Smoking affects the subgingival microflora in periodontitis

Area of Science:

• Periodontology
• Microbiology
• Oral Health

Background:

• Tobacco smoking is a major risk factor for destructive periodontal disease.
• Periodontal treatment, including scaling and root planing, is less effective in smokers.
• Understanding the subgingival microbial differences between smokers and non-smokers with periodontitis is crucial.

Purpose of the Study:

• To compare the subgingival microbial flora in treated and untreated smokers and non-smokers with periodontitis.
• To identify specific bacterial pathogens associated with smoking in periodontitis patients.

Main Methods:

• Inclusion of four adult patient groups: untreated smokers (U-S), untreated non-smokers (U-NS), treated non-smokers (T-NS), and treated smokers (T-S).
• Clinical variables assessed included plaque index, probing depth, clinical attachment level, bleeding index, and suppuration index.
• Subgingival paper point samples analyzed for 6 periodontal bacterial pathogens using anaerobic culture techniques.

Main Results:

• Untreated smokers (U-S) exhibited higher plaque indices compared to untreated non-smokers (U-NS).
• Treated smokers (T-S) showed greater probing depth and clinical attachment loss than treated non-smokers (T-NS).
• Smokers presented higher prevalence and levels of specific bacteria, including Prevotella intermedia/nigrescens, Peptostreptococcus micros (Pm), Fusobacterium nucleatum (Fn), Bacteroides forsythus (Bf), and Campylobacter rectus (Cr).

Conclusions:

• Smoking is a determining factor in the subgingival microflora composition of periodontitis patients.
• Smoking may select for specific periodontal pathogens like Bf, Pm, Fn, and Cr.
• Smoking status should be considered when deciding on systemic antibiotic therapy for refractory periodontitis in smokers.