Is there any correlation between smoking and periodontitis?

Introduction 

Tobacco smoking is a well-known risk factor for gum disease. About one-third of the global population are smokers, 43% are females, and 57% are males. Smoking ` alters the humen microflora, a response of the immune system that destroys the tooth-supporting tissues. Smoking weakens the body's immune system, the body infection fighters, which makes it tougher to fight off infection of the gums. Once an individual has damaged gums, smoking causes it harder for the healing of the gums. Smoking increases the symptoms of periodontal disease. Thus, it can take a long time before the patient seeks professional help by time it might be too late. The paper aims to discuss the relationship smoking has to periodontal disease. 

Composition 

Periodontitis is a group of inflammatory illnesses that affect the tissues which support the periodontium or tooth. It comprises four tissues which are alveolar bone, periodontal ligaments, and gingiva. Smoking tobacco is a modifiable risk factor and has a significant impact on the progress, treatment, and development of periodontal illnesses (Muniandy, 2019). The relationship between periodontal health and has been explored as early as the middle of the past century. 

Progression and initiation of periodontitis are impacted by factors such as the use of tobacco 

The periodontal ligaments are largely widespread and can affect up to ninety percent of the global inhabitants. The minor form of periodontic illness is gingivitis which is brought about by dental plaque, a bacterial biofilm that concentrates on the teeth adjacent to the gums (gingiva). The symptoms include swollen red gums, which are easy to bleed. Nevertheless, the teeth' underlying supporting tissues are not affected by gingivitis, and the effects are easily reversible. However, if gingivitis remains untreated, it progresses to periodontitis. The condition results in the loss of bone support and connective tissue, and the effects are significant loss of teeth in adults (Muniandy, 2019). Moreover, progression and initiation of periodontitis are impacted by factors such as the use of tobacco.  

Smoking is a factor that is independent on the severity, initiation, and extent of periodontal illness 

Researchers have predicted that yearly deaths by tobacco use will increase to more than ten million individuals around the world in twenty years. The smoking rate in developing nations is rising by more than 3% yearly.  Therefore, researchers are correct to conclude that the rate of periodontal illnesses will also increase. The relationship between periodontal diseases and smoking has been researched since the middle of the last century. Smoking is a factor that is independent on the severity, initiation, and extent of periodontal illness (Saribas et al., 2017). Moreover, smoking can immensely lower the chances for treatments that are successful for the disease. 

Probability of Developing Rising Periodontal Illness Exhibits Dose Dependency 

Longitudinal and cross-sectional statistics offer strong support for the stand that the risk of developing periodontal illnesses as measured by the alveolar bone loss and clinical attachment loss rises with amplified smoking rate. Research has found out that former smokers who had smoked for two or more years have less attachment than smokers who are presently smoking but more than those who do not smoke (Saribas et al., 2017). Moreover, the probability of developing rising periodontal illness exhibits dose dependency. 

Smoking Is A Factor That Is Independent On The Severity, Initiation, And Extent Of Periodontal Illness 

Longitudinal and cross-sectional statistics offer firm support for the stand that the danger of developing periodontal illnesses as measured by the alveolar bone loss and clinical attachment loss rises with amplified rate of smoking. Research has found out that former smokers who had smoked for two or more years have less attachment than smokers who are presently smoking but more than those who do not smoke (Kim et al., 2017). Moreover, the probability of developing rising periodontal illness exhibits dose dependency. 

How smoking affects periodontal health and why individuals who have chronic periodontitis 

Researchers have established how smoking affects periodontal health and why individuals who have chronic periodontitis have a reduced clinical inflammation rate for an extended period. Currently, we are aware that smoking introduces changes to the 3-OH fatty acids found in lipid A in a way that is constant with a microflora of lessened potential of inflammation. According to research, smokers had substantial declines in the 3-OH fatty acids linked with the consensus enteric LPS structure were observed in individuals who smoked in comparison to individuals who do not smokes with lasting periodontal disease (Jiang et al., 2020). Therefore, smoking is linked with unique structural changes to the lipid-A-derived 3-OH fatty acid profile found in saliva consistent with an oral microflora of lessened inflammatory likelihood. The research provided mechanistic insight into the established clinical problem of the high rate of infection with periodontal pathogens but lessened clinical inflammations in individuals who smoked. 

