pack years)?
The relative risk for attachment loss in moderate smokers is 2.77.
What is the relative risk for attachment loss in heavy smokers (>30 pack years)?
The relative risk for attachment loss in heavy smokers is 4.75.
How does furcation involvement compare between smokers and non-smokers?
Smokers have twice as many teeth with furcation involvement compared to non-smokers.
How does smoking cessation affect periodontal risk factors?
Smoking cessation significantly reduces periodontal risk factors over time.
How does smoking affect wound healing in periodontal therapy?
Smoking inhibits revascularization of soft and hard tissues, suppresses osteoblast stimulation, and inhibits collagen production while increasing collagenase activity.
How else does smoking affect wound healing in periodontal therapy?
Vasoconstriction
Increased platelet aggregation (decreases blood flow)
Increased levels of carboxyhemoglobin (decreases O2 transport)
Changes in vascular endothelium
Elevated levels of TNF-alpha in GCF
How does smoking affect non-surgical periodontal therapy?
Smoking leads to less probing depth reduction, less attachment gain, and increased persistence of B. forsythus and P. gingivalis.
How does smoking impact surgical periodontal therapy?
Smokers experience less probing depth reduction, less attachment gain, and less bone height gain. They are also twice as likely to lose teeth in maintenance.
What is the effect of smoking on regenerative periodontal procedures?
Smoking reduces root coverage and clinical attachment gain in procedures like free gingival and connective tissue grafts.
How does smoking affect implant therapy?
Smoking increases the risk of early implant failure, higher peri-implantitis, bone loss rates, and localized impaired wound healing.
How do bioactive agents in e-cigarettes affect oral health?
Bioactive agents in e-cigarettes damage oral keratinocytes and periodontal fibroblasts.
How do e-cigarettes alter the oral microbiome?
increase biofilm volume and alter the composition of oral microbes, with glycerol/PEG carriers contributing to these changes.
How do e-cigarettes affect inflammatory responses in the mouth?
E-cigarettes increase cytokine release and enhance antimicrobial peptide (AMP) secretion, which can contribute to inflammation.
What is the Potential Mechanisms of Impact from e-cigarettes?
Presence of volatile organic compounds (VOCs).
