Smoking and Periodontal Bacteria

With cigarette smoking established as an important risk factor for periodontitis, investigators have evaluated the relationship of different aspects of the pathogenesis of periodontitis as modified by smoking. Toward this end, Shiloah et al from the University of Tennessee studied the presence of subgingival bacteria in smokers and non-smokers.   

Fifty individuals were examined. All were between 21 and 35 years of age and presented with a healthy periodontium or gingivitis. One half of the individuals were current smokers, with a history of at least 1.5 pack-years. The other 25 individuals had never smoked. Subgingival plaque samples were collected with paper points and 8 specific periodontal pathogens (including Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus and the spirochete Treponema denticola) were analyzed by DNA probes.

The clinical parameters were comparable for both groups. Eight of the 50 individuals demonstrated detectable levels of at least 1 of the 8 periodontal pathogens; 7 of these were smokers. The difference (7/25 versus 1/25) was statistically significant (p < 0.02). Upon further analysis, heavy smoking (35 pack-years) was associated with greater colonization by pathogens than light smoking.

Previous studies have compared the periodontal microbiology of smokers and non-smokers with periodontitis, and the results are not clear. This report is different in that younger subjects who had a healthy periodontium or displayed mild gingivitis were studied. Differences were seen between groups, with smokers harboring a bacterial microflora characteristic of more advanced disease. The authors of this    article suggested that this early colonization or pathogenic bacteria in smokers might be associated with the increased risk for periodontitis seen later in life.

Shiloah J, Patters MR, Waring MB.

• Association of Smoking and Periodontal Disease
• Smoking as a Risk Factor for Periodontitis
• Subgingival Oxygen Levels and Smoking
• Bone Mineral Density, Smoking and Alveolar Bone Loss