Association between smoking and periodontitis severity in patients attending a periodontology clinic: a...

The aim of this study was to evaluate the association of cigarette smoking on the development and severity of periodontitis and to examine the association of this relationship with demographic and behavioral factors.

Medical and dental histories, smoking characteristics, systemic parameters, and periodontal findings of all patients presenting to the periodontology clinic were routinely recorded. A total of 781 volunteers aged 18 years and older were included. Smoking status was further categorized based on daily cigarette consumption (non-smoker, ≤ 10 cigarettes/day, and > 10 cigarettes/day). Only conventional cigarette smoking was considered, and the use of alternative smoking devices (e.g., e-cigarettes or heated tobacco products) was not included. Periodontal diagnosis, staging, and grading were performed according to standard clinical criteria. Statistical analyses included Chi-square tests for categorical variables and Kruskal-Wallis tests for comparisons of periodontal parameters.

A significant association was observed between daily cigarette consumption and periodontitis stage severity (p < 0.001). The proportion of Stage IV periodontitis was higher among individuals smoking > 10 cigarettes/day than among non-smokers. Smoking status was also significantly associated with probing depth values (p = 0.012), suggesting greater periodontal destruction with increasing cigarette consumption. In the adjusted ordinal logistic regression model, smoking > 10 cigarettes/day remained significantly associated with higher periodontitis stage severity. Toothbrushing ≥ 2 times/day was associated with lower odds of severe periodontitis, whereas dental visit frequency and education level were not significantly associated with stage severity.

Smoking was significantly associated with increased severity and more advanced stages of periodontitis. Behavioral and demographic factors were also associated with periodontal disease severity.

This study did not involve a health care intervention or a randomized clinical trial. It is a cross-sectional observational study based on anonymized clinical records; therefore, prospective trial registration was not required.