Periodontal disease

Periodontal diseases are inflammatory disorders that may lead to the destruction of periodontal tissues and eventually tooth loss.

One of the major lifestyle-related risk factors for these diseases is smoking 1. It is reported in several in vitro and in vivo studies that smoking can induce oxidative stress 2-5, increase inflammatory responses and reduce the immune response to microorganisms 6,7, and ultimately alter the structure of the mucosal epithelium at the surface of the gingiva 8-10. The risk for a destructive periodontal disease can be 5- to 20-fold greater for a smoker compared with a person who has never smoked 11.


  1. Genco, R. J. et al. Risk factors for periodontal disease. Periodontology 2000 62, 59-94 (2013)
  2. D'Aiuto, F. et al. Oxidative stress, systemic inflammation, and severe periodontitis. J Dent Res 89, 1241-1246 (2010)
  3. Chapple, I. L. et al. The prevalence of inflammatory periodontitis is negatively associated with serum antioxidant concentrations. J Nutr 137, 657-664 (2007)
  4. Tsai, C. C. et al. Lipid peroxidation: a possible role in the induction and progression of chronic periodontitis. J Periodontal Res 40, 378-384 (2005)
  5. Carnevali, S. et al. Cigarette smoke extract induces oxidative stress and apoptosis in human lung fibroblasts. Am J Physiol Lung Cell Mol Physiol 284, L955-963 (2003)
  6. Genco, R. J. Current view of risk factors for periodontal diseases. J Periodontol 67, 1041-1049 (1996)
  7. James, J. A. et al. Effects of tobacco products on the attachment and growth of periodontal ligament fibroblasts. J Periodontol 70, 518-525 (1999)
  8. Coppe, J. P. et al. A role for fibroblasts in mediating the effects of tobacco-induced epithelial cell growth and invasion. Molecular cancer research : MCR 6, 1085-1098 (2008)
  9. Semlali, A. et al. Whole cigarette smoke promotes human gingival epithelial cell apoptosis and inhibits cell repair processes. J Periodontal Res 46, 533-541 (2011)
  10. Villar, C. C. et al. Smoking influences on the thickness of marginal gingival epithelium. Pesqui Odontol Bras 17, 41-45 (2003)
  11. Bergstrom, J. Tobacco smoking and chronic destructive periodontal disease. Odontology 92, 1-8 (2004)