Navigating the dual burden of dental and periodontal care in individuals who also smoke: an expert review
Kowalski J. La Rosa G.R.M. Di Stefano A. Gangi D. Sahni V. Yilmaz H.G. Fala V. Górska R. Ludovichetti F.S. Amaliya A. Alghalayini D. Raganin M. Chapple I. Kim B.I. Polosa R.
June 2025Elsevier Ltd
Journal of Dentistry
2025#157
Objectives: Smoking poses a significant challenge to oral health, particularly in individuals with dental and periodontal disease. This expert review explores the dual burden of managing periodontal and dental care in smokers, emphasizing the impact of chronic tobacco exposure on disease progression and treatment outcomes. Study Selection, Data, and Sources: Clinical trials, systematic reviews, and international guidelines were consulted where available. Search terms specific to the topic were entered into PubMed, Scopus, and Google Scholar to identify the most relevant literature. Results: Chronic smoking accelerates biofilm re-accumulation and periodontal tissue destruction, complicating treatment outcomes. Smoking cessation remains the most effective strategy for mitigating these risks, improving healing, reducing inflammation, and restoring microbiota balance. Dental professionals play a crucial role in integrating smoking cessation support into periodontal care through evidence-based interventions such as behavioral counseling, pharmacotherapy, and harm reduction strategies. Emerging technologies, including mobile health applications and remote monitoring, enhance patient engagement in smoking cessation efforts. Alternative nicotine products, such as e-cigarettes and heated tobacco products, may serve as harm reduction tools for smokers unwilling to quit, though their long-term effects on oral health remain unclear. Conclusions: A multidisciplinary approach that combines periodontal therapy with tailored smoking cessation interventions is essential for improving oral health outcomes in smokers. Future research should prioritize longitudinal studies to assess the effectiveness of integrated smoking cessation and periodontal treatment strategies. Clinical Relevance: The integration of smoking cessation into routine dental care is essential to improve treatment outcomes and long-term oral health. This review emphasizes the need for evidence-based strategies to manage smokers in dental settings and highlights the importance of further research to refine clinical guidelines.
Oral health , Periodontal disease , Periodontal treatment , Smoking , Smoking cessation
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Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
Addendo srl, Dental Clinic, Catania, Italy
Department of Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India. Institute of Medical Sciences, New Delhi, India
Department of Periodontology, Faculty of Dentistry, Near East University, Nicosia, Turkey
Faladental, Chișinău, Moldova
Nicolae Testemiţanu, State University of Medicine and Pharmacy, Chişinău, Moldova
Dentistry section, Department of Neuroscience, University of Padua, Padua, Italy
Department of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, West Java, Indonesia
Beam Dental Clinics, Amman, Jordan
President of Dental Society of Kazakhstan, Astana, Kazakhstan
M&K Clinic, Astana, Kazakhstan
Periodontal Research Group, The University of Birmingham & Birmingham Community Healthcare Trust, Birmingham, United Kingdom
Department of Preventive Dentistry & Public Oral Health, Yonsei University College of Dentistry, Seoul, South Korea
Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
Faculty of Medicine and Surgery, Kore University of Enna, Italy
Department of Periodontology
Department of Clinical and Experimental Medicine
Addendo srl
Department of Radiation Oncology
Department of Periodontology
Faladental
Nicolae Testemiţanu
Dentistry section
Department of Periodontology
Beam Dental Clinics
President of Dental Society of Kazakhstan
M&K Clinic
Periodontal Research Group
Department of Preventive Dentistry & Public Oral Health
Center of Excellence for the Acceleration of HArm Reduction (CoEHAR)
Faculty of Medicine and Surgery
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