Smoking Periodontal Treatment — ORE Part 1 MCQ
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Correct answer: D — It reduces response to periodontal therapy and increases tooth-loss risk
Explanation lettering: B = shown as A · C = shown as B · D = shown as C · A = shown as D
**A is correct.** Smoking is a dose-related risk factor for periodontitis and adversely affects treatment response. UK SDCEP guidance states that patients who smoke respond less well to periodontal treatment than non-smokers and are more likely to lose teeth. Evidence also shows less probing-depth reduction and clinical-attachment gain after both non-surgical therapy and periodontal flap surgery in smokers. Therefore, smoking cessation should be addressed as part of periodontal care. B and C contradict the established adverse effect on healing and clinical outcomes. D is incorrect because smoking affects periodontal disease and response to treatment, not merely gingival colour. E is incorrect because smoking has an important, well-established periodontal effect.
Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Prevention and Treatment of Periodontal Diseases in Primary Care, 2nd edition, Section 5.1.1 Smoking cessation, November 2025. https://www.periodontalcare.sdcep.org.uk/media/vjgfn5ak/sdcep-prevention-and-treatment-of-periodontal-diseases-in-primary-care-2nd-edition-nov-2025.pdf