The Impact of Heat-not-Burn Tobacco Products on Periodontal Diseases: A Review Heat-not-Burn Tobacco Products & Periodontal Diseases: A Review
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Abstract
Periodontitis is a complex chronic multifactorial inflammatory disease, and among the various risk factors, the one of the most important modifiable risk factors is smoking. Smoking is a significant public health problem because it affects not only the mouth, but also the immune system, and increases the risk of cancer, respiratory diseases and cardiovascular diseases. Smokers have higher risk of developing periodontal disease at about five to six times compared with non-smokers. Heat-not-burn tobacco products do not burn directly but produce an aerosol, marketed as a potentially reduced-risk alternative to conventional cigarettes. However, their impact on periodontal health remains to be determined. This literature review aims to underscore the potential role of heat-not-burn tobacco products on the periodontium, with particular focus on oxidative stress and antioxidant homeostasis. Current evidence indicates that heat-not-burn products may still be harmful to periodontal tissues, although some studies report that they may be less harmful than conventional cigarettes. These effects may include changes in the inflammatory response, oral microbiome, and oxidative stress/antioxidant balance, which may contribute to the progression of periodontitis. Therefore, more longitudinal clinical studies are required to elucidate the long-term effects of heat-not-burn tobacco products on periodontal health.
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