HOW SEVERELY CAN SMOKING DAMAGE YOUR GUMS?
Smoking can increase the risk of periodontal(Gum) diseases and can affect the surgical and non surgical periodontal cases and implants.
It is observed that in smokers, there is less of gingivitis but increase in periodontitis. studies have also showed that there is increase in pocket depth, attachment loss, increase in rate n severity of periodontal destruction, its conversion into severe periodontitis, tooth loss n alveolar bone loss in smokers,
and all this is decreased with smoking cessation!
Smokers are four times more likely to have gum diseases compared to people who have never smoked.
Former smokers are 1.7 times more likely than who have never smoked, a person who smokes less than 9 cigarettes per day is at a risk of 2.8 times more and the one who smokes more than 31 cigarettes per day is at 6 times more at risk.
This all is congruent with the number of years one has been smoking, to the amount of tooth loss, coronal root caries and periodontal diseases.
It is observed that in young smokers there is increase in generalized aggressive periodontitis. Cigar and pipe smokers also have similar effects, it also worsens nicotine withdrawal symptoms and psychological factors also contribute to it.
So how exactly smoking affects the gums?
There are changes in the subgingival biofilm, increase in virulence of pathogenic organisms and the change in host response to the bacterial challenge.
Smokers have higher levels of bacteria called tannerella forsythia. Smoking also effects the basic function of neutrophils, it creates alterations in chemotaxis, phagocytosis and oxidative burst n affects cell movements in the gums.
It reduces IGG2 and there is reduced protection against periodontal bacteria. There is an increased level of tumor necrosis factor and elevation in prostaglandin E2 (increase in release of tissue destructive enzymes).
There is decrease in oxygen concentration in healthy gums and it is observed that recovery from vasoconstriction caused by local anaesthetic administration takes longer time in smokers,
also there is transient increase in gingival bleeding when the smoker quits.
Can good dental professionals be able to manage periodontitis successfully if they focused more on smoking cessation?
This questions seems to be controversial. It is clear that smoking has a huge impact on periodontal status and quitting is a must for any kind of treatment, but the smoker must in any way should be educated about the harm they are causing to their gums & must be motivated and helped to quit smoking.. as treatment and prognosis is much improved among who quit compared to those who continue to do so.
Source- Caranzza.
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