Predictors of periodontal pocket depth reduction in smokers with dentin hypersensitivity

Abstract

Background: Smokers undergoing non-surgical periodontal therapy show smaller pocket depth reductions than non-smokers [13,14], and the same patients, who present with more baseline root exposure, are disproportionately prone to dentin hypersensitivity once instrumentation exposes their dentinal tubules [4].

Objective: This review synthesizes the literature on predictors of periodontal pocket depth reduction in smokers and situates dentin hypersensitivity as a co-occurring outcome.

Methods: We synthesized clinical trials, individual patient data meta-analyses, mixed-effects cohort studies, and mechanistic studies addressing smoking, systemic disease, and dentin hypersensitivity after periodontal therapy.

Findings: Baseline pocket depth is the strongest single predictor of reduction [10,11]; the smoking effect is graded, with nicotine dependence and cigarette count independently predicting smaller reductions [15]; diabetes and poor compliance compound rather than substitute for smoking [20,11]; cessation moves outcomes toward never-smoker levels [18]; and hypersensitivity tracks the recession burden smokers carry into treatment [1,22].

Conclusions: Clinicians should assess baseline depth, nicotine dependence, diabetes status, and recession extent together, and anticipate a desensitizing step for smokers, since no study has modelled both outcomes jointly in one cohort [21,15].