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Periodontal disease:
Periocontal diease is an infection of the gums and bone which supports
the teeth, is routinely found in the majority of adults who still have their teeth. Historically, it has been understood that
the bacteria in the mouth (called "bacterial plaque") has been the cause of periodontitis (gum disease). In the
past decade a growing body of research evidence has shown that there are risk factors which modify the initiation and progress
of the infection of the teeth and gums. Smoking is one of these "risk factors" which can make your gum disease worse
than if you did not smoke.
The Cause
of Halitosis: Halitosis, or bad breath, is caused by the bacteria in the mouth
which degrade or "breakdown" proteins that are present in the mouth. These proteins, and other materials which are
in the mouth naturally or from foods and drinks that we consume, are the fuel that powers "bad breath". The breakdown
products of these proteins and other substances are described as "volatile sulfur compounds", one of which is hydrogen
sulfide. Hydrogen sulfide is also the same gas that is produced when one has flatulence. It has been shown that the bacteria
that cause these sulfur compounds also are the bacteria that cause gum disease or periodontitis . Therefore, the bacterial
plaque which causes periodontitis has to be considered as a causative factor for bad breath.
The Sites of Halitosis. Halitosis can be caused by the bacterial actions
in various areas of the mouth. These areas are: 1. The tongue 2. The teeth -- on and between
the teeth 3. The gums 4. The stomach
The Tongue:
The tongue has emerged as the primary focal point regarding halitosis due to
the bacteria that accumulate on the tongue. Studies have shown that the bacteria on the tongue are similar to the odor-causing
bacteria that are associated with gum disease. However, it has been shown that the tongue surface is an important factor in
the development of bad breath in both healthy mouths or those which have gum disease.
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Smoking click on me
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THE SIGNIFICANCE
The significance of all of the research is that the presence of
gum disease is highest for smokers, next highest for ex-smokers and lowest for those people who had never smoked. It has also
been shown that former smokers and those who had never smoked did, in fact, respond better to the treatment of gum disease
than did those people who did still smoke. It can be concluded that those periodontal patients who stop smoking will have
a better chance of being successful with the periodontal therapy that is indicated for their case. We as dentists have evolved
into another broadly-encompassing role which allows us to favorably impact the total health of our patients.References:1.Tomar,
SL. and Asma, S. Smoking-attributable periodontitis in the United States: Findings from NHANES III, J. Perio.71:742-750; 2000.2.Salvi,
GE, et al. Influence of risk factors on the pathogenisis of periodontitis. Periodontol 2000, 1997;14:173-201.3.Gelskey, SC.
Cigarette smoking and periodontitis: Methodology to assess the strength of evidence in support of a causal association. Community
Dent. Oral Epidemiol. 1999;27:16-24.4.Baab,DA and Oberg, PA. The effect of cagarette smoking on gingival blood flow in humans.
J. Clin Periodontol. 1987;14:418-424.5.Barbour,SE, et al. Tobacco and smoking: Environmental factors that modify thehost response
(immune system) and have an impact on periodontal health. Crit Rev Oral Biol Med 1997;8:437-460.6.Zambon,JJ, et al. Cigarette
smoking increases the risk for subgingival infection with periodontal pathogens. J. Periodontol. 1996;67(suppl.):1050-1054.
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