Diagnostic pitfalls of tobacco smoking: The effect of nicotine addiction on the oral cavity – Literature review
More details
Hide details
Periodontology Outpatient Clinic, Provincial Specialist Dental Outpatient Clinic in Olsztyn, Poland
Submission date: 2013-01-09
Acceptance date: 2013-02-18
Online publication date: 2013-02-21
Publication date: 2020-04-07
Corresponding author
Marcela Koc-Gąska   

Żołnierska 12 C/31, 10-559 Olsztyn, Poland. Tel.: +48 880 195 626.
Pol. Ann. Med. 2013;20(1):56-61
Tobacco smoking is acknowledged to be the most dangerous risk factor for many diseases. Tobacco enters the organism through the oral cavity. Here, both local and systemic effects of smoking are visible. One of many clinical symptoms caused by smoking is ‘‘diagnostic masking.’’ The World Health Organization has recognized nicotine addiction as a chronic and recurring disease which requires a comprehensive therapy. A dentist can be the first person who begins such a therapy.

To present the effect of smoking on the condition of the oral cavity with reference to its masking influence and to promote an anti-nicotine attitude.

Material and methods:
This article is based on a review of the medical literature.

Results and discussion:
Making patients aware of the negative effects of nicotine on one’s organism is more difficult if they do not notice or experience negative symptoms of smoking.

The hazards associated with tobacco smoking have been known for a long time and confirmed with research results. The so-called ‘‘masking symptoms’’ should not escape a physician’s attention. A lack of reddening, swelling and bleeding of the gums during probing in smoking patients does not prove that they do not suffer from a periodontal disease. The presence of lesions typical of smoking in the oral cavity does not mean they should not be differentiated from diseases which pose threat to life and health. Thus it is indispensable to perform additional diagnostic procedures to avoid hypodiagnosis. Numerous unfavorable consequences of cigarette smoking which occur in the oral cavity and elsewhere should be presented as warnings and posted on tobacco products’ packaging.

None declared.
Chrzęszczyk D. Zastosowanie berneńskiego modelu heksagonalnego w określaniu czynników ryzyka progresji zapaleń przyzębia – na podstawie pśmiennictwa [Application of the periodontal risk assessment model in determining risk factors of periodontitis progression – based on literature]. Dent Med Probl. 2010;47(2):214–220.
Eley BM, Soory M, Manson JD. Periodontologia [Periodontics]. Wrocław: Elsevier Urban & Partner; 2010 43–48.
Knychalska-Karwan Z. Fizjologia i patologia błony śluzowej jamy ustnej [The Physiology and Pathology of the Oral Mucous Membrane], 3rd ed. Lublin: Czelej; 2009: 130–131.
Krzyżanowska A, Głogowski C. Nikotynizm na świecie. Następstwa ekonomiczne [Nicotine addiction in the world. Economic consequences]. Przew Lek. 2004;3:98–103.
Rakowe usta i ślepe oczy na paczkach papierosów. Polskie Radio Website. / Accessed 06.12.12.
Rudziński R, Banach J. Kierunki toksycznego oddziaływania nikotyny i jej metabolitów na tkanki przyzębia [Directions of the toxic effects of nicotine and its metabolites on the periodontal tissues/direction toxically nicotine affects and metabolites of nicotine on the periodontal tissues]. Dent Med Probl. 2007;44(2):251–254.
Rudziński R, Banach J, Safranow K, Dembowska E, Droździk A, Mazurek-Mochol M. Nikotynizm a wybrane parametry periodontologiczne w przewlekłym zapaleniu przyzębia [Nicotine addiction and selected periodontal parameters in chronic periodontitis]. Dent Med Probl. 2011;48(2):180–188.
Rudziński R, Banach J, Safranow K, Jakubowska K, Olszewska M, Dembowska E, et al. Nikotyna i jej główne metabolity a wybrane parametry periodontologiczne w ocenie narażenia na dym tytoniowy pacjentów z przewlekłym zapaleniem przyzębia [Nicotine, its major metabolites and selected periodontal parameters in the assessment of exposure to tobacco smoke of patients with chronic periodontitis]. Dent Med Probl. 2011;48(3):355–363.
Scully C. Choroby jamy ustnej. Diagnostyka i leczenie [Oral and Maxillofacial Medicine. The Basis of Diagnosis and Treatment]. 1st Polish ed. Wrocław: Elsevier Urban & Partner; 2004:153–169,308–332.
Slezak M. Epidemic of plain packaging to curb smoking uptake. NewScientist Website. / Accessed 06.12.12.
WHO. Global status report on noncommunicable diseases.; 2010. Accessed 06.12.12.
WHO Regional Office for Europe. The European report on tobacco control policy. Copenhagen: WHO.; 2007. Accessed 06.12.12.
WHO Regional Office for Europe. The European report on tobacco control policy: review of implementation of the third action plan for a tobacco-free Europe 1997–2001. Copenhagen: WHO. /; 2002. Accessed 06.12.12.
Wnukiewicz J, Nosow E, Nosow A, Nazar E, Siewiński M. Wpływ palenia papierosów na poziom inhibitorów cysteinowych peptydaz w ślinie [Influence of cigarette smoking on the level of cysteine peptidase inhibitors in saliva]. Czas Stomatol. 2010;63(2):108–115.
Wolf HF, Rateitschak EM, Rateitschak KH. Periodontologia [Paradontologie], Vol 51. 3rd ed. Lublin: Czelej; 2006: 51–193.
Journals System - logo
Scroll to top