Retrospective exploratory study of smoking status and e‐cigarette use with response to non‐surgical periodontal therapy

BACKGROUND: To compare periodontal treatment responses in electronic cigarette (e‐cigarette) users, non‐smokers, former and current smokers. METHODS: In this retrospective clinical study, 220 patients with periodontitis were seen for baseline periodontal charting, professional‐mechanical‐plaque‐removal (PMPR) and re‐evaluation by postgraduate students. Sixty of these patients were former smokers, twenty were former smokers now using e‐cigarettes, twenty current smokers, while all others (n = 120) were non‐smokers. Effects of smoking status and treatment duration on clinical outcomes were analyzed by linear models using generalized least squares adjusted for known confounders. The primary outcome was “need for surgery” defined as number of sextants with ≥2 non‐adjacent sites of probing depths (PD) ≥5 mm. RESULTS: Compared with non‐smokers, e‐cigarette users had a less favorable treatment response after PMPR. This included statistically significant increased “need for surgery”, as well as increased number of sextants with PD ≥5 mm, number of sites with PD >5 mm and mean PD. There were no statistically significant differences between e‐cigarette users and current smokers. Former smokers responded statistically significantly better than e‐cigarette users for the primary outcome as well as for the number of sextants and sites with PD ≥5 mm and mean PD. CONCLUSIONS: Overall, e‐cigarette users had a statistically significantly less favorable response to PMPR than non‐smokers; their response was not statistically significantly different to those of current smokers. This, however, needs to be validated with further research in prospective clinical and observational studies in different populations.