Smoking has a high negative impact on regenerative therapy 

Research has found out that smoking cigarettes are a significant factor in the environment with increased destruction of young adults' gums. For smokers, smoking cigarettes might differentially affect the neutrophil's function, which inhibits the elimination of periodontal pathogens. In heavy smokers, smoking stimulates the release of reactive oxygen species and oxidative stress-mediated tissue damage (Saribas et al., 2017). The immunosuppressants of tobacco contribute to increased susceptibility to developing periodontitis. 

Smoking suppresses the immune system causing the body weak to fight off gum disease 

Tobacco smoke consists of toxic constituents like nicotine which might penetrate the oral cavity soft tissue, stick to the tooth's surface or enter into the stream of blood. Potential cellular and molecular mechanisms in the pathogenesis of smoking-linked periodontal illnesses have been reported. In it, suppressing the immune system, inflammatory responses of the cell that are exaggerated, and stromal cell functions of oral tissues are impaired. The relationship between periodontal diseases and cigarette smoking represents a major oral health problem. Research has also shown that smokers who have periodontal illness have less gingival bleeding and clinical inflammation than individuals who don't smoke (Mihaela et al., 2017). It can be explained by the fact that most tobacco smoke products exert local vasoconstriction, edema, and reduction of the blood flow, which act to inhibit the early signs of periodontal disease symptoms by lessening bleeding, redness, and gingival inflammation. 

Smoking cessation has led to enhanced periodontal well-being and enhanced periodontal health therapy 

Smoking cigarettes is a preventable cause of premature death and morbidity globally. The prevalence of smoking had been reducing in recent years. Studies have shown that quiting of smoking has led to enhanced periodontal well-being and enhanced periodontal health therapy, enhancing overall health. Studies have evaluated the efficacy of control of periodontal illness control and unique periodontal procedures that include implant procedures, regenerative procedures, and soft tissue grafting have consistently demonstrated an effect that is negative from smoking on success rates ( Atuegwu et al., 2019). Thus, periodontal disease treatment is less likely to be successful in smokers than in non-smokers. 

Conclusion 

Conclusively, smoking is a risk factor that is well known for periodontal illness. It alters the humen immune response that leads to the destruction of the tooth-supporting tissues. It can take long periods before smokers seek help for periodontal diseases, which is often too late to treat the condition. Therefore, health and dental professionals should make a cautious effort to encourage programs that help in the eradication of smoking and teach the society on the advantages of quitting smoking. 

References 

Muniandy, S. (2019). Knowledge on smoking and periodontal disease: A cross-sectional survey among targeted respondents.  Journal of Indian Society of Periodontology ,  23 (3), 275. 

Kim, M. H., Yoon, M. S., Lim, Y. H., Lee, S. R., Kim, S. Y., Park, S. J., & Shin, S. J. (2017). The association between types of smoking and periodontal disease according to the survey year using the fourth and fifth Korea National Health and Nutrition Examination Surveys.  Journal of Dental Hygiene Science ,  17 (6), 487-494. 

Jiang, Y., Zhou, X., Cheng, L., & Li, M. (2020). The impact of smoking on subgingival microflora: From periodontal health to disease.  Frontiers in microbiology ,  11 , 66. 

Saribas, E., Kaya, F. A., Dogru, A. G., & Yildirim, T. T. (2017). Determination of periodontal status and smoking habits with CPITN index.  International Dental Research ,  7 (2), 26-31. 

Mihaela, S. S., Gianina, I., Liliana, P., Georgeta, S. I., Ioana, M., Ionuţ, L., ... & Silvia, M. (2017). Risk predictors in periodontal disease.  Romanian Journal of Oral Rehabilitation ,  9 (3), 89-96. 

Atuegwu, N. C., Perez, M. F., Oncken, C., Thacker, S., Mead, E. L., & Mortensen, E. M. (2019). Association between regular electronic nicotine product use and self-reported periodontal disease status: Population Assessment of Tobacco and Health Survey.  International journal of environmental research and public health ,  16 (7), 1263.