Assessing Periodontal Health in Tobacco Users: A Salivary Analysis.

Background: The risk of periodontal disease is considered to be high among tobacco users compared to those not consuming tobacco in any form. A rise in salivary enzyme levels reflects the destruction of healthy tissues, making it a potential clinical biomarker. Thus, the aim was to assess periodontal health and examine salivary enzyme levels and their correlation with tobacco use.

Methods: Unstimulated saliva was collected using a standard protocol from 128 individuals who visited the outpatient department (OPD) of a dental hospital, divided into four groups. Clinical assessment was done using the gingival index (1963) (GI) and the community periodontal index (1982) (CPI).

Findings: There was a strong correlation between tobacco use and salivary enzyme levels. Tobacco chewers had the most elevated salivary enzyme levels, followed by smokers and passive smokers. Significant periodontal deterioration presenting as an increase in probing depth and clinical loss of attachment (LOA) was seen among the chewers (3.22±0.87 and 2.16±1.27, respectively) and smokers (3.16±0.80 and 1.63±1.38, respectively), which was more than passive smokers (2.75±0.80 and 0.84±0.30, respectively) and was considered significant between all the groups (=0.001).

Conclusion: Tobacco use in either form affects the severity of periodontal diseases and the levels of salivary enzymes. Thus, salivary enzymes are regarded as reliable biochemical indicators of periodontal tissue damage and can be used as motivators to quit tobacco usage. Additionally, passive smoking was found to have a negative impact on periodontal health and can be considered a risk factor.