Clinical indicators of gingival inflammation in smokers with periodontitis

Abstract

Relevance. According to the latest international classification of periodontal diseases of 2018, smoking, along with diabetes mellitus, belongs to the main modifying factors of the periodontitis course. At the same time, the clinical signs of gingival inflammation in smokers are not very pronounced.The study aimed to determine significant clinical indicators of gingival inflammation in tobacco-dependent peri- odontal patients.Materials and methods. The study interviewed and examined 82 patients with generalized periodontitis aged 20 to 63 years. Patients with diabetes mellitus were excluded. The examination evaluated the caries prevalence (DMFT index), the degree of periodontal attachment loss, the periodontitis progression type by an indirect indicator, oral hygiene status (Green-Vermilion index), tooth mobility (D.A. Entin), bleeding on probing (Mühlemann modified by Cowell; Ainamo, Wow). Based on their attitude to smoking, patients were randomized into three groups: the first group consisted of 18 patients who smoked up to 10 cigarettes per day; the second group included 15 patients who smoked 10-20 or more cigarettes per day; and the third group (comparison group) consisted of 18 non-smokers.Results. The oral hygiene status, caries prevalence, the number of extracted teeth, the mobility of remaining teeth and the bleeding on probing score appeared to be the same in non-smoking and smoking periodontal patients. However, the number of patients with severe periodontitis was statistically significantly higher in heavy smokers with periodontitis (more than ten cigarettes per day); every other patient had comorbidity, rapid progression of the disease, and the clinical indicator of gingival inflammation based on the prevalence of bleeding on probing was at 100%.Conclusion. We believe that the prevalence of bleeding on probing should be the main parameter for gingival inflammation assessment in smokers, which allows for the objective follow-up of the process progression in such patients and motivation for treatment and smoking cessation.