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Smoking and Periodontitis Mechanism — NDEB AFK MCQ

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ModeratePeriodontologySmoking and Periodontitis MechanismNDEB AFK

Which of the following is the mechanism by which smoking increases the risk and severity of periodontal disease?

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Correct answer: E — Nicotine and other tobacco products cause vasoconstriction of gingival blood vessels, impair neutrophil function, reduce antibody production, promote pathogenic biofilm, and create a localised immunosuppressive environment

Smoking adversely affects the periodontium through multiple mechanisms: (1) nicotine causes vasoconstriction, reducing gingival blood flow, masking clinical signs of inflammation (reduced bleeding on probing), and impairing healing; (2) neutrophil function is impaired (reduced chemotaxis, phagocytosis, oxidative burst); (3) antibody production is reduced; (4) pro-inflammatory cytokine levels are altered; (5) the subgingival microflora shifts toward more pathogenic species; (6) fibroblast function and collagen production are impaired. Smokers have 2-8× higher risk of periodontitis and respond less favourably to treatment.

Reference: Newman – Newman and Carranza's Clinical Periodontology, 13th ed., 2019