Smoking and Teeth Loss

Authors: D. Hrubá;  V. Vondráček;  N. Salah;  F. L. Alradhi
Authors‘ workplace: Ústav preventivního lékařství LF MU, Brno
Published in: Česká stomatologie / Praktické zubní lékařství, ročník 114, 2014, 5, s. 69-73
Category: Review


Smoking is the most important single preventable risk factor for many diseases, including impaired oral health. Many studies have repeatedly documented the higher prevalence of caries, periodontitis, tooth loss and head-neck cancer among smokers.

Smoking can contribute to the initiation and progression of diseases in oral cavity both indirectly (by smokers´ bad nutrition and oral hygiene) and directly. The deleterious effect of smoking in the oral cavity is due to plaque accumulation and increased alveolar bone resorption. Main causal pathways are hypoxemia, inflammation, impaired immunity, mineral and bacterial imbalance. Cytotoxic effect of tobacco smoke on human gingival fibroblasts decreases their capacity for adhesion and proliferation. Compared to no-smokers, the outcome of implant treatment is among smokers usually less successful, as it is associated with many complications and poor healing.

In many developed countries, dentists are active in the support of no-smoking behaviour and in motivation their smoking patients to smoking cessation. Such approach may be the challenge also for dentists in the Czech Republic.

smoking – oral health – teeth loss - pathways


1. Aida, J., Ando, Y., Akher, R., Aoyama, H., Masui, M., Morita, M.: Reasons for permanent tooth extractions. Japan. J. Epidemiol., roč. 16, 2006, č. 5, s. 214–219.

2. Amarasena, N., Yoshihara, A., Hirotomi, T., Takano, N., Miyazaki, H.: Association between serum calcium and periodontal disease progression in non-institutionalized eldery. Gerontology, roč. 25, 2008, s. 245–250.

3. Baig, M. R., Rajan, M.: Effects of smoking on the outcome of implant treatment: A literature review. Indian J. Dent. Res., roč. 18, 2007, č. 4, s. 190–195.

4. Bain, C.A., Weng, D., Meltzer, A., Kholes, S. S., Stach, R. M.: A meta-analysis evaluating the risk for implant failure in patients who smoke. Compend. Contin. Educ. Dent., roč. 23, 2002, s. 695–706.

5. Buduneli, N., Brytkoglu, B., Sherrabeh, S., Lappin, D. F.: Saliva concentrations of RANKL and osteoprotegerin in smoker versus non-smoker chronic periodontitis patients. J. Clin. Periodontol., roč. 35, 2008, s. 846–852.

6. Dietrich, T., Maserejian, N. N., Joshipura, K. J., Krall, E. A., Garcia, R. I.: Tobacco use and incidence of tooth loss among US male health professionals. J. Dent. Res., roč. 86, 2007, č. 4, s. 373–377.

7. Fredriksson, M., Bergstrom, K., Asman, B.: IL-8 and TNF-alpha from peripheral neutrophils and acute-phase protein in periodontitis: effect of cigarette smoking: a pilot study. J. Clin. Periodontol., roč. 29, 2002, s. 123–128.

8. Galindo-Moreno, P., Fauri, M., Avila-Ortiz, G., Fernandez-Barbero, J. E., Cabrera-Leon, A., Sanchez-Fernandez, E.: Influence of alcohol and tobacco habits on peri-implant marginal bone loss. A prospective study. Clin. Oral. Implants Res., roč. 16, 2005, s. 579–586.

9. Hampl, J. S., Taylor, C. A., Johnston, C. S.: Vitamin C deficiency and depletion in United States: The Third National Health and Nutrition Examination Survey 1988–1994. Am. J. Public Health, roč. 94, 2004, s. 870–883.

10. Hashimoto, M., Yamanaka, K., Shimosato, T., et al.: Oral conditions and health status of people aged 80–85 years. Geriatrics, Gerontology Int., roč. 6, 2006, s. 60–64.

11. Hawn, M. T., Houston, T. K., Campagna, E. J., et al.: The attributable risk of smoking on surgical complications. Ann. Surg., roč. 254, 2011, s. 914–920.

12. Carr, A. B., Ebbert, J.: Interventions for tobacco cessation in the dental setting. Cochrane Database Syst. Rev. 2012, Jun 13, 6:CD005084.doi:10.1002/14651858.CD005084.pub3

13. Klein, B. E., Klein, R., Knudtson, M. D.: Life-style correlates of tooth loss in an adult Midwestern population. J. Public Health Dent., roč. 64, 2004, s. 145–150.

14. Mai, X., Wactawski-Wende, J., Hovey, K. M., LaMonte, M. J., Chen, C., Tezal, M., Genco, R. J.: Associations between smoking and tooth loss according to the reason for tooth loss. The Buffalo OsteoPerio Study. J. Am. Dent. Assoc., roč. 44, 2013, č.3, s. 252–265.

15. Meisel, P., Schwahn, C., Luedemann, J., John, U., Kroemer, H., Kocher, T.: Magnesium deficiency is associated with periodontal disease. J. Dent. Res., roč. 84, 2005, s. 937–941.

