Variation in tobacco use profiles obtained from periodontal maintenance patients
ABSTRACT To compare methods of tobacco use profiling in patients undergoing maintenance treatment for periodontitis.
The smoking status of 108 subjects attending a university-based specialist periodontics clinic was assessed by examination of referring records, patient-completed questionnaires, clinician-administered interviews and by salivary cotinine and expired-air carbon monoxide (ECO) measurement.
Ten percent of the detected smokers (salivary cotinine>14.2ngml(-1)) reported to be non-smokers in the clinician-administered interview. 4.2% of the smokers detected by ECO analysis (ECO>8ppm) reported to be non-smokers in the clinician-administered interview. Systematic under reporting of tobacco use was also apparent in patient-completed questionnaires from the periodontics clinic and, to a larger degree, in the referring clinic records when compared to the clinician-administered interview.
By biochemically analyzing recent cigarette smoke exposure, our data show that clinician assessment is the most accurate means by which to obtain anamnestic data concerning tobacco use. ECO analysis using portable CO monitors is inexpensive and simple with no requirement for laboratory support. The combination of ECO measurement and clinician-administered tobacco use interview represents a clinically applicable method to improve the detection of an important, periodontally susceptible population-regular smokers who deny smoking.
- SourceAvailable from: Kelvin I. Afrashtehfar[Show abstract] [Hide abstract]
ABSTRACT: ( Tabaquismo: factor de riesgo para enfermedad periodontal ) Objective: To establish, by reviewing the literature, the relationship between smoking and periodontal disease. Tobacco has a toxic effect on the periodontium and reduces the functional activity of leukocytes and macrophages; it decreases the phagocytosis of polymorphonuclear leukocytes, promoting an increase in the proportion of anaerobic bacteria in plaque, and presenting an increase in the levels of certain periodontal pathogens, alveolar bone loss, periodontal pocket formation, increased clinical attachment loss, furcation involvement, and tooth mobility. Smoking interferes with the healing of wounds and results in a lower response in guided tissue regeneration procedures, as well as less success in the osseointegration of implants and bone grafts. Smoking is strongly related to periodontal destruction in young adults between the second and third decade of life, the effect being more pronounced in women. Conclusion: Tobacco is a major risk factor in the development and severity of periodontal disease, as well as in the response to periodontal therapy. It is essential that methods be employed to increase awareness of the adverse effects on the oral cavity directly related to smoking, specifically the relationship between the latter and its impact on periodontal tissue. Key words: Smoking, periodontal disease, periodontium, periodontal therapy, tobacco. Palabras clave: Tabaquismo, periodonto, enfermedad periodontal, terapia periodontal, tabaco.ADM (Asociación Dental Mexicana: 1986) 05/2010; LXVII(3):101-13. (Spanish).