Smoking and the Periodontium

Question 1

Low doses of Nicotine can be stored in and released from?

Answer 1

periodontal fibroblasts

Question 2

Nicotineis an alkaloid and lipid soluble, how much is free in the blood? what can it do?

Answer 2

30%

pass through the blood brain barrier into NS

Question 3

nicotine affects the vessels in what way?

Answer 3

nicotine is a vasoconstrictor = restricts nutritional blood flow

Question 4

nicotine increases adhesiveness of?

Answer 4

platelets = risk of thrombosis

Question 5

nicotine reduced the proliferation of?

Answer 5

RBC’s/ fibroblasts/ macrophages

Question 6

Smokers have ? (8)

Answer 6

• Increased calculus deposits
• Deeper pockets
• Spend less time cleaning
• Increased plaque deposits
• Increased alveolar bone loss
• Lose more teeth
• Gingivae are more keratinised
• Perio tx often fails

Question 7

young smokers show more what than older smokers?

why is this?

Answer 7

more inflammation

older - more keratinized cells at gingivae/ more vasoconstriction

Question 8

What changes in tissue response are brought about by smoking?

Answer 8

• promote vasoconstriction at gingivae
• initial transient increase in GCF
• nicotine passes through Oral Mucosa and causes up to 50% inhibition of neutrophil function - mobility./chemotaxis
• relationship between NUG and smoking

Question 9

what effect does smoking have on the severity of perio disease?

Answer 9

link with NUG
chronic disease has more plaque/more LOA/deeper pockets/more bone loss/more calculus
less inflammation/bleeding
increased plaque years = increased severity

Question 10

what is the association of smoking an refractory response?

Answer 10

despite good OH perio disease still persists

Question 11

what are some examples of smokeless tobacco products ?

what can they cause?

Answer 11

snuff/ betel nut/ chewing tobacco

oral leukoplakia and carcinomas - found where tobacco is placed/ may affect PMNs

Question 12

smokers have increased levels of what calculus?

Answer 12

supra and sub calculus

Question 13

smokers pockets are more?

Answer 13

anaerobic

Question 14

smoking does not affect what composition?

Answer 14

plaque

Question 15

smokers have less? in response to treatment?

Answer 15

reduced salivary IgA to fusobacterium/P.Intermedia
reduced serum IgG to fusobacterium/P.Intermedia
reduced no. of T helper lymphocytes
reduced neutrophil function

Question 16

Smoking cessation investigation done by?

Answer 16

MacGregor 1996