Relationship between compliance and periodontal treatment outcome in smokers

Background: Smoking is an established risk factor of periodontal disease and smokers are regarded as patients with a high risk of periodontitis recurrence during the maintenance phase. Lack of compliance and smoking constitute significant factors for the risk of further periodontitis progression. The purpose of the present study was to investigate the relationship between periodontal status and the tendency to interrupt periodontal treatment and determine if this relationship differs significantly between smokers and non-smokers. Methods: The investigation was conducted as a retrospective study on a sample of 325 patients referred for treatment. The patients had been offered full periodontal treatment and a full-mouth oral radiographic examination. In order to investigate any correlations between periodontal status and smoking or interrupted periodontal treatments, stepwise multiple regression analyses were adopted. Results: The mean age of the sample was 49.7 years (range 25 to 83) and a majority were females (57%). The relative frequency of smoking was 52%. The relative frequency of interruption of periodontal treatment was 26% for non-smokers and 31% for smokers. Smokers who interrupted periodontal treatment after the reevaluation were found to have significantly deeper periodontal probing depths at the reevaluation compared to those who did not interrupt the treatment irrespective of smoking habits (P<0.001). Conclusions: The results of the study demonstrate that the non-complying individuals had the highest risk of recurrent periodontitis even if they had completed the treatment plan. An important task in the future will be to find ways to reduce the frequency of non-compliance and thus improve the prognosis.