Effect of Smoking on the periodontal health status in the population of Sundernagar, District Mandi, Himachal Pradesh, India: A comparative and Cross Sectional study.
Aims: The objective of the study was to evaluate the periodontal status among smokers and non-smokers and oral hygiene measures in the population of Sundernagar, District Mandi, Himachal Pradesh, India.
Settings and design: Cross sectional study.
Materials and Methods: The study included 400 males (200 smokers and 200 non smokers) aged 18-65 years who visited Dental OPD of Himachal Dental College, Sundernagar and Civil Hospital, Sundernagar. CPI score was recorded for each patient and a ...view middle of the document...
1 Left unchecked in susceptible individuals, it can result in the loosening and eventual loss of teeth. It is second only to dental caries as a cause of tooth loss among adults in developed countries. 2
It appears that about 30% of all cancer diseases and deaths; about 90% of all the lung cancers; 30% of all cases of ischaemic heart disease and strokes; about 80% of myocardial infarctions before the age of 50 years; and 70% of chronic lung diseases are caused by tobacco smoking. 3
Tobacco smoking, mostly in the form of cigarette smoking, is recognized as the most important environmental risk factor in periodontitis. 4
Periodontal diseases are understood to be a dynamic phenomenon with cyclical patterns of progression and resolution at any given site. 5 Smoking is thought to tip the balance toward progression by impairing the immune response and compromising the periodontal tissue’s ability to heal following a period of disease activity. 6
Tobacco smoke has a direct carcinogenic effect on the epithelial cells of the oral mucous membranes. It has been well demonstrated that there is a close-response relationship for tobacco use and the risk of the development of oral cancer. 7
Furthermore, the observed magnitude of the effect of smoking on periodontal status can vary among populations due to differences in distribution of risk factors for the diseases. The population impact of smoking on periodontitis also varies according to the frequency of exposure to tobacco smoking in populations. 8 Gingival bleeding has been consistently reported to occur less in smokers due to nicotine induced vasoconstriction in smoker’s gingiva as well as heavy gingival keratinization. 9 Pocket depth measurements are found to be greater in smokers due to increased alveolar bone loss. 10, 11
Tobacco smoking probably plays a significant role in the development of refractory periodontitis. 12 Periodontal breakdown has been shown to be more severe among current smokers compared to former smokers. Those who have never smoked have been observed to have the lowest risk. 13 Smoking has a strong negative impact on regenerative therapy, including osseous grafting, guided tissue regeneration, or a combination of this treatment.14
Josef Gooultschin et al. in 1990 examined periodontal needs according to CPITN and smoking habits. The results showed that effect of both smoking and the number of cigarettes smoked had deleterious effect on periodontal status. 15 Gerad J et al. in 1998 examined the relationship between cigarette smoking and periodontal destruction in young adults and concluded that cigarette smoking was a major environmental factor associated with accelerated periodontal destruction in young adults. 16 Palmer et al. in 2005 reviewed the potential biological mechanisms underlying the effects of tobacco smoking on periodontitis and concluded that tobacco smoking has widespread systemic effects, many of which may provide mechanisms for the...