Study Implicates Smoking In New Cases of Periodontal Disease

BUFFALO, N.Y. -- People who have healthy gums are highly likely to develop gum disease within two to five years if they smoke cigarettes, dental researchers from the University at Buffalo have found.

The study is the first to show a direct association between smoking and the development of gum detachment and loss of bone in the jaw -- symptoms of periodontal disease -- in healthy persons.

Results of the research were presented Sunday, March 23, at the International Association for Dental Research meeting in Orlando, Fla.

Sara Grossi, D.D.S., clinical director of the UB Periodontal Disease Research Center and director of the new study, has reported previously that smoking increases the severity of existing gum disease, that gum disease is more prevalent in smokers than non smokers, and that smoking slows the healing process after treatment, but had not yet implicated smoking in the initiation of the disease process.

"This is a definitive step in establishing smoking as a true risk factor," Grossi said. "We now can show, not only that people who have the disease have more, but that people who were free of disease now have the disease."

The study involved 181 men and 230 women who initially showed little or no evidence of clinical attachment loss (how far the gums have pulled away from the teeth) or alveolar bone loss (deterioration of the bone in which the teeth are embedded). Participants in the study were examined twice over five years for signs of these symptoms.

Persons who showed a designated rate of change between the first and second examination were considered to be new cases. Thirty-eight people, or 9 percent of the group, had developed clinical attachment loss by the second exam, and 87 people, or 29 percent, showed signs of alveolar bone loss.

The researchers then analyzed the impact of several conditions on disease development: dental care, the presence of certain bacteria, socioeconomic factors, systemic diseases, health habits and a history of smoking.

Of all the variables, only a history of smoking was associated with both gum detachment and bone loss, results showed. The presence of bacteria was a risk factor for developing bone loss.

"Of the individuals who did not have the disease and then developed it, significantly more had a smoking history than those who didn't develop the disease," Grossi said. "Some developed disease as early as two years into the study.

"This tells us that if we want to intervene and reduce the number of people who develop periodontal disease, we must control smoking."

Also participating in the study were Rosanna Menna, Maria Saraiva, Alex W. Ho, and Robert G. Dunford, all of the UB Periodontal Disease Research Center, and Robert J. Genco, D.D.S., Ph.D., SUNY Distinguished professor and chair of the UB Department of Oral Biology.

The research was funded by a grant from the U.S. Public Health Service.