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. 2018 Feb 2;11:47-54.
doi: 10.2147/IJGM.S150553. eCollection 2018.

Alterations in Oral Microbial Flora Induced by Waterpipe Tobacco Smoking

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Free PMC article

Alterations in Oral Microbial Flora Induced by Waterpipe Tobacco Smoking

Muhamad Ali K Shakhatreh et al. Int J Gen Med. .
Free PMC article

Abstract

Background: Waterpipe smoking is a global health problem and a serious public concern. Little is known about the effects of waterpipe smoking on oral health. In the current study, we examined the alterations of oral microbial flora by waterpipe smoking.

Methods: One hundred adult healthy subjects (59 waterpipe smokers and 41 non-smokers) were recruited into the study. Swabs were taken from the oral cavity and subgingival regions. Standard culturing techniques were used to identify types, frequency, and mean number of microorganisms in cultures obtained from the subjects.

Results: It was notable that waterpipe smokers were significantly associated with a history of oral infections. In subgingiva, Acinetobacter and Moraxella species were present only in waterpipe smokers. In addition, the frequency of Candida albicans was higher in the subgingiva of waterpipe smokers (p = 0.023) while the frequency of Fusobacterium nucleatum was significantly lower in the subgingiva of waterpipe smokers (p = 0.036). However, no change was observed in other tested bacteria, such as Campylobacter species; Viridans group streptococci, Enterobacteriaceae, and Staphylococcus aureus. In oral cavity and when colony-forming units were considered, the only bacterial species that showed significant difference were the black-pigmented bacteria (p < 0.001).

Conclusion: This study provides evidence indicating that some of the oral microflora is significantly altered by waterpipe smoking.

Keywords: hookah; oral microflora; smoking; tobacco; waterpipe.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
A waterpipe machine. The major components of a waterpipe machine are labeled and include the head, stem, vase, and hose.
Figure 2
Figure 2
Frequency of some microbes in the waterpipe smokers isolated from the subgingiva of participants. Significant changes in the frequency of (A) Fusobacerium nucleatum and (B) Candida albicans in the subgingiva of participants. *Indicates significant changes (p < 0.05) using the chi-square test.
Figure 3
Figure 3
Frequency of some microbes in the waterpipe smokers isolated from the oral cavity of the participants. Significant changes in the frequency of black-pigmented bacteria. *Indicates significant changes (p < 0.05) using the chi-square test.

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