Effect of smoking on dental pulp responses to thermal and electrical sensibility tests

Smoking is associated with vascular constriction and neural alterations that may influence pulpal blood flow and sensory responses. However, the relationship between cigarette consumption and dental pulp sensibility to thermal and electrical stimuli remains incompletely understood. This cross-sectional study aimed to evaluate the association between daily cigarette consumption and the dental pulp sensibility of maxillary central incisors assessed using a cold test and electric pulp test (EPT).

Eighty-eight systemically healthy participants aged 18-40 years were allocated into four groups according to daily cigarette consumption: non-smokers, 1-10, 11-20, and >20 cigarettes/day (n=22 per group). Pulp sensibility was assessed using EPT (stimulus range: 0-64) and cold testing (response time in seconds). Group comparisons were performed using Kruskal-Wallis and Mann-Whitney U tests, followed by Dunn's post hoc analysis where appropriate (p<0.05).

Mean EPT stimulus thresholds increased progressively with higher daily cigarette consumption, ranging from 4.27 ± 1.32 in non-smokers to 7.23 ± 1.80 in heavy smokers (p=0.001). Similarly, cold test response times were significantly prolonged with increasing cigarette intake (0.51 ± 0.31 s in non-smokers vs 1.07 ± 0.33 s in heavy smokers; p=0.001). In contrast, smoking duration was not significantly associated with either EPT thresholds (p=0.832) or cold test response times (p=0.258).

Dental pulp sensibility responses were increasingly attenuated with higher daily cigarette consumption, whereas smoking duration showed no significant association with test outcomes. These findings suggest that the daily quantity of cigarettes consumed may be a more relevant factor than smoking duration when interpreting pulp sensibility test results. Clinicians should consider smoking status as a potential modifier during pulp sensibility assessment.