Although most studies report smoking to increase the risk of periodontal disease in the order of two- to six-fold, a study carried out in Northern Ireland suggested that the odds ratio for established periodontitis in a group of 82 young subjects (20 to 30 years of age) who regularly attended their dentist was as high as 14.1(Linden and Mullally, 1994). Further evidence of the particularlv damaging effects of smoking on periodontal health in younger people was reported in a Swedish study. This longitudinal study investigated tooth loss in 273 individuals who were followed for a ten-year period. The risk attributable to smoking in younger males smoking more than 15 cigarettes per day was reported as 78% (Holm, 1994). This is given further weight by the findingsof Haber and colleagues, who, in determining the role of smokincg as a risk factor for periodcntitis in diabetic and non-diabetic study groups, suggested that in the non-diabetic group 51% of the periodontitis in the 19-30-year-olds and 32% in those aged 31 to 40 years were associaled with smoking (Haber et c1l., 1993). [emphasis added]
More, smokers account for roughly 90% of all cases of severe, persistent and treatment-resistant periodontitis. Tooth loss is almost a given, with smokers having up to a 4.5 fold higher risk than nonsmokers.
(For more on the smoking/gum disease/tooth loss relationship, see this and this .)
Is it any wonder some periodontists (dentists who specialize in the gums and other tissues supporting the teeth) refuse to treat smokers until they quit their habit? The odds of treatment success are none too good – but vastly improve if the individual quits using tobacco.
Wow, you say, that’s bad. But it doesn’t affect me. I don’t smoke.
But you may in fact be doing something – or not doing something, as the case may be – that significantly raises your odds of progressive periodontal disease: not getting enough sleep.
According to a 2007 Journal of Periodontology study of how various lifestyle factors – tobacco use, diet, sleep and so on – affect the course of gum disease, WebMD reported ,
Lack of sleep was the second most important lifestyle factor affecting periodontal disease with those who received seven to eight hours of sleep per night showing less periodontal disease progression than those who received six or fewer hours of sleep per night. High stress levels and daily alcohol consumption also had an impact on periodontal disease progression.
Of course, stress can contribute to sleep loss – both in total time at rest and the quality of that sleep – and both of these are associated with higher cortisol levels, as is inflammation, a key factor in gum disease. It’s a kind of perfect hormonal storm. Ultimately, it wreaks havoc on the immune system, increasing risk of all manner of systemic conditions. Vulnerabilities become compounded.
Happily, the solution is clear: Change those lifestyle factors that may be contributing to the disease. Between that, ramping up home hygiene and having professional periodontal treatment, you could save yourself a lot of time, trouble and more than a few teeth.