Smoking Flashcards
Major constituents of cigarettes
Nicotene, napthalene, aromatic hydrocarbons, phenols, tar, cerboxylic acids
Major constituents of gaseous phase
Hydrogen sulphide, aldehydes, carboxylic acids, alcohols, ketones
Explain the function of nicotene
Low doses of nicotine can be stored in and released by periodontial fibroblasts
It is a clear liquid which turns brown on burning
It is an alkaloid which is lipid soluble- passes through blood-brain barrier into NS
Nicotine receptors release dopamine
How is nicotine a vasoconstrictor?
Reduces nutritional blood flow to skin
Tissue is ischaemic and impaired healing
What effect does nicotine do on RBCs, fibroblasts and macrophages?
It decreases the proliferation of them
What happens to a smokers periodontium?! (12)
They have more calculus deposits
They have more plaque deposits
They spend less time brushing teeth
They have deeper pockets
They have greater alv bone loss
Lose more teeth than non smokers
Gingiva has higher number of keratinised cells
Perio treatment is higher failure rate
Young smokers show more inflammation
Old smokers show less inflammation than non smokers
Nicotine passes through oral mucosa and causes inhibition of function of PMNs- leading to less release and response of cytokines
Motility and chemotactic ability impaired
Relationship between tobacco and perio disease (6)
1. Effect on the prevalence and severity of perio disease
NUG- clear link between nug and smoking
Chronic gingivitis and periodontitis- increased plaque, calculus, LOA, bone loss…
- Possible association with a refractory response (healing impaired) to perio treatment
Despite good standard of perio treatment delivered and good standard of OH
- Smokeless tobacco on perio tissue
Snuff
Chewing tobacco
Clear links between these and leukoplakia (white patches) and carcinoma
- Possible mechanisms of its effect on perio tissue
Microbiology- smokers have more supra and sub ging calculus than non smokers
Perio pockets are more anaerobic
No differences between bacterial composition of plaque between smokers and non smokers
- Effects to response to treatment
Smokers have:
Decreased salivary IgA antibodies to fusobacterium and P. Intermedia
Decreased serum IgG antibodies to fusobacterium and P Intermedia
Decreased numbers of T helper lymphocytes
Decreased neutrophils function
- Smoking cessation in perio disease prevention
Informing patient about dangers and encouraging them to stop is v important
MacGregor 1996- smoking advice more likely to stop than other with no advice
