The effects of smoking on periodontal structures: a literature review.

Periodontal disease seems to be more prevalent in smokers than in nonsmokers. Studies have reported both increases and decreases in gingival blood flow due to smoking. Smoking does not increase the presence of the periodontopathogens Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Bacteroides intermedius. Both the chemotaxis and the phagocytic capacity of the polymorphonuclear leukocytes (PMNs) harvested from smokers are lower than with those harvested from nonsmokers. Furthermore, smokers have lower IgA, IgG, IgM, and suppressor CD8 lymphocytes levels than nonsmokers. These differences between smokers and nonsmokers should be taken into account by clinicians during periodontal examinations, therapy, and the healing process.