Smoking and periodontal disease
More than 4000 different toxins are present in cigarette smoke. They include carbon
monoxide, oxidating radicals, nitrosamines and nicotine.1 Fifty percent of smokers will die from a smoke related disease.2
Other than the many systemic diseases associated with tobacco use, there are many oral
conditions attributed to it, such as:
- Oral cancer
- Dental cavities
- Periodontal disease
- Partial and complete tooth loss
The effects of cigarette smoking on periodontal disease increases with the amount smoked.
Smokers have fewer teeth and higher rates of total tooth loss as compared to nonsmokers.4
Smoking creates environment for periodontal-causing bacteria to exist and to thrive.
Smokers have higher levels of periodontal pathogenic bacteria than nonsmokers. Smoking one pack per day for 10 years will
cause about a 10 percent loss of bone support. Smoking one pack per day for 20 years or two packs for ten years will cause
a 20 percent loss.5
Long-term studies reveal that the majority of tooth loss in 19 to 40 year olds is associated
with those smoking more than 15 cigarettes per day.
Smoking also has a detrimental effect on wound healing after surgical and nonsurgical
periodontal treatment. Nonsmokers respond better to periodontal therapy than smokers.
Gum grafting, which is used to cover exposed root surfaces, and guided tissue regeneration,
which is a procedure used to replace missing tissue support around teeth, are more successful in nonsmokers.7
Smoking is a significant contributor to many diseases. If you smoke, try to quit. If
you don't smoke, don't let your children start smoking.
1. U.S. Dept. of
Health and Human Services; publication No. 82-50179
2. Doll et all, Mortality
in relation to smoking; Br. Med J 1994:309; 901-911
3. Christen AG; The
impact of tobacco use and cessation of oral dental disease and conditions American Journal of Medicine 1992, 1993, 25s-31s.
4. Molin G; Smoking
as an additional risk for tooth loss; J. Perio 1994; 65:996-1001.
5. S. Grossi; Annual
meeting 1998 of the American Academy of Periodontology.
6. Page and Beck
Risk assessment for periodontal disease; Int. Rent J 47:61-87, 1997.
1996 Annals of Periodontology | 
