Informes & Estudios

Smoking & periodontitis

PD Dr. Kristina Bertl, PhD MSc MBA

Smoking and periodontitis – how bad is it really?


  • The risk of periodontitis occurring and progressing in smokers is much higher than it is in non-smokers. Moreover, the effect of smoking is cumulative – this means that ‘the more you smoke, the more periodontitis you get.’
  • Although smokers often have a severe degree of disease, their signs of inflammation are usually less pronounced. This means, for example, that smokers often have lower bleeding indices than non-smokers with a similarly severe level of periodontal disease.
  • Although the primary causes of periodontitis are bacterial infection and the body’s immune response to that infection, smoking nonetheless constitutes one of the most important avoidable risk factors.
  • Smoking substantially reduces the ability of the periodontium to heal during periodontal treatment – it is thought that the healing capacity of a 50-year-old smoker’s periodontium roughly corresponds to that of an 86-year-old non-smoker’s periodontium – that is a difference of 36 years!
  • Successful smoking cessation reduces the risk of periodontitis occurring and progressing and improves the patient’s treatment response – but probably only around 10 years after they stop smoking.

Reference

  1. Knight ET, Liu J, Seymour GJ, Faggion CM Jr, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000. 2016 Jun;71(1):22-51. doi: 10.1111/prd.12110. Faddy MJ, Cullinan MP, Palmer JE, Westerman B, Seymour GJ. Ante-dependence modeling in a longitudinal study of periodontal disease: the effect of age, gender, and smoking status. J Periodontol. 2000 Mar;71(3):454-9. Fiorini T, Musskopf ML, Oppermann RV, Susin C. Is there a positive effect of smoking cessation on periodontal health? A systematic review. J Periodontol. 2014 Jan;85(1):83-91. doi: 10.1902/jop.2013.130047. Epub 2013 Apr 19. Nociti FH Jr, Casati MZ, Duarte PM. Current perspective of the impact of smoking on the progression and treatment of periodontitis. Periodontol 2000. 2015 Feb;67(1):187-210. doi: 10.1111/prd.12063.

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