Smoking also affects the maintenance phase

A previous article (Smoking & periodontitis ) explained the severe effects of smoking on the periodontium. But how does a smoker’s periodontium behave compared with a non-smoker’s periodontium during the periodontal maintenance phase after active periodontal treatment?

This question was investigated by two Brazilian researchers (Costa & Cota 2019), who compared the results for 142 patients in periodontal maintenance therapy over a period of 6 years with regard to their smoking status. All patients came to periodontal maintenance therapy at least once per year over the 6 years. The smoking status of the patients could be classified as follows:

A ‘periodontal relapse’ was defined as a site with a pocket probing depth of ≥ 4 mm and clinical loss of attachment of ≥ 3 mm in conjunction with bleeding on probing and/or suppuration.

The following results were recorded after 6 years of periodontal maintenance therapy:

This study shows very clearly that, following successful periodontal treatment, both smokers and former smokers have a substantially higher risk of relapse and thus of needing further periodontal treatment.

* Tip!
Pack years among smokers are calculated by means of the following formula:
number of cigarettes smoked per day divided by 20 and multiplied by the number of years the patient has been smoking. For example, a smoker who has smoked 30 cigarettes per day for 5 years corresponds to 7.5 pack years (30/20*5).

Reference

1. Costa FO, Cota LOM. Cumulative smoking exposure and cessation associated with the recurrence of periodontitis in periodontal maintenance therapy: A 6-year follow-up. J Periodontol. 2019;90:855–865. https://doi.org/10.1002/JPER. 18-0635