Conclusion

In summary, smoking contributes to:

1. An increase of prevalence and severity of periodontitis.²⁰
2. An increase of pocket depths, marginal bone, and attachment loss.^{25, 28}
3. Deceased healing following periodontal therapy.²²
4. An increase of tooth loss.¹⁹
5. A strong association between periodontal disease, smoking, and heart disease.²⁰

In addition to periodontitis smoking has been shown to be strongly associated with necrotizing ulcerative gingivitis (Figure 7).  In a study of 100 patients presenting with necrotizing ulcerative gingivitis (NUG) 98 reported being smokers.³⁰  The exact mechanism of smoking to this multifactoral condition is unknown but may be a combination of poor oral hygiene, stress, poor diet, and smoking related physiological changes such as constricted blood vessels and lowered immune response.³⁰

Figure 7.  Necrotizing ulcerative gingivitis of a 24-year old smoker.  (Courtesy, Dr. A Christen, Indiana University School of Dentistry)

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Citation Number: Vol. 6, No. 2, Page 164