Despite the routine brushing and flossing, a healthy person's mouth contains a lot of healthy bacteria. New research shows that the mouth of a smoker is a much more chaotic, unhealthy, and more susceptible to invasion by harmful bacteria.
As a whole, smokers, in comparison to nonsmokers, suffer from increased rates of oral diseases, particulary gum disease. This statistic creates a unique challenge for dentists, according to Purnima Kumar, assistant professor of periodontology at Ohio State University. She and her colleagues are involved in a multi-study investigation of the role the body's microbial communities play in preventing oral disease.
"The smoker's mouth kicks out the good bacteria, and the pathogens are called in," said Kumar. "So they're allowed to proliferate much more quickly than they would in a non-smoking environment."
The results suggest that dentists may have to offer more aggressive treatment for smokers and would have very good reason to suggest quitting smoking, Kumar said.
"A few hours after you're born, bacteria start forming communities called biofilms in your mouth," said Kumar. "Your body learns to live with them, because for most people, healthy biofilms keep the bad bacteria away."
She likens a healthy biofilm to a lush, green lawn of grass. "When you change the dynamics of what goes into the lawn, like too much water or too little fertilizer," she said, "you get some of the grass dying, and weeds moving in." For smokers, the "weeds" are problem bacteria known to cause disease.
These factors have to impact how dentists deal with smokers. "It has to drive how we treat the smoking population," she said. "They need a more aggressive form of treatment, because even after a professional cleaning, they're still at a very high risk for getting these pathogens back in their mouths right away."
"Dentists don't often talk to their patients about smoking cessation," she continued. "These results show that dentists should take a really active role in helping patients to get the support they need to quit."
For Kumar, who is a practicing periodontist as well as a teaching professor, doing research has changed how she treats her patients. "I tell them about our studies, about the bacteria and the host response, and I say, 'Hey - I'm really scared for you.' Patients have been more willing to listen, and two actually quit."
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