The Role of Smoking in Periodontal Status (TRSPS)

The Role of Smoking Habits in Periodontal Health and Disease: A Cross-Sectional Study

484 patients were asked whether they currently smoked and whether they had smoked 100 or more cigarettes during their lifetime. Based on this information, they were divided into two groups: current smokers (test group, n=242) and non-smokers (control group, n=242). Current smokers were defined as individuals who had smoked ≥100 cigarettes in their lifetime and continued smoking. In contrast, non-smokers included individuals who had smoked fewer than 100 cigarettes in their lifetime and were not currently smoking. Participants were also asked about the number of cigarettes smoked per day and the duration of smoking in years, and pack-years were calculated accordingly. Plaque index, gingival index, probing depth, bleeding on probing, gingival recession, and attachment loss were evaluated for both groups. Periodontal health status (Periodontal health, gingivitis, and periodontitis) was assessed by one clinician applying the 2017 World Workshop on Classifying Periodontal and Peri-Implant Diseases and Conditions and the 2023 European Federation of Periodontology's Guidelines. Patients with periodontitis were classified according to stage and grade. This measurement was obtained via a calibrated UNC-15 periodontal probe at each tooth.

Study Overview

• Status: Completed
• Conditions: Periodontal Diseases
• Intervention / Treatment: Other: Intervention

Detailed Description

484 patients were asked whether they currently smoked and had smoked 100 or more cigarettes during their lifetime. Based on this information, they were divided into two groups: current smokers (test group, n=242) and non-smokers (control group, n=242). Current smokers were defined as individuals who had smoked ≥100 cigarettes in their lifetime and continued smoking. In contrast, non-smokers included individuals who had smoked fewer than 100 cigarettes in their lifetime and were not currently smoking. Participants were also asked about the number of cigarettes smoked per day and the duration of smoking in years, and pack-years were calculated accordingly. Plaque index, gingival index, probing depth, bleeding on probing, gingival recession, and attachment loss were evaluated for both groups. Periodontal health status (Periodontal health, gingivitis, and periodontitis) was assessed by one clinician applying the 2017 World Workshop on Classifying Periodontal and Peri-Implant Diseases and Conditions and the 2023 European Federation of Periodontology's Guidelines. Patients with periodontitis were classified according to stage and grade. This measurement was obtained via a calibrated UNC-15 periodontal probe at each tooth.

• Study Type: Observational
• Enrollment (Actual): 484

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Bolu, Turkey (Türkiye), 14030
    • Bolu Abant Izzet Baysal University, Dentistry Faculty

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study includes patients who are smokers and those who are non-smokers.

Description

Inclusion Criteria:

• Age 18 years or older
• No systemic diseases that could affect periodontal or general health
• No history of periodontal treatment within the past six months
• For the non-smoker group: abstinence from smoking for at least five years

Exclusion Criteria:

• Use of antibiotics or anti-inflammatory drugs
• Pregnant or lactating women
• Diabetes mellitus
• Use of waterpipe or chewing tobacco (for the smoker group)
• Individuals undergoing chemotherapy or radiotherapy

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Smoker; Current smokers were defined as individuals who had smoked ≥100 cigarettes in their lifetime and continued smoking.	Other: Intervention; The patient's daily cigarette consumption, duration of smoking, and pack-years were evaluated.; Other Names: Smoking
Non-smoker; Non-smokers included individuals who had smoked fewer than 100 cigarettes in their lifetime and were not currently smoking.	Other: Intervention; The patient's daily cigarette consumption, duration of smoking, and pack-years were evaluated.; Other Names: Smoking

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
periodontal pocket depth	Periodontal pocket depth measured in millimeters using a Williams periodontal probe. The distance from the gingival margin to the bottom of the periodontal pocket was recorded at each site.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
bleeding on probing	Bleeding on probing assessed using a periodontal probe. After gently inserting the probe into the gingival sulcus and moving it laterally along the pocket wall, bleeding was recorded as present (+) or absent (-).pocket and gently moved laterally along the pocket wall. + is maximum and - is minimum.	Baseline
plaque index	Oral hygiene status assessed using the Plaque Index, which measures dental plaque accumulation adjacent to the gingival margin. Scores range from 0 (no plaque) to 3 (abundant plaque), with higher scores indicating poorer oral hygiene.	Baseline
gingival index	Gingival inflammation assessed using the Löe and Silness Gingival Index. Each site was scored on a 0-3 scale, where 0 = normal gingiva and 3 = severe inflammation with edema, redness, and spontaneous bleeding. Higher scores indicate worsening gingival inflammation.	Baseline
clinical attachment level	Clinical attachment level measured in millimeters using a periodontal probe. CAL was calculated as the distance from the cementoenamel junction to the bottom of the periodontal pocket and used to assess periodontal tissue support loss.	Baseline
Daily cigarette	It includes the number of cigarettes smoked per day. Self-reported number of cigarettes smoked per day.	Baseline
Smoking Duration	Self-reported duration of smoking, recorded as the number of years the participant has smoked.	Baseline
Pack-years	Smoking exposure calculated as pack-years, defined as the number of cigarettes smoked per day divided by 20 and multiplied by the number of years of smoking.	Baseline

Collaborators and Investigators

• Sponsor: Tuğba ŞAHİN
• Investigators: Principal Investigator: TUGBA SAHIN, Abant Izzet Baysal University

Study record dates

Study Major Dates

• Study Start (Actual): January 2, 2025
• Primary Completion (Actual): September 15, 2025
• Study Completion (Actual): October 2, 2025

Study Registration Dates

• First Submitted: November 18, 2025
• First Submitted That Met QC Criteria: December 8, 2025
• First Posted (Actual): December 22, 2025

Study Record Updates

• Last Update Posted (Actual): December 22, 2025
• Last Update Submitted That Met QC Criteria: December 8, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: smoking; periodontitis; gingivitis; periodontal diseases; tabocco products
• Additional Relevant MeSH Terms: Mouth Diseases; Stomatognathic Diseases; Infections; Gingival Diseases; Behavior; Periodontitis; Periodontal Diseases; Gingivitis; Smoking; Investigative Techniques; Manufactured Materials; Technology, Industry, and Agriculture; Methods; Smoking Devices
• Other Study ID Numbers: BAIBU-DH-TS-05

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No