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Smoking cessation may decrease risk of tooth loss

By Dental Tribune International
December 06, 2019

SÃO PAULO, Brazil: Smoking cessation has been shown to have a positive impact on the outcome of periodontal therapy. Previous reviews have addressed the association between smoking and tooth loss, which is the final outcome of periodontal disease. However, so far, no systematic review has evaluated the effect of smoking cessation on tooth loss. Therefore, researchers from the University of São Paulo School of Dentistry recently investigated this topic and found that former smokers show a decreased risk compared with current smokers.

In a qualitative review, 21 studies were included, of which 12 were included in a quantitative analysis. An analysis of cross-sectional studies did not show any differences between former and current smokers regarding the risk of loss of one or more teeth, of loss of more than eight teeth or of complete edentulism. The research team believed that the inherent limitations of cross-sectional studies, especially the absence of information about the temporal relationship between cause (smoking cessation) and effect (tooth loss), were possible reasons for this lack of effect.

However, analysis from longitudinal studies showed that the rate of tooth loss in former smokers is similar to that in those who have never smoked. Moreover, current smokers have a risk of tooth loss twice as high as that of those who have never smoked.

According to the researchers, the most plausible biological explanation for the increased risk of tooth loss in smokers is the destruction of the periodontal supporting tissue. “Smoking does have a long-standing negative influence on oral health. After the subject stops smoking, it takes some months for the body to return to its normal immune-inflammatory conditions. It takes even more time—years—when it comes to serious outcomes, such as cardiovascular disease risk, or cancer risk,” explained study author Dr. Cláudio Mendes Pannuti, associate professor in the stomatology department at the university.

“After smoking cessation, the periodontal conditions slowly return to the same level of never smokers. But even after one to two years, the benefits are small, as demonstrated by a study from my research group from 2014 and by a study from the University of Newcastle upon Tyne from 2005. Thus, it may take many years—between five to ten—of abstinence for the risk of tooth loss in smokers to return to the level of never smokers,” he continued.

According to Mendes Pannuti, the duration of smoking cessation is very relevant and this period varied among the different studies. “In some studies, only after ten years the risk of tooth loss in former smokers was equivalent to the risk in never smokers,” he said.

“As health professionals, dentists should encourage their patients to quit smoking. Smoking cessation decreases the progression of periodontal disease, the risk of tooth loss and it may even decrease the risk of implant failure,” concluded Mendes Pannuti.

The study, titled “Effect of smoking cessation on tooth loss: A systematic review with meta-analysis,” was published on Nov. 12, 2019, in BMC Oral Health.

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