16. Moy, P. K., Medina, D., Shetty, V., Aghaloo, T. J.: Dental implant failure rates and associated risk factors. Int. J. Oral Maxillofac. Implants, roč. 20, 2005, s. 560–577.

17. Nakamura, T., Imai, Y., Matsumoto, T., et al.: Estrogen prevents bone via estrogen receptor alpha and induction of Fas ligand in osteoclasts. Cell, roč. 130, 2007, č. 5, s. 811–823.

18. Naroozi, A. R., Philbert, R. F.: Modern concepts in understanding and management of the „dry socket“ syndrome: Comprehensive review of the literature. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod., roč. 107, 2009, s. 30–39.

19. Nitzan, D., Mamlider, A., Levin, I., Schwartz-Arad, D.: Impact of smoking on marginal bone loss. Int. J Oral. Maxillofac. Implants, roč. 20, 2005, s. 605–609.

20. Ojima, M., Hanioka, T., Tanaka, K., Aoyama, H.: Cigarette smoking and tooth loss experience among young adults: a national record linkage study. BMC Public Helath, roč. 7, 2007, s. 313. Doi:10.1186/1471-2458-7-313

21. Palma-Carrio, C., Maestre-Ferrin, L., Penarrocha-Oltra, D., et al.: Risk factors associated with early failure of dental implants: A literature review. Med. Oral Patol. Cir. Bucal, roč. 16, 2011, č. 4, s. e514–e517.

22. Persson, L., Bergstrom, J., Ito, H., Gustafsson, A.: Tobacco smoking and neutrophil activity in patients with periodontal disease. J. Periodontol., roč. 72, 2011, s. 90–95.

23. Poggi, P., Rota, M. T., Boratto, R.: The volatile fraction of cigarette smoke induces alterations in the human gingival fibroblast cytoskeleton. J. Periodont. Res., roč. 37, 2002, s. 230–235.

24. Reichart, P. A.: Identification of risk groups for oral precancer and cancer and preventive measures. Clin. Oral Investig., roč. 5, 2001, č. 4, s. 207–213.

25. Rodriguez-Argueta, O. F., Figueiredo, R., Valmaseda-Castellon, E., Gay-Escoda, C.: Postoperative complications in smoking patients treated with implants: a retrospective study. J. Oral Maxillofac. Surg., roč. 69, 2011, s. 2152–2157.

26. Shibli, J. A., Piattelli, A., Jezzi, G., et al.: Effect of smoking on early bone healing around oxidized surfaces: A prospective controlled study in human jaws. J. Periodontol., roč. 81, 2010, s. 575–580.

27. Schwartz-Arad, D., Samet, N., Mamlider, A.: Smoking and complications of endosseous dental implants. J. Periodontol., roč. 73, 2002, s. 152–157.

28. Silva, C. O., Ribeiro-Edel, P., Sallum, A. W., et al.: Free gingival grafts: Graft shrinkage and donor-site healing in smokers and non-smokers. J. Periodontol., roč. 81, 2010, s. 692–705.

29. Slezák, R., Ryška, A.: Kouření a dutina ústní. Praha, Havlíček Brain Team, 2006.

30. Sǿrensen, L. T.: Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Arch. Surg., roč. 147, 2012, s. 373–383.

31. Strietzel, F. P., Reichart, P. A., Kale, A., et al.: Smoking interferes with the prognosis of dental implant treatment: A systematic review and meta-analysis. J. Clin. Periodontol., roč. 34, 2007, s. 523–530.

32. Šmejkalová, J., Slezák, R., Hodačová, L., Čermáková, E., Jacob, V., Fiala, Z.: Vliv kouření cigaret na stav chrupu a parodontu. Hygiena, roč. 54, 2009 a), č. 2, s. 44–51.

33. Takeuchi, C. Y. G., Correa-Alfonso, A. M., Pedrazzi, H., Dinelli, W., Palma-Dibb, R. G.: Deposition of lead and cadmium released by cigarette smoke in dental structures and resin composits. Microsc. Res. Tech., roč. 74, 2011, č. 3, s. 287–291.

34. Tomar, S. L., Asma, S.: Smoking attributable periodontitis in the United States: findings from NHANES III. National Health and Nutrition Examination Survey. J. Periodontol., roč. 71, 2000, č. 5, s. 743–751.

35. Vellappally, S., Fiala, Z., Šmejkalová, J., Jakob, V., Sriharsha, P.: Influence of tobacco use in dental caries development. Centr. Eur. J. Public Health, roč. 15, 2007, č. 3, s. 116–121.

36. Wan, C. P., Leung, W. K., Wong, M. C.: et al. Effects of smoking on healing response to non-surgical periodontal therapy: A multi-level modeling analysis. J. Clin. Periodontol., roč. 36, 2009, s. 229–236.

37. Yamano, S., Berley, J. A., Kuo, W. P., et al. Effects of nicotine on gene expression and osseointegration in rats. Clin. Oral Implants Res., roč. 21, 2010, s. 1353–1358.

Maxillofacial surgery Orthodontics Dental medicine
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