Tobacco smoking and periodontal hemorrhagic responsiveness

Objective: The influence of smoking on the periodontal hemorrhagic responsiveness was investigated in 2 different populations, one exclusively consisting of patients with established periodontal disease, the other of dental hospital admissions in general. Material and Methods: The hemorrhagic responsiveness of the patient was clinically found from bleeding on gentle probing expressed as the relative frequency of bleeding sites (%). In the periodontal patient population, gingival bleeding was assessed by 1 examiner with known probing force, whereas in the dental hospital admissions population assessments were done by a great number of non-calibrated examiners with unknown probing force. Results: Smokers exhibited a significantly lower hemorrhagic responsiveness than non-smokers. This held principally true for both populations but the effect was much more clearly detectable in periodontal patients than in dental hospital patients in general. A dose-reponse effect was typically evident in the periodontal patient population. Accounting for the periodontal disease severity, however, the effect of smoking became clearly detectable also in the general patient population. Conclusion: Tobacco smoking is associated with a clinically suppressed hemorrhagic responsiveness of the periodontium.