In the Mouth, Smoking Zaps Healthy Bacteria
Practically speaking, these findings have clear implications for patient care, according to Kumar.
“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.”
The team found that for nonsmokers, bacterial communities regain a similar balance of species to the communities that were scraped away during cleaning. Disease-associated bacteria are largely absent, and low levels of cytokines show that the body is not treating the helpful biofilms as a threat.
“By contrast,” said [Ohio State researcher Purnima Kumar, PhD,] “smokers start getting colonized by pathogens – bacteria that we know are harmful – within 24 hours. It takes longer for smokers to form a stable microbial community, and when they do, it’s a pathogen-rich community.”
Smokers also have higher levels of cytokines, indicating that the body is mounting defenses against infection. Clinically, this immune response takes the form of red, swollen gums – called gingivitis – that can lead to the irreversible bone loss of periodontitis.
In smokers, however, the body is not just trying to fight off harmful bacteria. The types of cytokines in smokers’ gum swabs showed the researchers that smokers’ bodies were treating even healthy bacteria as threatening.
Kumar’s collaborators include Chad Matthews and Vinayak Joshi of Ohio State’s College of Dentistry as well as Marko de Jager and Marcelo Aspiras of Philips Oral Healthcare. The research was sponsored by a grant from Philips Oral Healthcare.
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Source: Ohio State University