Oral mucosa and smoking
By * Pascal EPPE LSD Dentist Specialize in nutrition therapy
The consequences of smoking on the oral mucosa and periodontal tissues and natural solutions to remedy it
Impact of smoking on the oral mucosa and periodontal tissues
Smoking and oral cancer
Pathogenic mechanisms in the appearance of the periodontal pathologies
Introduction
According to recent scientific publications, it is now proven that the success rate of periodontal treatment is less favorable in smokers than non-smokers.
If you want to achieve, for smokers reached by periodontal disease, a causal therapy, it is advisable to check regularly the oral hygiene but also intervene at the level of tabagism habits.
Impact of smoking on the oral mucosa and periodontal tissues
Smoking causes deleterious impacts on the health of the oral cavity, ranging from minor aesthetic changes to the deadly cancer disease .
The report between smoking and diseases of the oral cavity has been proven scientifically.
Smoking and oral cancer
For example in Switzerland, each year, approximately five hundred people are suffering from carcinoma of the oral cavity.
The percentage of deaths remains high, with a survival rate of 50% after five years, although early detection increases appreciably the probability of survival.
The causes of cancer of the oral cavity are well documented in scientific literature. 75% to 90% of cases are due to the combined effect of smoking and alcohol.
The risk of being reached is six to fifteen times higher among heavy smokers who consume large quantities of alcohol, compared with non-smokers and non-alcohol drinkers.
The alterations in tissue at risk of malignancy degeneration, such as leukoplakia, occur six times more frequently among smokers than among non-smokers.
Cessation of smoking, allows to reduces almost to zero the risk of developing oral carcinoma in the space of five to ten years. The leukoplakias may decrease or even disappear after a definitive cessation of smoking.
Periodontitis and Smoking
Determination of the causal link
In 1993, Haber and coll. managed to provide clear evidence of the causal and quantitative link between smoking and periodontitis. The risk of developing periodontitis is four times higher for a big smoker than a moderate smoker. In this study, patients in the age group between 31 and 40 years who smoked more than ten cigarettes a day were suffering from periodontitis.
In 1995, Bergström and coll. examined 100 patients at an interval of ten years and they showed that, compared to moderate smokers, the heavy smokers had a higher number of periodontal pockets and, radiologically, the mass of the alveolar bone was less important.
In this study, patients in the age group between 31 and 40 years who smoked more than ten cigarettes a day were suffering from periodontitis.
In general way, we can say that cigarette smoke can appreciably disrupt the integrity and the function of periodontal tissues.
The nicotine and its metabolites (eg cotinine) can be detected in saliva, gingival fluid and at the level of the root surface. The nicotine diffuses through the oral mucosa in the direction of the connective tissue. It is fixed and absorbed by the fibroblasts, hindering their cellular activity.
The nicotine inhibits besides the synthesis of collagen. The age advancing, the smokers present a faster reduction of the osseous mass.
Furthermore, the bones of smokers are less mineralized because of the hormonal disturbances caused by nicotine.
The intestinal absorption of calcium is reduced in smokers.
The gingival bleeding is less marked in smokers, because nicotine has a vasoconstrictor effect. Therefore, the periodontium of smoker may seem clinically more healthier than non-smokers regarding the "gingival bleeding" but is not really the case.
Pathogenic mechanisms in the appearance of periodontal pathologies
Two major causes are behind the destruction of periodontal tissues during the evolution of periodontitis :
the bacteria in dental plaque and the immune reaction in tissues attacked by the dental plaque.
On one hand, the smokers produce more important deposits of dental plaque.
On the other hand, smokers have a relatively large number of specific bacteria, pathogens on periodontal plan.
Many authors have described the increased deposits of tartar. A high concentration of Ca2 + in saliva and dental plaque is the cause. The smokers have a greater flow of saliva, an oral pH higher and they seem to pay less attention and devoting less time to the daily oral hygiene.
The rate of success of the therapeutic elimination of pathogenic germs for the periodontium is the same for the smokers and the non-smokers. On the other hand, following the mechanical purification, germs in question are detectable longer in smokers than non-smokers.
Because these bacteria also colonize healthy sites, there is evidence that they exert their destructive effects on a weakened periodontal. In this case, the harmful effects of smoking are more important than those of the microbial flora.
How to act effectively ?
Local Action
With an application when brushing teeth, Dental Bianco HE makes healthy and white teeth with a visible result from the first applications.
More than that, he fights the dental plaque and the receding of gums teeth and makes fresh breath.
By its antibacterial, antifungal, antiviral and anti-inflammatory qualities, it insures a healthy oral cavity.
Remediation Program
As for the remediation, it will support both the cessation smoking and the reconsolidation of the general body.
The benefits of quitting smoking are indisputable.
Smokers who stopped smoking can, as well as non-smoking, maintain a healthy periodontium.
In 1991, Bergström and coll. measured an alveolar bone mass higher among dental hygienists who stopped smoking for several years, compared with the group of those who continued to smoke. Bone mass was nevertheless lower than that of dental hygienists who had never smoked.
In 1994, Haber and coll. assessed at one year the time required for the regeneration of the gum after smoking cessation. This recovery is also accompanied by the interruption of the loss of supporting periodontal tissues.
Withdrawal symptoms (physical symptoms such as headaches, digestive problems and sleep, increased appetite, etc.. - especially the "craving" to smoke) constitute a major obstacle to the smoking cessation, but the use of « DNN Down Nicotin Now » at 1 capsule per 7 cigarettes smoked allows of desensitizes. This product helps smokers to kick their nicotine addiction and their habits towards the tobacco.
Reconsolidation of the general body with TPD Action Program
For two months of treatment for each vial at a rate of 1 packet per day (in alternation the bag A of 2 capsules and the bag B of 3 capsules), the quintuple objective of TPD Action Program is simultaneously to support the reorganization of the bone parodontal, to fight and recover of the consequences resulting from the production of free radicals, to proceed to a massive mineral supplementation, support of liver functions and assist in recovery of the periodontal osseous.
Scientific Bibliography
Periodontology
Bergström J., Eliasson S., Preber H.: Cigarette smoking and periodontal bone loss. J Perio-dontol 62: 242-246:1991
Bergström J., Dock J., Eliasson S., Hultin M.: Tobacco smoking and periodontal disease: a dose-response
approach. J Dent Res 74: 469: 1995
Bergström J., Eliasson S., Dock J.: A 10-year prospective study of tobacco smoking and pe-riodontal health. J Periodontol:71(8):1338-47: 2000
Brochut P.F. & Cimasoni G., Auswirkungen des Rauchens auf das Parodont (I), Schweiz Monatsschr Zahnmed,Vol. 107: 8/1997
Brochut P.F. & Cimasoni G., Auswirkungen des Rauchens auf das Parodont (II), Schweiz Monatsschr Zahnmed, Vol. 107: 9/1997
Haber J., Wattles J., Crowley M., Mandell R.: Joshipura K., Kent R.L.: Evidence for cigarette smoking as a major risk factor for periodontitis. J Periodontol 64: 16-23: 1993
Haber J.: Smoking is a major risk factor for periodontitis. Curr Opin Periodontol: 12-18: 1994
Haffajee A.D., Socransky S.S.: Relationship of cigarette smoking to the subgingival microbiota. J Clin
Periodontol 28(5):377-88: 2001
Pindborg J.J., Tobacco and gingivitis. I. Statistical examination of the significance of tobacco in the development of ulceromembraneous gingivitis and the formation of calculus. J Dent Res 26: 261-264: 1947
Désaccoutumance tabagique
Beck-Mannagetta J.: Hilfe für rauchende Patienten - eine Anleitung für das zahnärztliche Team von Richard Watt und Mary Robinson, 2000
Humair J.P., Cornuz J., Raucherentwöhnung, Basisdokumentation für Ärztinnen und Ärzte: Verbindung der Schweizer Ärztinnen und Ärzte FMH, «Frei von Tabak», Bundesamt für Gesundheit BAG
Prochaska J.O., Di Clemente C.C., Stages and processes of self-change of smoking: toward an integrative
model of change. J Consult Clin Psychol: 51(3): 390-5: 1983
Watt R.G., Robinson M., Helping Smokers to Stop - a guide for the dental team. Health Education Authorities, London, 1999
Fiore M.C., US public health service clinical practice guideline: treating tobacco use and dependence, Review, Respir Care: 45(10):1200-62: 2000
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