Effects of Tobacco on Periodontal Disease
Intro
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Periodontal disease is stated to be as old as mankind. Early writings show that magical, religious, and herbal treatments were used for relief. The middle-ages brought methodical therapeutic approaches and the 18th century brought modern treatment with a scientific knowledge base. Before the 1950s, root debridement and tooth extraction were used to treat diseases. The 1970s focused on treatment of periodontal disease symptoms. Goals included elimination of the periodontal pocket, using gingivectomy, flap procedures, and osseous surgery. These procedures resulted in the loss of tissues with no regeneration and elongated teeth. Questions were raised regarding total pocket elimination and by the 1980s, control of subgingival infection was sought by thorough scaling and root planing, with or without antibiotics. Today's focus is on causes, regenerativity, and disease specifics. The restoration of a normal periodontal status is yet to be achieved, in spite of all that is achieved currently with guided tissue regeneration and graft materials. Currently the direction appears to lie in biological mediators with emphasis on preventive strategies (Yilmaz, Efeoglu, Noyan, Kuru, Kilie, & Kuru, 1994, p. 414). Prevention of periodontal disease includes a focus on oral health, which has also been shown to effect the quality of life. Canto, Horowitx, Goodman, Watson, cohen, and Fedele (1999) studied the effects of poor oral health on a veteran population. For t
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There was a positive relationship between degree of smoking and amount of risk (p. 599).
For the present study, 143 patients were studied who underwent four to six sessions of subgingival scaling and root planing as well as oral hygiene instruction. For this study, smokers were found to have less healing and reduction in subgingival Bacteroides forsythus and Porphyromonas gingivalis after receiving treatment. Smokers were compared to former and nonsmokers, thus it was also indicated that smoking cessation restores normal periodontal healing responses (p. 599).
This study demonstrated a stronger methodological section, to include qualification of patients for the study, and elimination of those who had received recent previous periodontal therapy, or antibiotics or antimicrobials. Smoking habits were not only assessed, they were controlled for and offered additional information. Baseline and three month assessments were made. Baseline showed that all three groups had comparable severity of attachment loss. All groups received the same treatment and differed only in smoking habits. Thus it was logically concluded that smoking was the cause of lack of healing (pp. 600, 604).
In a study of 74 patients with periodontit
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Approximate Word count = 2045
Approximate Pages = 8 (250 words per page)
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