Smoking In Periodontal Disease

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(C)Biological Effects of Smoking in Periodontal Disease:
Tobacco smoke contains carbon monoxide (CO) which will lower the oxygen(O₂) saturation of haemoglobin in healthy gingiva. Oxygen tension within the pockets was substantially reduced in smokers. This may favour the growth of anaerobic bacteria, even in the shallower pockets 21.The local host response to bacteria, which initiates periodontitis, includes the recruitment of leukocytes and the subsequent release of infiammatory mediators and cytokines such as interleukin (IL-1,6,8,10,12) and tumor necrosis factor (TNF- alpha). Researchers have tried to study a possible relationship between smoking, stress and cytokine production.15 Giannopoulou studied cytokines in the pathogenesis of periodontal
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If smoking is associated with increased risk for periodontal disease, a reduction or elimination of tobacco use should reduce this risk and should be beneficial to the patient. There is good evidence that the occurrence of periodontal disease is less in previous smokers than in those who continue to smoke.
Fullmer found that microbial profiles differed extensively between smokers and quitters at 6 and 12 months following smoking termination. The microbial community in smokers was similar to the baseline, while quitters demonstrated radically more divergent profiles. Changes in bacterial levels contributed to this shift. These findings reveal a vital role for smoking cessation in changing the subgingival biofilm and suggest a mechanism for enhanced periodontal health linked with smoking termination.10In a ten-year radiographic follow-up of alveolar bone loss, it was reported that progression of bone loss was significantly retarded in those who had given up smoking during the study, compared with those who sustained to smoke (Bolin et al., 2003)(X). Even though there may be conflicts in the research, particularly concerning smoking's effect on the microflora, there is very strong substantiation of more severe dose-related periodontal destruction among smokers and a return to a healthier status once periodontal remedy and smoking cessation
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