Supragingival Microbiome Alternations as a Consequence of Smoking Different Tobacco Types and Its Relation to Dental Caries

Abstract

This study aimed to assess the effect of smoking different tobacco types on the supragingival microbiome and its relation to dental caries. Forty supragingival plaques were collected from smokers of a single tobacco type and non-smokers seeking treatment at the University Dental Hospital Sharjah, UAE. DMFT (decayed, missing and filled teeth) was determined for all participants who were divided into two groups: no-low caries (NC-LC: DMFT= 0-4; n=18) and moderate-high caries (MC-HC: DMFT= 5-20; n=22). 16S rRNA gene was sequenced using third-generation sequencing with Nanopore technology. Microbiome composition and diversity were compared. Caries were most common among cigarette smokers. Supragingival microbiota were significantly altered among smokers of different tobacco types. In cigarette smokers, cariogenic bacteria from genus Streptococcus (including S. mutans) were significantly more among subjects with NC-LC, while Lactobacilli (including L. fermentum) were more among subjects with MC-HC. In medwakh smokers, several periodontopathogens were significantly elevated in subjects with NC-LC, while other pathogenic bacteria (as Klebsiella pneumoniae) were more in those with MC-HC. Cigarette and alternative tobacco smoking had a significant impact on the supragingival microbiome. Dysbiosis triggered by smoking can be a predisposing factor to caries. Tobacco cessation and oral health-promoting strategies are required to prevent dental caries when the oral microbiome is disturbed.

Impact of waterpipe smoking on the salivary microbiome

“…A few cigarette smoking studies reported a lack of difference in alpha diversity; this difference could be attributed to the type of tobacco used, sample size, and geographical heterogeneity (25)(26)(27). Our result showed that a significantly higher abundance of Firmicutes and Streptococcus is a feature of the waterpipe smoker, consistent with existing literature on cigarette smoking (26)(27)(28). These results were also consistent with a study performed with supragingival plaque samples of waterpipe smokers, where Al-Marzooq et al found that phyla Firmicutes was the most abundant and abundance of Proteobacteria and Actinobacteria were significantly higher in waterpipe smokers.…”

“…These results were also consistent with a study performed with supragingival plaque samples of waterpipe smokers, where Al-Marzooq et al found that phyla Firmicutes was the most abundant and abundance of Proteobacteria and Actinobacteria were significantly higher in waterpipe smokers. It was also found that Bacteroidota were significantly more common in non-smokers (28). However, in our study, though Firmicutes was the most abundant phylum, Proteobacteria was depleted, and Bacteroidota showed a minor increase in abundance in waterpipe smokers.…”

Effect of different forms of tobacco on the oral microbiome in healthy adults: a systematic review

“…Studies conducted using an oral rinse and saliva of cigarette and tobacco smokers were enriched with phylum Actinobacteria in current users (25,28,46,49). Similarly, an abundance of Actinobacteria in water pipe smokers was reported in another study (36). Bacteroidetes dominated smoker and chewer samples in two studies (22,29) compared to another, which reported a lower relative abundance in cigarette smokers compared to e-cigarette users and controls (23).…”

“…Screening of articles by title and abstract and reviewing of full text resulted in 36 eligible articles for full text (Figure 1). Of the 36 articles, nine were from the United States of America (18)(19)(20)(21)(22)(23)(24)(25)(26), six were from India (15, 27-31), five were from the United Arab Emirates (32)(33)(34)(35)(36),three were from China (37-39), two from Japan (40,41) and others including Brazil (42), Jordan (43), Hungary (44), Croatia (45), Iran (46), Germany (47), Denmark (48), Italy (49), Sudan (50), Ireland (51) and Korea (52).…”

“…As displayed in Table 2 (42-52), all included studies except five assessed microbial diversity and richness (23,28,31,38,45). Five studies reported no difference in diversity difference between the smokers and control groups (34,36,41,49,52). Four studies (21,26,40,42) reported lower diversity and richness in smokers.…”