Periodontal Health Among Cigarette, Electronic Cigarettes, and Narghile Smokers

Evaluation of Periodontal Health Among Cigarette, Electronic Cigarettes, and Narghile Smokers Among a Sample of Alhawsh Private University Students

This study compares the different effects of traditional cigarettes, e-cigarettes, and narghile on periodontal health among a sample of Al-Hawash Private University students. The main question it aims to answer is: Are there statistically significant differences in periodontal parameters among different types of smokers?

Study Overview

• Status: Recruiting
• Conditions: Smokers; Periodontal Status
• Intervention / Treatment: Other: Non-Interventional Study

Detailed Description

The emergence of e-cigarettes and the increasing popularity of hookah smoking, alongside traditional cigarette use, have created a complex health landscape, particularly regarding periodontal health. Despite growing global awareness of smoking-related dangers, particularly among young people due to marketing of "safer" alternatives, there is a lack of research directly comparing the effects of these three smoking methods on periodontal tissues.

While research extensively covers the impact of smoking on periodontal tissues, despite the individual studies on each type of smoking, no study has directly compared the effects of cigarettes, e-cigarettes, and hookah on periodontal health in the same population.

Aim: study and compare the different effects of traditional cigarettes, e-cigarettes, and narghile on periodontal health among a sample of students at Al-Hawash Private University.

• Study Type: Observational
• Enrollment (Estimated): 90

Contacts and Locations

• Study Contact: Name: Ali Abou Sulaiman, Ph.D. in Periodontology; Phone Number: +963956790836; Email: dr.ali.abousulaiman@hpu.edu.sy

Study Locations

• Syria
  • Homs Governorate
    • Homs, Homs Governorate, Syria, 0000
      • Recruiting
      • Al-Hawash Private University
      • Contact: Ali Vice President, PhD; Phone Number: +963-956790836; Email: dr.ali.abousulaiman@hpu.edu.sy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Smoker students at Al-Hawash Private University

Description

Inclusion Criteria:

• Cigarette smokers: Individuals who have smoked five or more cigarettes per day for at least one year.
• E-cigarette smokers: Individuals who have smoked e-cigarettes one or more times per day for at least one year.
• narghile smokers: Individuals who have used a hookah one or more times per day for at least one year.

Exclusion Criteria:

• Non-smokers
• Ages older than 25 years
• Dual smokers: Individuals who smoke two or more types of tobacco.
• Individuals with systemic diseases, such as diabetes, heart disease, liver problems, and kidney disease
• Individuals who reported using antibiotics, steroids, or NSAIDs within the past month
• Individuals who have received periodontal treatment at least six months ago

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Cigarette Smokers	Other: Non-Interventional Study; Non-Interventional Study
E-cigarette Smokers	Other: Non-Interventional Study; Non-Interventional Study
Narghile Smokers	Other: Non-Interventional Study; Non-Interventional Study

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Plaque Index (PI)	Plaque Index (PI) The PI was evaluated according to the Silness and Löe (1964) system. This system assesses the plaque thickness at the tooth cervical margin (closest to the gum) and has four scores: 0: no plaque; a film of plaque adhering to the free gingival margin which is nonvisible and it can be scraped from the tooth surface using a probe;; moderate accumulation of soft deposits within the gingival pocket or between the tooth and the gingival margin;; abundance of soft matter within the gingival pocket and/or on the tooth and the gingival margin. The presence of visible dental plaque was recorded on the four sites (vestibular, lingual, mesial, and distal) of all the teeth, except the third molars. three PI classes (PI%; [0-1[; [1-2[; [2-3]) were arbitrarily defined	At enrollment
Gingival Index (GI)	The gingival status was evaluated using the method of Löe and Silness (1963). The GI score perfectly evaluates the marginal and inter proximal tissues separately on the basis of the following three criteria (Löe & Silness, 1963): 0: no inflammation, healthy gingiva; mild inflammation, slight change in color, slight edema, no bleeding on pressure;; moderate inflammation, moderate glazing, red ness, bleeding on pressure;; severe inflammation, marked redness and hypertrophy, ulceration, tendency to spontaneous bleeding.	At enrollment
Probing Pocket Depth (PPD)	PPD is the distance between the gingival margin and the apical depth of the periodontal probe tip penetration. The depth of the sulci or pockets was probed using a Williams periodontal probe with markings 1, 2, 3, 5,7,8, 9, 10 mm. The clinical measurements were based on the four sites (buccal, mesial, distal, and lingual) of all the teeth, except the third molars (Natto et al., 2005b).	At enrollment
Clinical Attachment Level (CAL)	Clinical attachment level (CAL) is measured from the cementoenamel junction to the bottom of the sulcus or pocket at the four sites. The mean is then calculated for each patient.	At enrollment
Bleeding On Probing (BOP)	The bleeding on probing was assessed through gentle probing of the orifice of the gingival crevice .If bleeding occurs within 10 seconds, a positive finding was established and the number of positive sites was recorded and then expressed as the percentage of the number of sites examined.	At enrollment
Tooth Mobility (TM)	Tooth mobility, was performed by alternatively pressing on the tooth buccal and lingual surfaces using one finger and one metallic instrument Tooth mobility was recorded (Fleszar et al., 1980) as follows: 0: physiologic mobility, firm tooth; slightly increased mobility;; definite to considerable increase in mobility but no function impairment;; extreme mobility, a loose tooth that would be incomparable in function	At enrollment
Gingival Recession (GR)	Gingival recession is measured by measuring the distance from the cementoenamel junction to the free gingival margin at the midpoint of the buccal surface.	At enrollment
Furcation Involvement ( FI)	Furcation involvement, is investigated clinically with a probe and classified according to the Hamp's classification system: Class 0 = no horizontal loss of periodontal tissue support (apart from the original scoring scale). Class I ≤3mm horizontal loss of periodontal tissue support. Class II > 3 mm horizontal loss of periodontal tissue support, no through-and-through furcation Class III through-and-through furcation (required to see the tip of the probe at the contralateral furcation opening) and additionally	At enrollment

Collaborators and Investigators

• Sponsor: Al-Hawash Private University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): August 1, 2026

Study Registration Dates

• First Submitted: April 25, 2026
• First Submitted That Met QC Criteria: April 25, 2026
• First Posted (Actual): May 1, 2026

Study Record Updates

• Last Update Posted (Actual): May 1, 2026
• Last Update Submitted That Met QC Criteria: April 25, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Smoking; Cigarettes; Electronic Cigarettes; Periodontal Health; Narghile Smokers
• Additional Relevant MeSH Terms: Behavior; Smoking; Vaping
• Other Study ID Numbers: 15-6-2025

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