Personalized periodontal treatment for the tobacco- and alcohol-using patient

Periodontol 2000. 2018 Oct;78(1):30-46. doi: 10.1111/prd.12229.

Abstract

The use of various forms of tobacco is one of the most important preventable risk factors for the incidence and progression of periodontal disease. Tobacco use negatively affects treatment outcomes for both periodontal diseases and conditions, and for dental implants. Tobacco-cessation programs can mitigate these adverse dental treatment outcomes and may be the most effective component of a personalized periodontal treatment approach. In addition, heavy alcohol consumption may exacerbate the adverse effects of tobacco use. In this review, the microbiology, host/inflammatory responses and genetic characteristics of the tobacco-using patient are presented as a framework to aid the practitioner in developing personalized treatment strategies for these patients. These personalized approaches can be used for patients who use a variety of tobacco products, including cigarettes, cigars, pipes, smokeless tobacco products, e-cigarettes and other tobacco forms, as well as patients who consume large amounts of alcohol. In addition, principles for developing personalized tobacco-cessation programs, using both traditional and newer motivational and pharmacological approaches, are presented.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Alcohol Drinking* / adverse effects
  • Alcohol Drinking* / genetics
  • Alcohol Drinking* / psychology
  • Alcohol Drinking* / therapy
  • Dental Care
  • Electronic Nicotine Delivery Systems
  • Humans
  • Nicotiana / adverse effects*
  • Periodontal Diseases / genetics
  • Periodontal Diseases / microbiology
  • Periodontal Diseases / psychology*
  • Periodontal Diseases / therapy*
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / psychology
  • Smoking / therapy
  • Smoking Cessation / methods
  • Smoking Cessation / psychology
  • Tobacco Products / adverse effects*
  • Tobacco Use Cessation / methods
  • Tobacco Use Cessation / psychology
  • Tobacco, Smokeless / adverse effects