Effects of tobacco on periodontal health


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Effects of tobacco on periodontal health

  1. 1. H.K.Ajeya Ranganathan G D C R I , Bangalore.
  2. 2. * 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.
  3. 3. * *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 FACTORS Cigarette smoking, beedi, Smokeless tobacco usage like beeda, pan masala, pan chewing, Gutka SYSTEMIC FACTORS
  4. 4. * 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
  5. 5. * Acetone Aluminium Ammonia Arsenic Benzene Butane Cadmium Carbon monoxide Carbon dioxide Chloroform Cyanide DDT/Dieldrin Ethanol Formaldehyde Hydrogen cyanide Lead Methanol Nicotine Tar 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.
  6. 6. Rolling paper Tobacco blend Cigarette filter Cigarette but • Holds tobacco blend • Controls the rate of burning and production of ash • It provides taste and flavour • It may vary from region to region • 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 • It holds the burnt ash and remnants of tobacco • It is 30% of the length of a cigarette
  7. 7. * 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.
  8. 8. Serum Osteoprotegerin levels increased initially followed by decreased gradually M-CSF, OPG , PGE2 are decreased Saliva OPG levels decreased and sRANKL levels increased OPG/sRANKL ratio is reduced
  9. 9. * 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
  10. 10. Increased levels of T.forsythia , T.denticola, P.gingivalis Increased tissue destruction Increased colonization of bacteria in sub gingival plaque Impaired mechanical prophylaxis
  11. 11. Increased levels of TNFα and matrix metalloprotien 8 Decreased levels of neutrophils and PGE2 Impaired neutrophil activity Increased risk of tissue destruction
  12. 12. Decrased GCF production Decreased blood flow Decreased Microvasculature Added vasoconstriction Decreased Inflammatory response Slow recovery from Local anaesthasia