Smoking can greatly affect the treatment of periodontitis, according to a recent study that examined the effect of different levels of smoking exposure on the clinical outcomes of non-surgical periodontal treatment. In addition to highlighting the adverse effects of tobacco use on oral health, the study highlighted the need to rethink current periodontal treatments.
The study was conducted at Aarhus University and included 80 smokers with periodontitis who were offered an individualized voluntary smoking cessation program and received periodontal therapy. Based on the degree of nicotine addiction, participants were classified as light smokers or quitters (those who quit during the study), moderate smokers, and heavy smokers. Investigators then assessed periodontal treatment based on clinical parameters such as clinical level of attachment, periodontal pocket depth, and bleeding on probing for 12 months, and provided supportive periodontal care every three months.
The investigators noted that heavy smokers entered the study with a higher average clinical attachment rate of 1.1 mm and an additional ten sites of severe periodontitis compared with average smokers or quitters. They stated that in light smokers or those who quit smoking and moderate smokers on average, periodontal pocket depth decreased by 0.6 mm and the clinical level of attachment increased by an average of 0.7 mm, respectively, while in heavy smokers in smokers, attachment loss was 0.5 mm.
The findings show that heavy smokers with the most severe forms of inflammation did not benefit from treatment and that periodontal scores in heavy smokers with moderate periodontitis only improved by 50% compared with those who smoked less.
“We are surprised that the disease actually worsened in some ways in the most affected group, despite the fact that this group received the most extensive, individually tailored treatment,” study co-author Julie Pajaniaye, a dentist, said in a release. – Hygienist and Associate Professor of the Department of Dentistry and Oral Hygiene at the University.
According to the World Health Organization, severe periodontal disease affects about 19% of the adult population of the world, which is more than a billion cases.
“This is completely new knowledge for dentistry and should be taken into account when planning the treatment of individual patients,” she commented. “For the heavy smoker with periodontitis, it is very important to understand that working to stop smoking is a critical step in the effective treatment of the disease,” she concluded.