Assessing the relationship between Tooth Heavy Metal Deposition and Periodontal Disease in Smokers and Non-Smokers Effects of smoking to the periodontal health related with heavy metal

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Meltem Başaran Acar
Meltem Zihni Korkmaz


Objective: Heavy metals threaten life by accumulating in the body via various sources as water,air and foods. Smoking is one of the important factors that causes this problem. Despite there is an abundant number of studies showing the detrimental effects of smoking on periodontal health, the mechanisms that cause these harmful effects is not clearly known yet. The main aim of our study is to discover whether heavy metal deposition on the tooth surface is related to the disease-causing potential of smoking.

Materials and Method: Total of 80 individuals consist of 43 women and 37 men were included in this study. The participants were divided into 4 groups of 20 individuals each according to the results from clinical examination and anamnesis. Plaque index, gingival index, pocket depth, bleeding on probing and clinical attachment level were recorded clinically. The teeth indicated for extraction were collected. Cd, Pb, Ni, Cr and Fe depositions on teeth were measured by ICP-OES device. Kolmogorov-Smirnov, Student T, Mann Whitney U, One way ANOVA, Kruskal Wallis, Ki-Kare, Pearson, and Spearman tests were performed for the statistical analysis.

Results: Smoking increases the accumulation of heavy metals such as Cd, Ni, Cr, and Pb. The Pb level was higher in both the smoking group and the periodontitis group, compared with the control group. Fe levels were found high in the non-smoking healthy group. Cr and Fe levels were found higher in women while Cd level was higher in men. Positive correlations were found between Pb and plaque index, gingival index, pocket depth and bleeding on probing; and also between Ni and plaque index. ( p=0.000, p=0.009, p=0.025, p=0.011, p=0.019)

Conclusion: In conclusion, our study explored the connection between heavy metal deposition on tooth surfaces and the disease-causing potential of smoking. Smoking has been identified as a significant factor in the increased accumulation of heavy metals, including Cd, Ni, Cr, and Pb. The higher Pb levels seen in both the smoking and periodontitis groups, compared to the control group, suggest a potential link between Pb accumulation and periodontal health. Additionally, differences based on gender were observed, with women showing higher Cr and Fe levels, while Cd levels were more elevated in men. The positive correlations between Pb and various periodontal indices, along with the correlation between Ni and plaque index, shed light on the potential influence of heavy metal deposition on periodontal health. While our findings enhance our understanding of the interplay between smoking, heavy metal deposition, and oral health, further research is needed to fully comprehend the underlying mechanisms. Such insights could lead to interventions aimed at minimizing the adverse effects of heavy metal accumulation on oral health.


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Başaran Acar, M., & Zihni Korkmaz, M. (2023). Assessing the relationship between Tooth Heavy Metal Deposition and Periodontal Disease in Smokers and Non-Smokers: Effects of smoking to the periodontal health related with heavy metal. Medical Science and Discovery, 10(9), 662–668.
Research Article
Received 2023-08-22
Accepted 2023-08-29
Published 2023-09-01


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