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A Bad Combination: Healthy Gums and Hookah Pipes

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A Bad Combination: Healthy Gums and Hookah Pipes

A Bad Combination: Healthy Gums and Hookah Pipes

December 05, 2005
By: Jennifer Jope for Dental1

A hookah – or water pipe – is typically an elaborate, but beautiful contraption used to smoke tobacco, usually sweetened with dried fruit or honey. However, a new study suggests that despite its beauty, smoking a hookah is just as bad as lighting up a cigarette.
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Know the warning signs for periodontal disease:

Pain in your mouth

Bleeding gums when you brush your teeth or eat hard foods

Spaces developing between teeth

Gums feel swollen or tender

Receding gums (pulling back from your teeth) or teeth appear longer than before

Persistent bad breath

Pus between your teeth and gums

Any change in the way your teeth fit together when you bite

Sores developing in your mouth

We’ve all heard the warnings of what cigarettes can do to our bodies. Specifically, cigarettes have been known to cause mouth cancer and periodontal disease. But the negative impact of smoking using a hookah, which has gained popularity recently in the U.S., is about the same magnitude as smoking cigarettes.

According to a study which appears in the November issue of the Journal of Periodontology, the prevalence of periodontal (gum) diseases was 30 percent in water pipe smokers, 24 percent in cigarette smokers and 8 percent in non-smokers.

The American Academy of Periodontology defines gum disease as “serious infections” that can result in tooth loss if left untreated. Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. The disease can affect one tooth or multiple teeth. It begins when the bacteria in plaque causes the gums to become inflamed.

The study examined 262 citizens of Saudi Arabian city, Jeddah, between the ages of 17 and 60. It included assessments of oral hygiene, gingival inflammation and probing depth. Smoking behavior was registered through a questionnaire and subsequently confirmed through an interview. The participants were stratified into water pipe smokers (31 percent), cigarette smokers (19 percent), mixed smokers (20 percent) and non-smokers (31 percent).

“Research from this study shows that the relative risk for periodontal disease increased by 5-fold in water pipe and 3.8-fold in cigarette smokers compared to non-smokers,” said Kenneth A. Krebs, dentist and American Academy of Periodontology president. “Even though the smoke is filtered out by water, inhalation of toxic substances is similar to or even greater than that of cigarette smoking.”

Smoking a hookah pipe, which is common in Middle Eastern countries like Saudi Arabia and Lebanon, involves shisha tobacco, which is available in flavors like strawberry, mango or mint. But researchers say don’t be fooled by the sweet flavor of the tobacco.

“Many people are misled in believing that water filters out the toxins and that nicotine is reduced in water pipe smoking,” Krebs said. “Not only does water pipe smoking include the same substances as cigarette smoke such as carbon monoxide and tar, tobacco used for water pipe smoking contains 2 to 4 percent nicotine verses 1 to 3 percent for cigarettes.”

Researchers found higher levels of nicotine and cotinine – a breakdown product of nicotine – in plasma, saliva and urine, supporting that water pipe smoking affects the periodontal tissues in the same way as cigarette smoking.

“This study provides convincing evidence supporting the role of tobacco smoking as a risk factor for periodontal disease,” said Krebs. “Although the precise mechanisms of the action of tobacco smoke are not well understood, it seems highly likely that the periodontal bone is one of the most susceptible tissues. This hypothesis will be further tested by investigating the periodontal bone height levels of various tobacco smokers in the presently studied population.”

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