The Treatment of Gum Disease
The Periodontists
Gum Recession
Dental Implants
Gummy Smiles
Gum Disease and
Heart Disease
Gum Disease and
Premature Births
Gum Disease and Diabetes
Transmissability of
Gum Disease
Bad Breath and Gum Disease
Gum Disease and Smoking
The Gum Disease - Smoking Project

Periodontal disease, the infection of the gums and bone which supports the teeth, is routinely found in the majority of adults who still have their teeth. Historically, it has been understood that the bacteria in the mouth (called "bacterial plaque") has been the cause of periodontitis (gum disease). In the past decade a growing body of research evidence has shown that there are risk factors which modify the initiation and progress of the infection of the teeth and gums. Smoking is one of these "risk factors" which can make your gum disease worse than if you did not smoke.

While smoking has been identified as a "risk factor", it is one that can be influenced by the patient. It has been described "that cigarette smoking may well be the major preventable risk factor for periodontitis in the United States. More than one-half of the cases of periodontits affecting the nation's adults may be attributable to cigarette smoking, as may three-fourths of the periodontitis cases among current smokers" (reference #1).

How does this impact smokers? According to one study, smokers who had quit smoking in the previous two years were three times more likely to have gum disease than those individuals who did not smoke. However, if one had quit smoking eleven years or longer before this study, the odds of getting periodontitis were the same as those patients who had never smoked (reference #1) It is readily apparent from the research that cigarette smoking is a major risk factor for the initiation and/or progression of gum disease (reference #2-3).

There are different opinions regarding how cigarette smoking may influence the onset and progression of gum disease. Tobacco smoke and nicotine cause small blood vessels to constrict which reduces the delivery of oxygen and nutrients to gum tissue (reference # 4). Cigarette smoking can also reduce the effectiveness of the body's ability to fight infections (reference #5). One study has even suggested that smokers are more likely to be infected with more aggressive gum disease-causing bacteria (reference #6).
The significance of all of the research is that the presence of gum disease is highest for smokers, next highest for ex-smokers and lowest for those people who had never smoked. It has also been shown that former smokers and those who had never smoked did, in fact, respond better to the treatment of gum disease than did those people who did still smoke. It can be concluded that those periodontal patients who stop smoking will have a better chance of being successful with the periodontal therapy that is indicated for their case. We as dentists have evolved into another broadly-encompassing role which allows us to favorably impact the total health of our patients.
1. Tomar, SL. and Asma, S. Smoking-attributable periodontitis in the United States: Findings from NHANES III, J. Perio.71:742-750; 2000.
2. Salvi, GE, et al. Influence of risk factors on the pathogenisis of periodontitis. Periodontol 2000, 1997;14:173-201.
3. Gelskey, SC. Cigarette smoking and periodontitis: Methodology to assess the strength of evidence in support of a causal association. Community Dent. Oral Epidemiol. 1999;27:16-24.
4. Baab,DA and Oberg, PA. The effect of cagarette smoking on gingival blood flow in humans. J. Clin Periodontol. 1987;14:418-424.
5. Barbour,SE, et al. Tobacco and smoking: Environmental factors that modify thehost response (immune system) and have an impact on periodontal health. Crit Rev Oral Biol Med 1997;8:437-460.
6. Zambon,JJ, et al. Cigarette smoking increases the risk for subgingival infection with periodontal pathogens. J. Periodontol. 1996;67(suppl.):1050-1054.

This website
will additionally cover:
1. Treatment of Gum Disease
    A. Signs
    B. Causes
    C. Risk Factors
    D. Treatments
2. The Periodontists

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