Research Pinpoints Possible Mechanism That Causes Severe Gum Disease In Smokers

BUFFALO, N.Y. -- University at Buffalo dental researchers have identified a mechanism that may help to explain why people who smoke have more severe gum disease than non-smokers.

Their study is one of the first to show that a procoagulant called von Willebrand factor (vWF), which causes platelets to clump around injured endothelial cells and is known to be elevated in certain systemic diseases, also is elevated in smokers with severe periodontal disease, said Sara G. Grossi, D.D.S., clinical director of the UB Periodontal Disease Research Center.

Results of the research were presented last week at the International Association for Dental Research meeting in San Francisco.

It is well-known that smoking increases the risk of severe periodontal disease, although researchers have not known how this takes place. They have known that smoking seems to have an adverse effect on the endothelium, the tissue that lines blood vessels, and that von Willebrand factor has been used as an indicator of damage to cells in this layer.

To determine if a relationship exists between von Willebrand factor, periodontal disease and smoking, UB researchers examined 79 subjects between the ages of 25-58. Health and smoking data were collected from all subjects, and periodontal disease status was determined by measuring amount of gum detachment. Persons with diseases known to cause elevated vWF were eliminated from the study.

Subjects were classified as heavy smokers or non-smokers, and as high (periodontal) disease or low disease. From these classifications, four test groups were formed: high disease/heavy smokers; high disease/non-smokers; low disease/heavy smokers and low disease/non-smokers.

Researchers measured concentrations of vWF in blood from each patient to assess evidence of damage to endothelial cells. Results showed that concentrations of the procoagulant were significantly higher in the heavy smokers with severe periodontal disease than in non-smokers with low disease.

Even subjects with low levels of gum disease who smoked had higher concentrations of vWF than persons with high disease levels who didn¹t smoke, and significantly higher levels than non-smokers with low disease.

³The data indicate that smoking markedly elevates levels of von Willebrand factor in adults,² said Grossi. ³The results from this study, which suggest that endothelium damage and the vascular system play a role in increasing periodontal disease in smokers, is very exciting and offers new avenues for research into the mechanism by which smoking contributes to severe periodontal disease.²