Serum Cotinine Levels, Smoking, and Periodontal Attachment Loss

Abstract

Cigarette smoking and tobacco use have been the subjects of numerous studies for many years. Smoking has also been associated with periodontal disease. However, no relationship between a reliable biochemical marker and increased severity of the periodontal condition has yet been described. It was thus the aim of this study to apply the measurement of cotinine, the major metabolite of nicotine, as a quantitative method to assess levels of smoking, and to correlate serum levels of cotinine with severity of periodontal disease. The degree of association between smoking and periodontal attachment loss was investigated in a study including 79 patients 25 to 64 years old suffering from periodontitis. Patients were examined and the following parameters recorded: Gingival Assessment (GA), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), and Bone Crest Height (BCH). In addition, self-reported histories of tobacco use as well as blood samples for quantitative analysis of serum levels of cotinine were taken. The serum samples were analyzed for cotinine content by means of a competitive-inhibition ELISA technique. The differences in mean cotinine levels were statistically significant (p = 0.0001) between smokers and non-smokers, showing no overlap between the groups. Severity of periodontal attachment loss was positively correlated with serum levels of cotinine for both measures of periodontal disease (CAL p = 0.005; BCH p = 0.008). Results from the present study indicate that serum cotinine levels used as a biochemical marker of smoking status are correlated with severity of periodontal attachment loss.

Association between anxiety and depression with chronic periodontitis

“…Tobacco nicotine and its byproducts have a vasoconstrictive effect, not only on peripheral circulation but also on coronary, placental, and gingival blood vessels as well. 18 In addition, smoking may reduce the functional activity of leukocytes and macrophages in saliva and crevicular fluid, as well as decreasing chemotaxis and phagocytosis of blood and tissue polymorphonuclear leukocytes, thereby likely depressing phagocyte-mediated protective responses to periodontal pathogens. 19 The study also revealed that both plaque and gingival index scores were higher in the Periodontitis group compared to Group 1.…”

The Relationship between Serum Cotinine Levels and Periodontal Status

“…Unfortunately, the utility of the finer measure will be limited to the abilities of the participants to gauge their true intake accurately (Gonzalez et al, 1996;Klesges et al, 1995).…”

Smoking and Periodontal Disease

“…However, it should be remembered that all retrospective studies are subject to recall bias, and while some studies have quantified lifetime exposure in packyears, current levels of smoking may not reflect past exposure. In one of the few studies which, to date, have measured cotinine, the severity of periodontal destruction, measured either as clinical attachment level or crestal bone height, was shown to be statistically positively correlated with serum cotinine levels (Gonzalez et al, 1996). Cotinine is the principle metabolite of nicotine and as such provides a valuable quantitative measure of smoking status.…”