Dental News - Smoking weakens mechanisms needed to fight pulpitis, study finds

Dental Tribune International

Fri. 5. October 2018

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CLEVELAND, U.S.: The negative health impacts of smoking are widely known; however, few have researched its consequences regarding endodontics. In a new study led by scientists at the Case Western Reserve University School of Dental Medicine, Cleveland, researchers have found that smoking weakens the ability for dental pulp to fight illness and disease.

Speaking about the research, Dr. Anita Aminoshariae, associate professor of endodontics and Director of Predoctoral Endodontics at Case Western, said: “That might explain why smokers have poorer endodontic outcomes and delayed healing than nonsmokers. Imagine TNF-α [tumor necrosis factor α] and hBD-2 [human beta defensin 2] are among the soldiers in a last line of defense fortifying a castle. Smoking kills these soldiers before they even have a chance at mounting a solid defense.”

In the study, the researchers set out to further understand why smokers have a greater possibility of developing periodontal disease and are nearly twice as likely to require root canal therapy.

From the pulp chambers of 32 smokers and 37 nonsmokers, all diagnosed with either normal, symptomatic irreversible pulpitis or asymptomatic irreversible pulpitis, the team collected samples and measured the interleukin (IL) 1β, TNF-α, hBD-2 and hBD-3 levels. “We hypothesized that the natural defenses would be reduced in smokers; we didn’t expect them to have them completely depleted,” explained Aminoshariae.

According to the study’s results, pulpal concentrations of TNF-α and hBD-2 were significantly lower among smokers, whereas there was no significant difference in IL-1βor hBD-3. Two-way analysis of covariance also revealed that smoking status, not endodontic diagnosis (pulpal status), significantly affected TNF-α and hBD-2 levels.

Although the study results provide yet another argument against smoking, an encouraging finding of the research was that two of the patients in the study who quit smoking experienced a return of the defense mechanisms needed to fight pulpitis.

The study, titled “Comparison of IL-1β, TNF-α, hBD-2, and hBD-3 expression in the dental pulp of smokers versus nonsmokers,” was published in the December 2017 issue of the Journal of Endodontics.

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