Nicotine Dependence, Periodontal Awareness, and Clinical Periodontal Parameters in Smokers With Gingivitis and Periodontitis

Cigarette smoking is a well-established risk factor for periodontal disease and has been associated with increased periodontal destruction and impaired healing responses. However, smoking may also influence the perception and recognition of periodontal disease symptoms. Previous periodontal research has primarily evaluated smoking exposure using quantitative measures such as daily cigarette consumption and duration of smoking. These measures may not fully capture the behavioral and psychological aspects of nicotine addiction.

Nicotine dependence represents a behavioral component of smoking behavior that may affect how individuals perceive symptoms and respond to disease-related changes in their oral health. The Fagerström Test for Nicotine Dependence (FTND) is a validated instrument widely used to quantify nicotine addiction levels. Despite its extensive use in smoking research, the relationship between nicotine dependence and periodontal disease awareness has received limited attention in periodontal literature.

The present study is designed as a cross-sectional observational investigation conducted among individuals diagnosed with gingivitis or periodontitis. Participants will be recruited from patients attending a periodontal clinic. After obtaining informed consent, participants will complete the FTND questionnaire and a brief questionnaire assessing periodontal disease awareness.

A comprehensive periodontal examination will be performed by an experienced periodontist. Clinical parameters including plaque index, bleeding on probing (BOP), maximum probing depth (PD), and maximum clinical attachment loss (CAL) will be recorded using standardized periodontal probes.

The primary aim of the study is to evaluate whether nicotine dependence level is associated with periodontal disease awareness. Secondary analyses will examine associations between nicotine dependence and clinical periodontal parameters, including PD, CAL, and BOP, in order to explore potential pathways linking nicotine dependence with periodontal disease perception.

By introducing nicotine dependence as a behavioral measure of smoking exposure, this study aims to provide a new perspective on the relationship between smoking and periodontal disease awareness. The findings may contribute to improved periodontal screening strategies and patient education approaches for individuals with higher nicotine dependence.

Inclusion criteria

• Individuals aged 18 years or older
• Current smokers
• Diagnosis of gingivitis or periodontitis according to periodontal clinical examination
• Ability to complete the Fagerström Test for Nicotine Dependence questionnaire
• Provided informed consent to participate in the study

Exclusion criteria

• Individuals with systemic diseases known to affect periodontal tissues
• History of periodontal treatment within the previous 6 months
• Use of medications that may influence periodontal status
• Pregnancy or lactation
• Inability to complete the study questionnaire