Smoking Weakens Dental Pulp’s Defenses

Dentistry Today


Smoking weakens dental pulp’s ability to fight illness and disease, according to the Case Western University School of Dental Medicine, further weakening the teeth’s defense mechanisms. 

“That might explain why smokers have poorer endodontic outcomes and delayed healing than non-smokers,” said Anita Aminoshariae, DDS, MS, associate professor of endodontics and director of predoctoral endodontics.

The study explored the expression of interleukin 1β (IL-1β), tumor necrosis factor a (TNF-α), human beta defensin 2 (hBD-2), and hBD-3 in the dental pulp of smokers and compared them with nonsmokers. These cytokines and defensins play a role in the body’s immunity system.

“Imagine TNF-α and hBD-2 are among the soldiers in a last line of defense fortifying a castle. Smoking kills these soldiers before they even have a chance at mounting a solid defense,” Aminoshariae said.

Previously, there had been little research into the endodontic effects of smoking, according to Aminoshariae. But smokers have had worse outcomes than nonsmokers, with greater chances of developing gum disease and twice the risk of needing a root canal.

The new research set out to explain the possible contributing factors to these poorer outcomes, as 32 smokers and 37 smokers with endodontic pulpitis were included in the study.

“We began with a look at the dental pulp of smokers compared with nonsmokers,” Aminoshariae said. “We hypothesized that the natural defenses would be reduced in smokers. We didn’t expect to have them completely depleted.”

Interestingly, Aminosharie noted, two patients who quit smoking then saw those defenses return. 

The study, “Comparison of IL-1β, TNF-α, hBD-2, and hBD-3 Expression in the Dental Pulp of Smokers Versus Nonsmokers,” was published by the Journal of Endodontics.

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