Smoking and Periodontal Health. Current State of the Art

Many dentists realise that smoking may be hazardous to dental health, but do they appreciate how hazardous it really is? Although spreading throughout the world, smoking is still at its worst in Europe. WHO estimates that 800 000 deaths per year in Europe are caused by tobacco, four fifths of which occur in middle age. In fact, also periodontal disease occurs in middle age and 50-80% of cases are attributable to smoking. Whereas other medical disciplines accept smoking as a serious hazard, dentistry still is reluctant to accept smoking as the number one hazard to periodontal health. The most prevalent belief, or disbelief, is that dental plaque is the unique etiological factor, while ignoring that “informed” people who regularly brush their teeth and smoke go on losing their teeth. As all clinicians know, periodontal treatment is unsuccessful in the smoker patient, a clinicians' experience that there is currently firm scientific evidence to support. There is a lot more evidence that this symposium wants to convey and discuss to support that smoking causes harm to the periodontium. The mechanisms by which smoking interferes are complex, where some seem to be specific to the periodontium, whereas others may be general, thus shedding light on possible associations between periodontal and systemic diseases. The symposium also offers strategies for reducing the smoking harms to be used in the everyday dental clinical care. Thus, the current evidence base of smoking and periodontal disease may be profitably implemented into the worldwide successful practice of dental prevention.