A comparative study on periodontal health among smokers and non-smokers in Bangladesh

Abstract

Background: Smoking is a well-known risk factor for periodontal disease, which can lead to various clinical and biochemical changes in the oral cavity. Despite numerous studies, there is still a need for further understanding of the comparative effect of smoking on periodontal health and inflammatory biomarkers. Objective: To compare the clinical periodontal parameters and biochemical markers between smokers and non-smokers and determine the influence of smoking on periodontal health and inflammation. Methods: A cross-sectional comparative study was conducted involving 100 participants, split into two groups: 50 smokers and 50 non-smokers. Periodontal health was assessed through clinical parameters such as plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP). Biochemical markers including salivary pH, C-reactive protein (CRP), and interleukin-6 (IL-6) levels were also measured. Comparisons between the two groups were made using t-tests for continuous variables and chi-square tests for categorical outcomes. Results: Smokers showed significantly higher PI (2.1 ± 0.5 vs. 1.5 ± 0.3, p < 0.01), GI (1.8 ± 0.6 vs. 1.3 ± 0.4, p < 0.05), PPD (3.2 ± 1.1 mm vs. 2.4 ± 0.8 mm, p < 0.01), and CAL (2.5 ± 1.0 mm vs. 1.9 ± 0.7 mm, p < 0.05) compared to non-smokers. Bleeding on probing was also more frequent in smokers (15% vs. 30%, p < 0.01). Biochemical analysis revealed significantly higher CRP (5.3 ± 1.2 mg/L vs. 3.2 ± 0.8 mg/L, p < 0.05) and IL-6 (12.4 ± 3.1 pg/mL vs. 8.1 ± 2.4 pg/mL, p < 0.05) levels in smokers, though no significant difference in salivary pH was found (6.9 ± 0.2 vs. 7.0 ± 0.3, p = 0.34). Conclusion: Smoking contributes to poorer periodontal health, with higher plaque accumulation, deeper probing pocket depths, greater clinical attachment loss, and more frequent bleeding on probing in smokers compared to non-smokers. Moreover, smoking is associated with elevated systemic inflammation, as evidenced by higher levels of CRP and IL-6. These findings emphasize the importance of smoking cessation programs in improving periodontal health 4.