“…At the time, the aforementioned systematic review included only five studies (Al-Belasy, 2004; Baljoon, Natto, Abanmy, & Bergström, 2005; Natto, Baljoon, Abanmy, & Bergström, 2004; Natto, Baljoon, & Bergström, 2005a, 2005b; Natto, Baljoon, Dahlén, & Bergström, 2005) with only two related to PD (Natto et al, 2004, 2005b). By the end of 2018, almost 10 studies had evaluated the effects of narghile use on the periodontium, and their results were controversial (Al-Alimi et al, 2018; Al-Mufti & Saliem, 2018; Bibars, Obeidat, Khader, Mahasneh, & Khabour, 2015; Javed et al, 2016; Khemiss, Ben Khelifa, Ben Rejeb, & Ben Saad, 2016; Khemiss, Ben Khelifa, & Ben Saad, 2017; Malik, Khan, Rahman, & Malik, 2012; Mokeem et al, 2018; Natto et al, 2004, 2005b). According to Malik et al (2012), the worst nightmare for narghile smokers is PD.…”