effects of tobacco on periodontal health
Post on 18-Jan-2015
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H.K.Ajeya Ranganathan
G D C R I , Bangalore.
EFFECTS OF TOBACCO ON PERIODONTAL TISSUES
Periodontitis* Periodontitis is one of the most common oral diseases
and is characterised by gingival inflammation and alveolar bone resorption
* Periodontitis is a multifactorial and cumulative condition, initiated and propagated by bacteria and host factors
* There are two forms of periodontitis; chronic and aggressive Periodontitis
* Both differ from each other not only in clinical findings but also age of onset and rate of progression.
*General causes for periodontitis*Factors playing role in Periodontitis are
LOCAL FACTORS like calculus, food impaction and microbial
plaque which includes Aggrobacter actinomycetemcomitans, Bacteroides forsuthus & Prevotella intermedia , Fusobacterium nucleatum , Bacteroides melaninogenicus
ENVIRONMENTAL FACTORSCigarette smoking, beedi,
Smokeless tobacco usage like beeda, pan masala, pan chewing, Gutka
SYSTEMIC FACTORS
Periodontitis: Environmental Factors* Environmental factors are not found in oral cavity
always but are acting as and when habits are cultivated
*Environmental factors include
*SMOKING
*Pan chewing
*Smokeless tobacco consumption and
*Poor dental awareness
Contents of cigarattes
*Acetone Cyanide Aluminium DDT/Dieldrin Ammonia Ethanol Arsenic Formaldehyde Benzene Hydrogen cyanide Butane Lead Cadmium Methanol Carbon monoxide Nicotine Carbon dioxide Tar Chloroform Vinyl Chloride
*1. Filter made of 95% cellulose acetate.
*2. Tipping paper to cover the filter.
*3. Rolling paper to cover the tobacco.
*4. Tobacco blend.
Functions of different layers and part of cigarette
Rolling paper• Holds tobacco blend • Controls the rate of
burning and production of ash
Tobacco blend• It provides taste and
flavour• It may vary from
region to region
Cigarette filter• It is the
biodegradable part of cigarette made of cellulose acetate.
• It filters the main stream of smoke from tobacco blend to the mouth piece
Cigarette but• It holds the burnt ash
and remnants of tobacco
• It is 30% of the length of a cigarette
Effects on periodontia*Gingivitis:
smokers develop less inflammatory response than non smoking counterparts which shows that occurrence of gingivitis is comparatively low in smokers than in non-smokers
*Periodontitis
Smokers are more prone to periodontitis than non smokers since smoking plays an important role in destruction of periodontium , loss of attachment and sub-gingival plaque accumulation.
Biochemical findings in smokers
Osteoprotegerin levels increased initially followed by decreased gradually
M-CSF, OPG , PGE2 are decreased
Serum OPG levels
decreased and sRANKL levels increased
OPG/sRANKL ratio is reduced
Saliva
Effects of tobacco smoking on microbiology, immune inflammatory response & physiology of periodontitis
*Increased destruction of periodontia by smoking would lead to the breakdown balance between microbial colonies and host immune response and causes changes in the contents of sub-gingival plaque
* This would lead to increased virulence and changes the host response to the bacterial challenge which in turn lead to increased periodontal destruction
Effects of tobacco on microbiology of plaqueIncreased levels of
T.forsythia ,
T.denticola,
P.gingivalis
Increased colonization of bacteria
in sub gingival plaque
Impaired mechanical prophylaxis
Increased tissue
destruction
Effects of tobacco smoking on immune response during Periodontitis
Increased risk of tissue
destruction
Impaired neutrophil
activity
Increased levels of TNFα and
matrix metalloprotie
n 8 Decreased levels of
neutrophils and PGE2
Effects of tobacco smoking on periodontal
Physiology
Decreased Microvasculatu
re
Decreased blood flow
Decrased GCF production
DecreasedInflammatory
response
Added vasoconstrictio
nSlow recovery
from Local anaesthasia
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