{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:15:09Z","timestamp":1790712909335,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Periodontal disease, a prevalent oral health condition, is exacerbated by smoking, which accelerates tissue destruction and complicates disease management. This study investigates the association between smoking and periodontal health by comparing key periodontal indicators between smokers and nonsmokers in Afghanistan, where smoking prevalence is rising.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A case\u2013control study was conducted at Ghalib University Hospital in Kabul, Afghanistan, involving male participants aged 15\u201350 years. Smokers with stage II or III periodontitis, as defined by the clinical attachment loss (CAL) and probing pocket depth (PPD) criteria, were included in the case group, while nonsmokers without signs of periodontitis were assigned to the control group. Periodontal assessments included PPD, CAL, and bleeding on probing (BOP). The data were analyzed to evaluate differences in periodontal health indicators between the two groups and to assess the association between smoking duration and periodontal severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Smokers exhibited significantly worse periodontal health compared to nonsmokers. Mean PPD was 3.8\u00a0mm in smokers versus 2.5\u00a0mm in nonsmokers, and mean CAL was 2.9\u00a0mm in smokers compared to 1.7\u00a0mm in nonsmokers (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001 for both measures). Additionally, smokers showed a reduced BOP score, with bleeding observed in only 45% of sites among smokers versus 78% among nonsmokers, indicating a masking effect of nicotine on gingival inflammation. Longer smoking duration was associated with more severe periodontal damage, with increased PPD and CAL values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study underscores the negative impact of smoking on periodontal health, particularly in populations with limited access to dental care. The findings support the need for integrating smoking cessation programs into oral healthcare strategies to mitigate periodontal disease progression among smokers. Public health initiatives should prioritize smoking prevention and cessation, particularly in underserved regions with high smoking prevalence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>Smoking has a major impact on oral health, specifically by worsening periodontal (gum) disease. This study aimed to understand how smoking affects gum health by comparing smokers and nonsmokers in Afghanistan. Periodontal disease is a common condition in which the structures that support the teeth become inflamed and, if untreated, can lead to tooth loss. This study involved examining the gums of 122 participants, some of whom smoked while others did not. Several indicators of gum health were measured, such as probing depth, clinical attachment loss, and bleeding on probing.<\/jats:p><jats:p>The findings revealed that smokers showed significantly worse gum health than nonsmokers. Smokers had deeper pockets around their teeth, more attachment loss, and less gum bleeding, which can make it harder to detect early signs of disease. These results confirm that smoking is a serious risk factor for periodontal disease, suggesting that quitting smoking could be key to improving oral health. This research highlights the importance of public health programs focusing on smoking prevention and cessation to reduce periodontal disease risk in communities where smoking rates are high.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.24-0693","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T09:03:38Z","timestamp":1739869418000},"page":"817-825","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The influence of smoking on periodontal health: A case\u2013control study in Afghanistan"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5970-713X","authenticated-orcid":false,"given":"Hedayatullah","family":"Ehsan","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Dentistry, Medical Sciences Research Center Ghalib University Kabul Afghanistan"},{"name":"Faculty of Medicine and Dentistry Kabul University of Medical Sciences Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600\u20100757.2002.290109.x"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034512457373"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12064"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2004.75.2.196"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.4812678"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12061"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13016"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051X.2005.00710.x"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0906\u20106713.2002.003421.x"},{"key":"e_1_2_13_11_1","unstructured":"World Health Organization.WHO global report on trends in tobacco smoking 2000\u20132025 third edition..World Health Organization;2019. doi:10.1787\/9789264309881\u2010en"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCIDE.S444093"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051X.2005.00869.x"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.18\u20100450"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2015.140520"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051X.2004.00476.x"}],"container-title":["Journal of Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/JPER.24-0693","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T10:50:06Z","timestamp":1760871006000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1002\/JPER.24-0693"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,18]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/JPER.24-0693"],"URL":"https:\/\/doi.org\/10.1002\/jper.24-0693","archive":["Portico"],"relation":{},"ISSN":["0022-3492","1943-3670"],"issn-type":[{"value":"0022-3492","type":"print"},{"value":"1943-3670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,18]]},"assertion":[{"value":"2024-10-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}