Smoking as A Risk Factor for Periodontitis in Erbil City

Author: Saya Mustafa Azeez1
1Department of Orthodontics, Faculty of Dentistry, Tishk International University-Erbil, Kurdistan Region, Iraq

Abstract: Background and Objective: Nicotine in cigarettes can harm the immune system and lead to constriction of blood vessels, plus the blood vessels in the tissues encircling the tooth. Constriction of blood vessels can form an encouraging environment for the growth of microorganisms that cause periodontal disease. The purpose of this study is to verify the risk of smoking on the periodontal health status. Material and Method: a comparative cross-sectional study carried out on 400 patients including 200 smokers and 200 nonsmokers of age range (18-64) years. Chi-square test was used to compare data recorded (p-value <0.05). Results: Most of the smokers were male. Most of the participants didn’t use interdental aid. There was a significant relation between age, gender, smoking habit including frequency and duration, oral hygiene habit, and dental care visit with periodontitis (P-value <0.05). Conclusion: The current study demonstrates smoking as the major etiological factor associated with periodontal tissue destruction.

Keywords: Smoking, Periodontitis, Oral Health

Download the PDF Document

Doi: 10.23918/eajse.v9i1p1

Published: January 9, 2023


Ababneh, K. T., Abu Hwaij, Z. M., & Khader, Y. S. (2012). Prevalence and risk indicators of gingivitis and periodontitis in a multi-centre study in North Jordan: a cross sectional study. BMC oral health, 12, 1.

Abdulkarim, A. A., Mokuolu, O. A., & Adeniyi, A. (2005). Drug use among adolescents in Ilorin, Nigeria. Tropical Doctor, 35(4), 225–228.

Amarasena, N., Ekanayaka, A. N. I., Herath, L., & Miyazaki, H. (2002). Tobacco use and oral hygiene as risk indicators for periodontitis. Community Dentistry and Oral Epidemiology, 30(2), 115–123.

Bergström, J. (2003). Tobacco smoking and risk for periodontal disease. Journal of Clinical Periodontology, 30(2), 107–113.

Calsina, G., Ramón, J. M., & Echeverría, J. J. (2002). Effects of smoking on periodontal tissues. Journal of clinical periodontology, 29(8), 771–776.

Cigarette smoking behaviour [Internet]. [cited 2017 Mar 17]. Available from:

Do, L. G., Slade, G. D., Roberts-Thomson, K. F., & Sanders, A. E. (2008). Smoking-attributable periodontal disease in the Australian adult population. Journal of clinical periodontology, 35(5), 398–404.

Elahe, MS., Elham, MS., & Rarnaz, HF (2015). Passive Smoking: Dental and Oral Effects. Iran Journal Public Health, 44(4): 600-1.
Horning, G. M., Hatch, C. L., & Cohen, M. E. (1992). Risk Indicators for Periodontitis in a Military Treatment Population. Journal of Periodontology, 63(4), 297–302.

Johnson, G. K., & Guthmiller, J. M. (2007). The impact of cigarette smoking on periodontal disease and treatment. Periodontology 2000, 44(1), 178–194.

Johnson, G. K., & Hill, M. (2004). Cigarette Smoking and the Periodontal Patient. Journal of Periodontology, 75(2), 196–209.

Johnson, N. W., & Bain, C. A. (2000). Tobacco and oral disease. EU-Working Group on Tobacco and Oral Health. British dental journal, 189(4), 200–206.

Kaleem, M., Nazir, R., Rafi, S., & Manzoor, MH (2009). Association between cigarette smoking and periodontitis in Pakistani population. Pakistan oral and dental Journal, 29(2) :345-52.

Kerdvongbundit, V., & Wikesjö, U. M. (2000). Effect of Smoking on Periodontal Health in Molar Teeth. Journal of Periodontology, 71(3), 433–437.

Lung, Z. H. S., Kelleher, M. G. D., Porter, R. W. J., Gonzalez, J., & Lung, R. F. H. (2005). Poor patient awareness of the relationship between smoking and periodontal diseases. British Dental Journal, 199(11), 731–737.

Machuca, G., Rosales, I., Lacalle, J. R., Machuca, C., & Bullón, P. (2000). Effect of Cigarette Smoking on Periodontal Status of Healthy Young Adults. Journal of Periodontology, 71(1), 73–78.

Martinez-Canut, P., Lorca, A., & Magan, R. (1995). Smoking and periodontal disease severity. Journal of Clinical Periodontology, 22(10), 743–749.

Natto S. B. (2005). Tobacco smoking and periodontal health in a Saudi Arabian population. Swedish dental journal. Supplement, (176), 8-52.

Newman, MG., Takei, HH., Klokkevold, PP., & Caranza, FA (2015). Caranza’s Clinical Periodontology. 12th ed. Canada: Elsevier Saunders. P. 178-85.

Ojima, M., Hanioka, T., Tanaka, K., Inoshita, E., & Aoyama, H. (2006). Relationship between smoking status and periodontal conditions: findings from national databases in Japan. Journal of periodontal research, 41(6), 573–579.

Papapanou P. N. (1996). Periodontal diseases: epidemiology. Annals of periodontology, 1(1), 1–36.

Persson, R. E., Kiyak, A. H., Wyatt, C. C. I., MacEntee, M., & Persson, G. R. (2005). Smoking, a weak predictor of periodontitis in older adults. Journal of Clinical Periodontology, 32(5), 512–517.

Russell A. L. (1956). A system of classification and scoring for prevalence surveys of periodontal disease. Journal of dental research, 35(3), 350–359.

Russell A. L. (1967). The Periodontal Index. Journal of periodontology, 38(6), 585–591.

Suratri, M.A.L., & Notohartojo, I.T. (2016). Smoking as a risk factor for periodontal disease. Health Sci J Indones, 7(2): 107-12.

Susin, C., & Albandar, J. M. (2005). Aggressive Periodontitis in an Urban Population in Southern Brazil. Journal of Periodontology, 76(3), 468–475.

Susin, C., Haas, A. N., Valle, P. M., Oppermann, R. V., & Albandar, J. M. (2011). Prevalence and risk indicators for chronic periodontitis in adolescents and young adults in south Brazil. Journal of Clinical Periodontology, 38(4), 326–333.

Tomar, S. L., & Asma, S. (2000). Smoking-attributable periodontitis in the United States: findings from NHANES III. National Health and Nutrition Examination Survey. Journal of periodontology, 71(5), 743–751.

Torrungruang, K., Tamsailom, S., Rojanasomsith, K., Sutdhibhisal, S., Nisapakultorn, K., Vanichjakvong, O., Prapakamol, S., Premsirinirund, T., Pusiri, T., Jaratkulangkoon, O., Unkurapinun, N., & Sritara, P. (2005). Risk indicators of periodontal disease in older Thai adults. Journal of periodontology, 76(4), 558–565.

WPRO | Smoking Statistics [Internet]. WPRO. [cited 2017 Mar 16]. Available from: