Smoking confounds the periodontal diagnostics using saliva biomarkers

Abstract

Aim Smoking is a risk factor for periodontal disease because of its complex impact on the inflammatory response in the periodontium. We investigated the effect of smoking on salivary periodontal biomarkers, matrix metalloproteinase (MMP)‐8, MMP‐9, tissue inhibitor of metalloproteinase (TIMP)‐1 and myeloperoxidase (MPO).

Methods Saliva biomarkers were analyzed in the Parogene population (n = 480) comprising a random cohort of patients that have undergone coronary angiography and oral examination. The effect of time since cessation and pack years of smoking on biomarkers were investigated.

Results Saliva MMP‐8, MMP‐9, TIMP‐1, and MPO concentrations distinguished periodontitis patients significantly from patients without periodontitis. When the time since cessation was considered, the area‐under‐the‐curve values (p‐value) for periodontitis were 0.76 (<0.001), 0.74 (<0.001), 0.70 (<0.001), and 0.76 (<0.001), respectively. Adding information about smoking habits in the models improved slightly the sensitivities of all biomarkers. In logistic regression model saliva, MMP‐8 was mainly affected by pack years of smoking, whereas saliva MMP‐9, TIMP‐1, and MPO were mostly affected by time since cessation, especially if smoking currently or quit recently (<1 year ago).

Conclusions Smoking confounds the salivary diagnostics of periodontitis and should be considered when interpreting the results obtained by potential diagnostic tests.