Smoking behaviour and attitudes to periodontal health and quit smoking in patients with periodontal disease

Is insufficient sleep duration a risk indicator for periodontal disease? A systematic review

OBJECTIVES

In this study, we conducted a systematic review and meta-analysis to assess whether people who achieved <7 h of sleep were more likely to develop periodontal disease (PD).

SOURCES

We executed electronic searches in the PubMed, EMBASE and Cochrane Library, as well as a manual search of articles published by leading journals in related fields, for observational studies, published in English from 1 January 1966 to 31 March 2021.which evaluated the relationship between sleep duration and PD. The Agency for Healthcare Research and Quality (AHRQ) quality evaluation scale was used for the cross-sectional studies, and the random effects model was used to summarize the effect sizes in the included studies with a 95% confidence interval (CI).

RESULTS

A total of six cross-sectional studies met the inclusion criteria, totaling 107,777 participants, of which 69,773 had PD. The results of the present indicated that shorter sleep duration (<7 h) is significantly associated with PD (Odd ratio [OR], 1.19; 95% CI, 1.16-1.23; p < 0.001; I² , 0.0%, I² interval, 0%-75%). The strength of the sensitivity analysis and cumulative meta-analysis confirmed the reliability of the results.

CONCLUSION

Although the inclusion of only six studies makes it difficult to explore whether there is a publication bias, we found that insufficient sleep duration was closely related to PD, and we therefore speculated that getting enough sleep may help prevent PD.

Using risk assessment in periodontics

Risk assessment has become a regular feature in both dental practice and society as a whole, and principles used to assess risk in society are similar to those used in a clinical setting. Although the concept of risk assessment as a prognostic indicator for periodontal disease incidence and activity is well established in the management of periodontitis, the use of risk assessment to manage the practical treatment of periodontitis and its sequelae appears to have less foundation. A simple system of initial risk assessment - building on the use of the Basic Periodontal Examination (BPE), clinical, medical and social factors - is described, linked to protocols for delivering care suited to general dental practice and stressing the role of long-term supportive care. The risks of not treating the patient are considered, together with the possible causes of failure, and the problems of successful treatment are illustrated by the practical management of post-treatment recession.

Motivating patients

Patients who seek advice and treatment for periodontal conditions often find challenges in the personal involvement required for successful care. This paper reviews methods of advising and motivating patients to adhere to oral hygiene regimens and understand the necessity for long-term management of the condition.

Patients' awareness of the potential benefit of smoking cessation. A study evaluating self-reported and clinical data from patients referred to an oral medicine unit

The present study analyzed history of smoking and willingness to quit smoking in patients referred for diagnosis and treatment of different oral mucosal lesions. Prior to the initial clinical examination, patients filled in a standardized questionnaire regarding their current and former smoking habits and willingness to quit. Definitive diagnoses were classified into three groups (benign/reactive lesions, premalignant lesions and conditions, and malignant diseases) and correlated with the self-reported data in the questionnaires. Of the 980 patients included, 514 (52%) described themselves as never smokers, 202 (21%) as former smokers, and 264 (27%) as current smokers. In the group of current smokers, 23% thought their premalignant lesions/conditions were related to their smoking habit, but only 15% of the patients with malignant mucosal diseases saw that correlation. Only 14% of the smokers wanted to commence smoking cessation within the next 30 days. Patients with malignant diseases (31%) showed greater willingness to quit than patients diagnosed with benign/reactive lesions (11%). Future clinical studies should attempt (1) to enhance patients' awareness of the negative impact of smoking on the oral mucosa and (2) to increase willingness to quit in smokers referred to a dental/oral medicine setting.