Ch 17. Tobacco, Smoking, and Perio Disease Flashcards
(24 cards)
Nicotine
not a carcinogen itself; can be as addictive as alcohol, cocaine, or heroin
Nicotine + Pregnancy
Hazardous to pregnant women and fetuses
FDA classifies nicotine as Category D drug
Tobacco
over 7000 toxins present in cigarette smoke; tobacco absorbs chemical from soil and fertilizers (cadmium, lead, arsenic, nitrates)
Other examples: benzene, carbon monoxide, carbon dioxide nitrogen oxides, ammonium hydrogen cyanide, volatile sulfur-containing compounds, volatile hydrocarbons
Tar
sticky resinous semi-combusted residue adhering to epithelium lining of oral cavity, teeth, and lungs
Not addictive but dangerous when builds up in lungs
Associated w/ dark discolored stains on smokers teeth, discoloration of tongue, halitosis
Waterpipe Tobacco Smoking
Higher amounts of nicotine than cigarettes
27 carcinogens
Impact on periodontium same as smoking; often not considered “smoking” by patients
Prevalence
51 million adults use tobacco, 81% use combustible products
2.55 million middle and high schoolers report using tobacco in past 30 days, e-cigarettes most commonly used
Periodontitis
smoking very strong risk factor for perio (2-3x more likely)
Smoking increases risk of…
risk of tooth loss and attachment loss, severe recession, loss of attachment to buccal surfaces
How many cases of perio are due to current or former smoking
about half of cases
The affects of smoking are _____ dependent.
Risk-dose dependent and duration dependent
Impact on Oral Microbial Biofilm
diverse and distinct subgingival microbial profile for periodontitis in smokers than nonsmokers (more likely to be colonized by P. gingivalis)
Responsible for depletion of beneficial bacteria and increase in pathogenic bacteria
Associated w/ lower oxygen tension in perio pocket, creates environment favorable to anaerobic bacteria
Impact on Immune System
Impairs gingival blood flow through vasoconstrictors
Impairs neutrophil function (but, higher number of neutrophils)
Decreases IgG2 antibody production
Impact on Bone Metabolism
greater alveolar bone destruction compared to nonsmokers
Nicotine suppresses osteoblasts and fuels alkaline phosphatase activity
Increases secretion of IL-6 and TNF-a in osteoblasts
Increases releases of matrix metalloproteinase (MMP)
Environmental Tobacco Smoke (ETS)
increases risk for periodontitis in nonsmokers
ETS is ______ dependent.
Dose-dependent
1-25 hr per week = 28% increases in risk
>26 hr per week = 2x as high risk
Effects of Smokeless Tobacco
associated w/ oral carcinoma and white oral mucosa lesions
Effects of E-cigarettes
highly addictive, known toxins, unknown long term effects, increased risk for periodontal diseases, benefits as smoking cessation aid is unclear
volatile components
acrolein and acetaldehyde
Effects of chemical and toxins
Inhibits gingival fibroblasts attachment and proliferation
Influences wound healing and progression of periodontitis
Perio therapy
mokers show poorer response to perio therapy
Less reduction in probing depths
Less gain in clinical attachment after treatment
Cannabis and Perio
May be risk factor for perio separate from tobacco use
Risk same or higher
Generally poorer health; associated w/ gingival enlargement, erythroplakia, chronic inflammation, deeper probing depths, more clinical attachment loss, higher odds of severe periodontitis
Dental Implants
increased risk for impaired healing after implant surgery
Risk factors associated w/ increased peri-implant mucositis and peri-implantitis
Poor plaque biofilm control, history of perio, diabetes, smoking
Benefits of smoking cessation
reduction in pathogenic bacteria in subgingival biofilm, improved vascular circulation in gingiva, improvements in host inflammatory response
