IADR Abstract Archives
Waterpipe Smoking and Oral Wound Healing Study
Objectives: There is evidence that waterpipe tobacco smoking shifts the subgingival microbial ecosystem to a poor-commensal, rich pathogen community, which leads to an elaborate inflammatory response that can be observed clinically. The aim of this study is to measure the clinical effect of smoking hookah on an induced palatal wound.
Methods: A prospective case-control clinical study was conducted, 5 never smokers and 2 hookah users were recruited.
A total of 7 visits were needed. A 5 mm diameter partial thickness (1.5 mm) palatal wound was induced using punch biopsy on the 2nd visit, which was taken 3-5 mm from the free gingival margin in the bicuspid region of both right and left palate. Two subsequent 3 mm diameter partial thickness (1.5 mm) palatal wound were induced respectively, one on the right side on the 4th visit, and the other on the left side on the 6th visit.
Hookah users were instructed to use tobacco products 2 times per day, with 20 puffs, the consumption of Hookah daily was instructed until the end of the 7th visit.
Starting from the 3rd visit and on each subsequent visit, the Pippi modification of the Landry index was used to evaluate clinical healing. Peroxide testing was employed to determine the extent of epithelization.
Subjects were also asked to report any pain, discomfort, bleeding, and suppuration following palatal wounding.
Results: Hookah smoker group reported a lower scoring of 2.5/7 on the 4th visit, 7 days after the first wounding, compared to the non- smoker group which scored 3.4/7. A slower rate of healing in the hookah group was evident, with a score of 5/7 and 6/7 on the 6th and 7th visit, compared to a score of 6.4/7 and 6.8/7 in the control group. Comparing the Pippi index on the left side of the palate, hookah subjects recorded a lower score of 4.5/7 on the 5th visit, 14 days after the first wounding, compared to the non-smoker group with the score of 5.8/7.
Conclusions: Hookah subjects reported higher rates of pain and longer periods of discomfort. Upon inspection and palpation of the wound site, pain was observed more frequently in hookah smokers in the subsequent post-operative visits. Moreover, the overall score of The Pippi modification of the Landry index in Hookah smoker subjects was lower in comparison to never smoker subjects, indicating a slower rate of clinical healing.
Methods: A prospective case-control clinical study was conducted, 5 never smokers and 2 hookah users were recruited.
A total of 7 visits were needed. A 5 mm diameter partial thickness (1.5 mm) palatal wound was induced using punch biopsy on the 2nd visit, which was taken 3-5 mm from the free gingival margin in the bicuspid region of both right and left palate. Two subsequent 3 mm diameter partial thickness (1.5 mm) palatal wound were induced respectively, one on the right side on the 4th visit, and the other on the left side on the 6th visit.
Hookah users were instructed to use tobacco products 2 times per day, with 20 puffs, the consumption of Hookah daily was instructed until the end of the 7th visit.
Starting from the 3rd visit and on each subsequent visit, the Pippi modification of the Landry index was used to evaluate clinical healing. Peroxide testing was employed to determine the extent of epithelization.
Subjects were also asked to report any pain, discomfort, bleeding, and suppuration following palatal wounding.
Results: Hookah smoker group reported a lower scoring of 2.5/7 on the 4th visit, 7 days after the first wounding, compared to the non- smoker group which scored 3.4/7. A slower rate of healing in the hookah group was evident, with a score of 5/7 and 6/7 on the 6th and 7th visit, compared to a score of 6.4/7 and 6.8/7 in the control group. Comparing the Pippi index on the left side of the palate, hookah subjects recorded a lower score of 4.5/7 on the 5th visit, 14 days after the first wounding, compared to the non-smoker group with the score of 5.8/7.
Conclusions: Hookah subjects reported higher rates of pain and longer periods of discomfort. Upon inspection and palpation of the wound site, pain was observed more frequently in hookah smokers in the subsequent post-operative visits. Moreover, the overall score of The Pippi modification of the Landry index in Hookah smoker subjects was lower in comparison to never smoker subjects, indicating a slower rate of clinical healing.