Effect of Smoking and Tobacco Chewing on Periodontal Disease and Non-Surgical Treatment Outcome: A Clinical and Biochemical Study

Abstract

Objective: The purpose of this study was to compare effects of smoking and smokeless forms of tobacco consumption (tobacco chewing) on periodontal disease parameters and response of these subjects to non-surgical periodontal therapy.

Methods: One hundred sixty-eight patients with chronic periodontitis were screened for the study. Eighteen patients were excluded as they decided to quit the tobacco habit. One hundred fifty patients fulfilling the inclusion and exclusion criteria were grouped as: Group 1, 50 smokers; Group 2, 50 tobacco chewers; and Group 3, 50 non-smokers, non-tobacco chewers (controls). Scaling and root planing was performed at the initial visit as a part of initial therapy. The clinical parameters recorded at baseline, 1 month, 2 months and 3 months were plaque index (PI), gingival index (GI), probing depth (PD), gingival recession (GR), and gingival crevicular fluid (GCF) measurement.

Results: With respect to the comparison between smokers and tobacco chewers, smokers had significantly more probing depth at baseline examination, while tobacco chewers had more gingival recession. Gingival inflammation, response to non-surgical treatment and oral hygiene maintenance were more suppressed in smokers as compared to tobacco chewers.

Conclusion: Tobacco consumption in both forms affects the severity of periodontal disease. It affects the response of periodontal tissues to non-surgical treatment. In addition it leads to poorer oral hygiene and hampers maintenance of oral hygiene.

Keywords: non-surgical therapy; oral hygiene; periodontal disease; smokers; tobacco chewers.