AFFECT OF SMOKING ON PERIODONTIUM

Student Name : Dhuha Khalid , Hanan Tahsin

INTRODUCTION Periodontal disease is defined

as inflammatory destruction of periodontal tissue and alveolar bone supporting the teeth.

Progression and severity of the disease depends on complex interactions between several risk factors such as microbial, immunological, environmental and genetic factors, as well as age, sex, and race.

Smoking and other tobacco products can lead to gum disease by affecting the attachment of bone and soft tissue to the teeth. More specifically, it appears that smoking interferes with the normal function of gum tissue cells. This interference makes smokers more susceptible to infections, such as periodontal disease, and also seems to impair blood flow to the gums - which may affect wound healing.

Smoking component Tobacco contains over 4,000chemicals, many of which

are harmful. These include

Benzene- solvent used in fuel manufacture

Formaldehyde- highly poisonous, colourless liquid used to preserve

dead bodies Ammonia- chemical found in cleaning fluids.Used in- cigarettes to increase the delivery of nicotine

Hydrogen cyanide- poisonous gas used in the manufacture of plastics,

dyes, and pesticides.- Often used as a fumigant to kill rats

Cadmium- extremely poisonous metal found in batteries

Acetone- solvent found in nail polish remover

POTENT CARCINOGENS• Nitrosamine• Polycyclic aromatic hydrocarbons• Radiation-emitting polonium

COMPONENTS OF INHALED SMOKE • Nicotine• Carbon monoxide• Tar 

all of which can cause disease

Proposed mechanism for the negative periodontal effects of smoking

1- vascular alteration 2- altered neutrophil function 3- decrease IgG production 4- decrease lymphocyte proliferation 5- increase prevalence of perio-pathogens6- altered fibroblast attachment and function 7- difficulty eliminating pathogens by mechanical

therapy

One of the most common problems people experience when it comes to smoking is tooth staining. Over time smoking tobacco can result in the teeth yellowing, maybe even with brown spots, which can leave you very self-aware and lacking in confidence.

Tooth staining is caused by the nicotine and tar found in cigarettes.

Most people first experiencegingivitis, which is a mild tomoderate gum disease. Withgingivitis treatment is quick andeasy and a few professionalcleans with a dental hygienistfollowed by a good oral hygieneroutine at home and your gumscan heal themselves and behealthy again. Failure to treatgingivitis can result in seriousproblems, including periodontaldisease.

EFFECT OF SMOKING ON GINGIVA

Cigarette Smoking and Gingival Bleeding ::

1- Smokers expressed less gingival bleeding than non smokers

2- This is also proved to be dose dependant

3- This may be due to vasoconstrictive effect of nicotine.

Smoking and gingival inflammation

Heavy smokers often present with athickened, fibrotic appearance oftheir gingival tissues,

Smoking and Acute Necrotizing Ulcerative Gingivitis (ANUG)

more frequently in smokers. Possible mechanisms for this increased susceptibility include vasoconstriction of gingival blood vessels, reduced activity of leukocytes, and proliferation of anaerobic, fuso-spirochaetal micro-organisms, These factors interact with the other factors implicated in the etiology of ANUG, manely poor oral hygiene and mental stress.

Periodontal fibroblast PDL fibroblast growth, attachment and was inhibited by nicotine at high

concentrations

Nicotine at high concentrations can be cytotoxic by inhibiting the vacuolation and proliferation of fibroblasts.

PDL cell proliferation and protein synthesis were also inhibited in a dose dependent manner.

Cell attachment was significantly less on root surfaces obtained from heavy smokers compared with nonsmokers

Smoking and periodontitis in young adults

Periodontal disease is a very severe form of gum disease. It is caused when gingivitis is left untreated. With this particular gum disease, which is often caused by smoking, the gum pulls always from the tooth to cause pockets. These pockets are breeding grounds for dangerous bacteria. Failure to treat periodontal disease can result in tooth loss

Tobacco may alter the immune system's capacity to maintain an ecological balance. Smoking inhibit oral cellular immunity by reducing the activity of leukocytes. Smoking causes peripheral vasoconstriction, further limiting the ability of the tissues to effect an immune response. 

Smoking and Periodontitis in Adults

-Current smokers have deeper probingdepths, greater attachment loss, more boneloss, and fewer teeth.

-Smokers also exhibit more supragingival calculus deposits.

-Smokers were four times more likely to haveperiodontitis as compared to non-smokers

CIGARETTE SMOKING AND ORAL HYGIENE

Several studies demonstrated higher levels of oral debris in smokers than in non-smokers develop gum disease, persistent bad breath

Increased levels of debris observed in smokers have been primarily attributed to personality traits leading to decreased oral hygiene habits, increased rates of plaque formation, or a combination of the above.

• Tooth brushing efficiency of smokers was much less and the calcium concentration in the dental plaque of smokers was found to be significantly higher than in nonsmokers.

Conclusion It is clear that smokers Present with periodontitis at an early age Difficult to treat them with conventional therapy Continue to have recurrence of periodontitis leading to tooth loss The opportunity for dentists to become more active in evaluation

of tobacco use by patients and more aggressive in offering counseling and cessation services can positively impact both the oral and general health of dental patients.

THANK YOU