Old habits die hard but they do die when you have made-up your mind !!!! : Journal of Indian Society of Periodontology

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President's Message

Old habits die hard but they do die when you have made-up your mind !!!!

Khatri, Manish Acting President, Indian Society of Periodontology, Prof. & Head

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Journal of Indian Society of Periodontology 26(5):p 423, Sep–Oct 2022. | DOI: 10.4103/jisp.jisp_337_22
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Tobacco in its various forms especially the smoked one, poses a considerable risk not only on oral health but also negatively impacts the clinical management of various oral pathologies and the outcomes of the therapeutic procedures particularly pertaining to Periodontology. Tobacco consumption is a major challenge that a Periodontist faces in his practice on a day-to-day basis. This vice has been continuously showing a downward trend in most developed countries, however in third world countries, the upward trend continues and is of significant concern.

The periodontal conditions encountered in smokers are not only due to improper oral hygiene but is also influenced by the effect of smoking on the microflora of the plaque, the changes in immune response and the deleterious effects on healing capacity of periodontal tissues. The diseases affecting the oral cavity caused by cigarette smoking include gum disease and recession, tooth decay, bone loss, failure of dental implants and oral cancer.

The clinician must undergo Tobacco Cessation Training and work in co-ordination with other medical practitioners to ensure that the patient keeps away from tobacco. A mandatory oral examination along with behavioural counselling should be the cornerstone of every periodontal practice. It is important to identify tobacco users and follow FDI recommendations in delivering the 5 A's: ASK all patients about their tobacco use, ADVISE them to quit the habit, ASSESS their quitting motives, ASSIST the patients in quitting and ARRANGE follow-up.[1] We also need to refer them to de-addiction centres if required. It is also our responsibility to arrange or participate in tobacco cessation programs at personal as well as community levels. Nicotine replacement therapy (NRT) is an essential cornerstone for a dentist's effective intervention in tobacco cessation and when combined with counselling, it has been found to be more effective.

It is imperative for us as Periodontists to contribute significantly towards tobacco cessation. The onus on us increases as Periodontal therapies often require multiple visits which is an ideal template for effective communication and reinforcement of guidelines towards quitting the habit. The periodic oral examinations also provide feedback for the success or failure of the constituted therapeutic interventions.

Periodontists can be incredibly influential through their clinical position and with the application of the right strategies can contribute significantly in curbing this menace.

Say YES to LIFE……….

Say NO to TOBACCO………


1. Tobacco Cessation Guidance For Oral Health Professionals. FDI World Dental Federation [Internet]. 2021 Geneva Switzerland Available from: https://www.fdiworlddental.org/sites/default/files/2021-07/FDI%20Tobacco%20Cessation%20Guide%20160621.pdf. [Last cited on 2022 Aug 18]
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