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The following factors can worsen periodontitis:

- a disturbance of the thyroid gland

- diabetes

- tobacco and drugs

- malnutrition

- certain medications

Proofs are irrefutable on the fact that smoking is the main extrinsic factor causing periodontal diseases. Not only it diminishes the quantity of saliva, stains the teeth and surcharges the tongue, it makes the gums more susceptible to periodontal diseases by :

1. -diminishing the blood flow to gums & the velocity of the blood
   

2. -increasing the blood viscosity
   

3. -diminishing inflammatory response
   

4. -diminishing immune response
   

5. -increasing the quantity of scale on teeth
   

6. -diminishing bone metabolism
   

The severity of periodontitis is directly proportional to the quantity of cigarettes smoked daily. From  8 to 10 cigarettes per 

day, the risks of being affected by periodontitis are increased.

Despite gums treatment, scaling, laser therapy, smokers gums cannot heal properly. Smoking has a harmful effect on the periodontal healing process and is strongly associated with refractory periodontitis (resistant to therapies).

The benefits that come with quitting the smoking habit are demonstrated by many studies : if the patient completely and permanently stops smoking  before the beginning of periodontitis treatment, the response to the treatment will be significantly more favourable and stable in a long term.

PERIODONTICS

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