title: The Effect of Waterpipe Smoking on Periodontal Health.
abstract: OBJECTIVE
  To determine the effect of waterpipe smoking on periodontal health.
  
  
  METHODS
  The study included 190 participants who were categorised into four groups; cigarette smokers, waterpipe smokers, dual smokers and nonsmokers. Intraoral examination included plaque (PI), gingival (GI) and calculus (CI) indices, probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BOP).
  
  
  RESULTS
  The four groups differed significantly in the prevalence and extent of periodontal disease. Pairwise comparison tests showed that the means of percentages of sites with PPD > 3 mm, PPD > 4 mm, CAL > 1 mm and bleeding on probing were significantly higher among smoking groups compared to the nonsmoking group (p < 0.05). After adjusting for age, cigarette smokers (OR = 4.6), waterpipe smokers (OR = 4.3) and dual smokers (OR = 4.9) were significantly more likely to have periodontal disease compared to nonsmokers. When data were analysed according to the smoking method, no significant differences in the odds of periodontal disease were detected between different smoking groups (p > 0.05).
  
  
  CONCLUSIONS
  Waterpipe tobacco smoking is not an alternative, safe way of smoking considering periodontal disease. Thus, global actions against waterpipe smoking are required.
authors.forename: Abdel Rahim M
authors.initials: AR
authors.lastname: Bibars
authors.forename: Suhair R
authors.initials: SR
authors.lastname: Obeidat
authors.forename: Yousef
authors.initials: Y
authors.lastname: Khader
authors.forename: Arwa M
authors.initials: AM
authors.lastname: Mahasneh
authors.forename: Omar F
authors.initials: OF
authors.lastname: Khabour
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003728:Dental Calculus / Q000145:classification; D003729:Dental Care; D003742:Dental Devices, Home Care; D003774:Dental Plaque Index; D004522:Educational Status; D005260:Female; D005884:Gingival Hemorrhage / Q000145:classification; D015438:Health Behavior; D006801:Humans; D007182:Income; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009909:Oral Health; D009911:Oral Hygiene Index; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D012907:Smoking; D014099:Toothbrushing; D055815:Young Adult