Periodontitis Disease Severity in Smokers and Non-smokers

OBJECTIVE: Smoking has been associated with increased risk of periodontitis. The aim of the present study was to compare the periodontal disease severity of adult heavy smokers and never smokers referred for assessment and treatment of chronic periodontitis. MATERIALS AND METHODS: A random sample of patients with at least 20 teeth, stratified for smoking and age (5 year blocks, 35 - 55 years), was selected from an original referral population of 982 subjects with chronic adult periodontitis. Adequate records for 59 never-smokers and 44 current smokers who smoked at least 20 cigarettes per day were retrieved. The percentage of alveolar bone support was measured with a Schei ruler at x3 magnification from dental panoramic radiographs with the examiner unaware of the smoking status. Probing depths at six sites per tooth were obtained from records of the initial consultation. RESULTS: There was no significant difference in age or gender between smoking groups. Smokers had fewer teeth, less sites probing 1-3mm and more sites probing 4-6mm and > 7mm. These differences were greater in subjects 45 years of age and over, where smokers had approximately 13% more bone loss, 15% more sites probing 4-6mm and 7% more sites probing > 7mm than the non-smokers. CONCLUSION: This study confirmed that age-matched smokers had evidence of more severe periodontal disease than non-smokers in a referral population. The difference increased with age confirming an exposure-related response.