The effect of smoking on periodontal treatment response: a review of clinical evidence

Abstract

Background: Smoking has been identified as a significant risk factor for periodontal diseases and is regarded as being responsible for incomplete or delayed healing in patients following treatment. Aim and Method: The aim of this conventional review was to review, collate and tabulate the relative effectiveness of treatments of chronic periodontitis in smokers, non‐smokers and ex‐smokers. Observations: The majority of clinical trials show significantly greater reductions in probing depths and bleeding on probing, and significantly greater gain of clinical attachment following non‐surgical and surgical treatments in non‐smokers compared with smokers. This benefit is also seen at class I and II furcation sites and in patients prescribed systemic or local antimicrobial treatments. Conclusions: Data from epidemiological, cross‐sectional and case–control studies strongly suggest that quitting smoking is beneficial to patients following periodontal treatments. The periodontal status of ex‐smokers following treatment suggests that quitting the habit is beneficial although there are only limited data from long‐term longitudinal clinical trials to demonstrate unequivocally the periodontal benefit of quitting smoking.