Smoking

• How does smoking affect blood flow to oral tissues?

  It reduces blood flow, affecting disease depiction
• Why might bleeding index (BI) be misleading in smokers?

  Advanced periodontal disease may be hidden
• What effect do chemicals and nicotine have on oral tissues?

  They cause keratinisation, increasing cancer risk
• How does nicotine affect the immune response?

  It inhibits the immune response, increasing infections
• What is a consequence of nicotine on healing after periodontal treatment?

  Longer healing periods are required for smokers
• How much more likely are smokers to require additional periodontal treatment?

  They are more likely to require additional treatment
• What is the increased risk of oral cancer for smokers compared to non-smokers?

  Three times more likely to develop oral cancer
• How does the duration and amount of smoking affect damage to oral health?

  Damage is dose-dependent; more smoking equals more damage
• What taste disturbances can smoking cause?

  It can cause disturbances to the tongue's taste
• How does smoking lead to dry mouth?

  It reduces salivary flow, affecting oral health
• What oral health issue can arise from dry mouth due to smoking?

  It can lead to calculus deposits and periodontal disease
• How can smoking contribute to periodontal disease through staining?

  Staining creates a plaque-retentive surface
• What is the effect of smoking on the keratinisation of oral mucosa?

  It causes over keratinisation, increasing ulceration risk
• What is the relationship between smoking and oral cancer risk?

  Smokers are three times more at risk
• What are the benefits of quitting smoking?

  • Improved periodontal health
  • Reduced cancer risk
  • Enhanced immune response
  • Better healing after treatments
• What information should be gathered before a patient decides to quit smoking?

  Detailed smoking history and triggers for smoking
• What is the 3 As approach to smoking cessation?

  Ask, Advise, Act
• How can a quit date help a patient stop smoking?

  It serves as a motivational target
• What is nicotine replacement therapy (NRT)?

  It includes patches and gum to reduce cravings
• What should patients expect regarding gum bleeding after quitting smoking?

  Gums may bleed more due to increased blood flow
• What prescription medications can be used to help stop smoking?

  Varenicline and bupropion
• What advice can be given about e-cigarettes for smoking cessation?

  Provide information, but they aren't prescribed
• What alternative activities can help with nicotine cravings?

  Making tea, eating snacks, going for a walk
• What dietary advice should be given to patients who snack while quitting?

  Encourage low sugar alternatives for snacks
• How can changing daily routines help in quitting smoking?

  It prevents falling into old habits
• What oral health instructions should be given after quitting smoking?

  Review tooth brushing methods and cleaning types
• What services can support patients in quitting smoking?

  • Referral to NHS stop-smoking services
  • Community pharmacy support
  • Smokefree National Helpline: 0300 123 1044
• How does smoking act as a modifiable risk factor for periodontal disease?

  It can be changed to reduce disease risk
• What oral infections are smokers more likely to develop?

  They are more likely to develop candida infections
• How does smoking cause vasoconstriction in the gingiva?

  It reduces blood flow to the gingival tissues
• What is the impact of nicotine and cotinine on periodontal health?

  They prevent clinical re-attachment in the gums
• How does smoking impair healing after root surface debridement (RSD)?

  It inhibits fibroblast growth, delaying healing
• What is the effect of smoking on neutrophil levels?

  It lowers neutrophil counts, impairing immune response
• How does reduced salivary flow from smoking affect oral health?

  It increases plaque accumulation and caries risk
• What staining effect does smoking have on oral health?

  It creates a plaque-retentive surface, worsening disease
• What is the risk of ulceration in smokers due to oral mucosa changes?

  Over keratinisation increases ulceration risk
• How does smoking affect the risk of developing oral cancer?

  It increases the risk by three-fold