Systematic Review and Meta-analysis of the Association Between Exposure to Environmental Tobacco Smoke and Periodontitis Endpoints Among Nonsmokers

Abstract

Objective: A systematic review was conducted to summarize the epidemiological evidence on environmental tobacco smoke (ETS) exposure and prevalent periodontitis endpoints among nonsmokers. Methods: We searched PubMed, EMBASE, Web of Science, Pro-Quest dissertations, and conference proceedings of a dental research association. We included studies from which prevalence odds ratios (POR) could be extracted for periodontitis determined by examiner measurements of clinical attachment level (CAL) and/or probing pocket depth (PD) or self-report of missing teeth. Studies determined ETS exposure by self-report or biomarker (cotinine) levels. Results: For studies reporting CAL and/or PD (n = 6), associations were stronger with cotininemeasured exposure (n = 3; random effects POR [95% prediction interval] = 1.63 (0.90, 2.96)) than self-reported exposure (n = 3; random effects POR = 1.15 (0.68, 1.96)). There was no meaningful difference in summary estimate for studies reporting CAL and/or PD endpoint (n = 6; random effects POR = 1.34 (0.93, 1.94)) as opposed to tooth loss (n = 2; random effects POR = 1.33 (0.52, 3.40)).Conclusions: There appears to be a positive association between exposure to ETS and prevalent periodontitis endpoints among nonsmokers, the magnitude of which depended mostly on the method of ETS assessment. Implications: The notoriety of ETS is often discussed in terms of its associations with cancer, chronic conditions like cardiovascular diseases, and respiratory illnesses in children. However, very little attention is paid to its association with oral diseases, especially periodontitis. Periodontitis affects a large proportion of the population and is a major cause of tooth loss. This study summarized the epidemiologic association between exposure to ETS and periodontitis among nonsmokers. Although the findings are consistent with a positive association, methodological weaknesses relating to study design, assessment of ETS, periodontitis, and adjustment covariates were highlighted and recommendations for improvement in future studies provided.

Antimicrobial peptides as a possible interlink between periodontal diseases and its risk factors: A systematic review

“…Previous studies have indicated that smoking, which may suppress an innate immune response of periodontal tissue, is a major risk factor for periodontitis . Several in vitro studies have determined that smoking can affect the expression of AMPs in gingival epithelial cells or skin keratinocytes (Table ).…”

“…Previous studies have indicated that smoking, which may suppress an innate immune response of periodontal tissue, is a major risk factor for periodontitis. [16][17][18] Several in vitro studies [19][20][21][22] have determined that smoking can affect the expression of AMPs in gingival epithelial cells or skin keratinocytes (Table 1). Besides, some cross-sectional, in vivo studies [23][24][25] have sought to identify the effect of smoking or nicotine use on AMP expression in saliva or gingival crevicular fluid of periodontitis patients ( Table 1) HGECs -HBD-2: (i) experimental group with cigarette exposed for 15 or 30 min>non-exposed group (control group) (P<.05); (ii) experimental group with cigarette exposed after 24 h>non-exposed group (control group) (P<.01); (iii) experimental group with cigarette exposed after 30 min>experimental group with cigarette exposed after 15 min (P<.05); HBD-3: (i) experimental group with cigarette exposed after 3 h>nonexposed group (control group) (P<.01); (ii) experimental group with cigarette exposed after 30 min>experimental group with cigarette exposed after 15 min (P<.01) HNP, produced by neutrophils, are very abundant in tissue and secretions of the oral cavity.…”

Tobacco‐induced suppression of the vascular response to dental plaque

“…Tobacco use has been associated with increased disease progression and severity, as well as with refractory disease . Risk appears dose‐related while environmental smoke exposure may also be associated with increased risk of destructive forms of periodontitis . At the population level, smoking alone may account for most cases of periodontitis in adults in developed nations .…”

“…3,4 Risk appears dose-related 1,5,6 while environmental smoke exposure may also be associated with increased risk of destructive forms of periodontitis. [7][8][9] At the population level, smoking alone may account for most cases of periodontitis in adults in developed nations. [10][11][12][13] Indeed, smoking rates and sales each predict periodontitis prevalence.…”

Is the use of Cannabis associated with periodontitis? A systematic review and meta‐analysis

“…6 Considering that periodontitis is more prevalent in elderly individuals and in view of worldwide (especially in developed countries) trend of population aging, an increase of periodontitis prevalence is expected in the near future. 6,7 Based on the fact that tobacco smoke is a well-known risk factor to periodontitis-mainly due to decrease of oxygenation though the vasoconstriction of tissues caused by the nicotine 8 -recent studies have shown that there is also biological plausibility for a possible relationship between periodontal disease and Cannabis use. [9][10][11][12][13][14][15][16] A longitudinal study carried in a birth-cohort in New Zealand showed that Recent studies have shown that there is also biological plausibility for a possible relationship between periodontal disease and Cannabis use, thus the aim of this study was to investigate whether the use of Cannabis is associated with periodontitis.…”