title: Tobacco smoking and gingival health in a Saudi Arabian population.
abstract: OBJECTIVE
  While cigarette smoking is recognized as being detrimental to periodontal health, the effect of water pipe smoking on gingival health is not known. The present study was conducted to determine whether water pipe smoking has an influence on gingival health.
  
  
  METHODS
  A cross-sectional study was carried out in 244 individuals aged 25-70 years. The levels of plaque and gingivitis were recorded on four sites of all present teeth, using the plaque index (PI) and gingival index (GI). Information about oral hygiene practices, dental care and smoking habits was obtained at the time of the clinical examination in accordance with a predetermined questionnaire.
  
  
  RESULTS
  The means of plaque index and gingival index values were 1.2 and 0.9, respectively. Similarly, the mean percentages of surfaces with plaque and gingival bleeding sites were 66.7% and 30.4%, respectively. There was an overall significant association between smoking and plaque index and gingival index (F = 22.9 and F = 10.8, respectively, p < 0.001). Oral hygiene was inferior in water pipe smokers, cigarette smokers, and mixed smokers when compared to non-smokers. The correlation between plaque % and gingival bleeding % in cigarette smokers was significantly weaker than in non-smokers. It was also weaker in water pipe smokers, but the difference was not statistically significant.
  
  
  CONCLUSIONS
  The gingival bleeding response to plaque was significantly suppressed in cigarette smokers. There was a tendency towards suppression also in water pipe smokers.
authors.affiliation: Department of Periodontology, Institute of Odontology, Karolinska Institutet, Huddinge, Sweden. Suzan_natto@hotmail.com
authors.forename: Suzan
authors.initials: S
authors.lastname: Natto
authors.forename: Mostafa
authors.initials: M
authors.lastname: Baljoon
authors.forename: Abdulhadi
authors.initials: A
authors.lastname: Abanmy
authors.forename: Jan
authors.initials: J
authors.lastname: Bergstrom
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D003773:Dental Plaque / Q000209:etiology*; D003774:Dental Plaque Index; D005260:Female; D005891:Gingivitis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D010512:Periodontal Index; D012529:Saudi Arabia; D012907:Smoking / Q000009:adverse effects*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires