Volume 6 Issue 5 May 2016
Consultation Liaison Psychiatry Focus: ‘Dentistry’
Tobacco use in any form has the potential to profoundly alter the systemic and oral health of the individual. The use of tobacco is associated with a wide spectrum of disease affecting the general health and oral health in particular. Apart from causing oral cancers, it has also been recognized to be a significant risk factor for periodontal disease which is a common bacterial infection that affects the gingiva and bone supporting the teeth. The relationship between smoking and periodontitis has been studied extensively and it has been proved to be strongly associated with destruction of supporting tissues of the teeth, with ensuing clinical symptoms like attachment loss, pocket formation, severe alveolar bone loss which results in loosening of the teeth. Smokeless forms of tobacco lead to white lesions in the oral cavity which further ends in oral carcinoma. Nicotine, a major component and the most pharmacologically active agent in tobacco is likely to be a significant contributing factor for the exacerbation of periodontal diseases. Available literature suggests that nicotine causes vascular alterations in the gingiva, decreased IgG production, decreased lymphocyte proliferation, and altered fibroblast attachment which can be the possible mechanisms responsible for overall effects of tobacco on periodontal tissues.
The ability to control the ill effects of tobacco will depend on two cornerstones: prevention and early diagnosis. Educational campaigns to educate the public about the risk factors and early signs/symptoms associated with this disease. Individuals also need to be encouraged to seek regular professional oral examinations by a dentist and/or physician. Multidisciplinary approach, integrated clinics, training of health professionals and medical students for comprehensive assessment and holistic management of patients with tobacco and other substance dependence are vital steps to curb drug menace and promoting healthy life style.
Dr. Monica M, MD, Reader, Department of Public Health Dentistry, Sri Sai College of Dental Surgery, Vikarabad, Telanagana. Email: docmonica81@yahoo.co.in
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