Smoking & periodontitis
PD Dr. Kristina Bertl, PhD MSc MBA
Smoking and periodontitis – how bad is it really?
- The risk of periodontitis occurring and progressing in smokers is much higher than it is in non-smokers. Moreover, the effect of smoking is cumulative – this means that ‘the more you smoke, the more periodontitis you get.’
- Although smokers often have a severe degree of disease, their signs of inflammation are usually less pronounced. This means, for example, that smokers often have lower bleeding indices than non-smokers with a similarly severe level of periodontal disease.
- Although the primary causes of periodontitis are bacterial infection and the body’s immune response to that infection, smoking nonetheless constitutes one of the most important avoidable risk factors.
- Smoking substantially reduces the ability of the periodontium to heal during periodontal treatment – it is thought that the healing capacity of a 50-year-old smoker’s periodontium roughly corresponds to that of an 86-year-old non-smoker’s periodontium – that is a difference of 36 years!
- Successful smoking cessation reduces the risk of periodontitis occurring and progressing and improves the patient’s treatment response – but probably only around 10 years after they stop smoking.
- Knight ET, Liu J, Seymour GJ, Faggion CM Jr, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000. 2016 Jun;71(1):22-51. doi: 10.1111/prd.12110. Faddy MJ, Cullinan MP, Palmer JE, Westerman B, Seymour GJ. Ante-dependence modeling in a longitudinal study of periodontal disease: the effect of age, gender, and smoking status. J Periodontol. 2000 Mar;71(3):454-9. Fiorini T, Musskopf ML, Oppermann RV, Susin C. Is there a positive effect of smoking cessation on periodontal health? A systematic review. J Periodontol. 2014 Jan;85(1):83-91. doi: 10.1902/jop.2013.130047. Epub 2013 Apr 19. Nociti FH Jr, Casati MZ, Duarte PM. Current perspective of the impact of smoking on the progression and treatment of periodontitis. Periodontol 2000. 2015 Feb;67(1):187-210. doi: 10.1111/prd.12063.