ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Water Pipe Smoking And Conventional Cigarette Smoking Has Similar Harmful Effects On The Periodontium
Clinical Question Does water pipe smoking have less harmful effects on the periodontium than conventional cigarette smoking?
Clinical Bottom Line The association of poor oral health and water pipe smoking was consistent in both studies; both conventional cigarette and water pipe smoking have similar harmful effects on the periodontium.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 16274311Natto/2005262 smokers between the ages of 17 and 60Case-Control Study
Key resultsData showed that both cigarette and water pipe smokers experienced similar harmful effects to the periodontium from smoking. When measured for periodontal probing depths, the mean value for water pipe smokers was 3.1 mm, 3.0 mm for cigarette smokers, and only 2.3 mm for non-smokers. The prevalence of periodontal disease in water pipe smokers was 30%, 24% in cigarette smokers, and 8% in non-smokers. There was a statistically significant increase in risk of developing periodontal disease in both water pipe smokers (P <0.001) and cigarette smokers (P <0.05) when compared to non-smoking participants.
#2) 16104965Natto/ 2005355 participants between the ages of 17 and 60Case-Control Study
Key resultsThis study compared periodontal bone height in conventional cigarette smokers, water pipe smokers, mixed smokers, and non-smokers. The data was collected by observing the mesial and distal bone height of each tooth on a panoramic radiograph. The measurements were noted as a factor of root length percentage. A link was found between water pipe smokers and mean bone height, and cigarette smokers and mean bone height. These findings were statistically significant (p <0.01). The mean periodontal bone height was 75.8% for cigarette smokers, 76.2% for water pipe smokers, and 80.9% for non-smokers.
Evidence Search ("smoking"[MeSH Terms] OR "smoking"[All Fields] OR ("tobacco"[All Fields] AND "smoking"[All Fields]) OR "tobacco smoking"[All Fields]) AND Periodontal[All Fields] AND ("health"[MeSH Terms] OR "health"[All Fields])
Comments on
The Evidence
Validity: The cohort studies included in this analysis clearly defined each participant as a cigarette smoker, water pipe smoker, and non-smoker. However, not all participants were similar at the start of the study; most participants had different lifetime exposure to tobacco, dependent on age and tobacco usage frequency. Both studies took this into consideration by calculating the accumulated exposure to tobacco over time for each participant. There are limited studies available on water pipe smoking and its effects on the periodontium; the same author wrote both cohort studies included in this analysis. This could limit the diversity in data collection. The association of poor oral health and water pipe smoking was consistent in both studies ; both conventional cigarette and water pipe smoking have similar harmful effects on the periodontium. Perspective: The studies included in this analysis only gathered data from Saudi Arabian populations. In addition, more data was collected from male participants in both cohort studies than was from female participants. A study with equal male and female participation, and a more ethnically mixed population needs to be performed in order for the results to be more generalizable.
Applicability It is a common misconception that water pipe smoking is harmless. With the recent rise in popularity of water pipe smoking this misconception has become a relevant issue in the past decade. Studies, such as the ones in this analysis, provide accurate information that can be used to educate patients about the risks that are associated with the use of water pipe smoking.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics)
Keywords Water pipe, cigarette, smoking, shisha
ID# 3076
Date of submission: 03/29/2016spacer
E-mail varelam@livemail.uthscsa.edu
Author Monica Varela
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Juanita Lozano-Pineda, DDS, MPH
Faculty mentor/Co-author e-mail pinedaj@uthscsa.edu
Basic Science Rationale
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