Impact of tobacco smoking on oral microbiota – a case-control study.

Abdulrahman Ali Hattan, Essa Ali Hattan, Abdulaziz Maree Alqahtani, Omar Saud Alqutaym, Refdan Obeid Alqahtani, Khaled Ghormallah Alzahrani, Abdulrahman Abdullah Al-Otaibi, Omar Mufi Aldwsari, Khalid Mansour Alkhathlan, Mohammed Abdullah Aldossari


Oral microbiota is a vital part of human microbiota, including bacterial, protozoa, viral and fungal species. Beneficial microbes form biofilms to form a first-line defense against harmful microorganisms. Tobacco smoking is considered a major environmental factor affecting the orodental microbiota. Smokers harbor more pathogenic microbes than non-smokers. In fact, cigarette smoking exposes the oral cavity to a large number of toxicants, perturbing the oral microbial ecology through various mechanisms. In Saudi Arabia, research on the impact of tobacco smoking on oral microbiota is still lacking. Therefore, this case-control study is an important addition to the literature in terms of tobacco use and its effects on oral microbiota and oral hygiene. 130 men were recruited for this study, including 65 smokers and 65 non-smokers. The following parameters were recorded for all 130 participants – age, weight, height and education. The aim of this study was to investigate and compare the effect of tobacco smoking on the oral microbiome of smokers and non-smokers. The majority of the smokers were young adults between the ages of 21 and 30 inclusive (n=27). The results show that excessive microorganism growth was seen in smokers to a greater degree than non-smokers (38.5% of smokers vs. 8.8% of non-smokers). Not surprisingly, a significant majority (85.3%) of non-smokers had moderate microorganism growth compared to only 53.8% of smokers. cigarette smoking facilitates excessive growth of oral microorganisms, predisposing smokers to various periodontal diseases. In fact, smoking perturbs the balance of oral microbiota, producing a viable environment for microbes to cause diseases. Further large scale prospective studies are required to determine the exact mechanism that causes tobacco to affect oral microbiota.


oral microbiota; oral health; impact of tobacco smoking

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AvilaM, Ojcius DM, Yilmaz O. The oral micro­biota: living with a permanent guest. DNA and Cell Biology. 2009;28(8):405-11.

Kato I, Vasquez A, Moyerbrailean G, Land S, Djuric Z, et al. Nutritional Correlates of Human Oral Microbiome. Journal of theAmericanCollegeof Nut­rition. 2017;36(2):88-98.

Duran-Pinedo AE, Frias-Lopez J. Beyond micro­bial community composition: functional activities of the oral microbiome in health and disease. Microbes and Infection. 2015;17(7):505-16.

Adler CJ, Dobney K, Weyrich LS, Kaidonis J, et al. Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions. Nature Genetics. 2013;45(4):450-5.

Dagli N, Dagli R, Darwish S, Baroudi K. Oral microbial shift: factors affecting the microbiome and prevention of oral disease. The Journal of Contemporary Dental Practice. 2016;17(1):90-96.

Wade WG. The oral microbiome in health and disease. Pharmacological Research. 2013;69(1):137-43.

Wu J, Peters BA, Dominianni C, Zhang Y, et al. Cigarette smoking and the oral microbiome in a large study of American adults. The ISME Journal. 2016;10(10):2435-46.

Macgregor ID. Effects of smoking on oral ecolo­gy. A review of the literature. Clinical Preventive Den­tistry. 1989;11(1):3-7.

Tomar SL, Asma S. Smoking-attributable perio­dontitis in theUnited States: findings from NHANES III National Health and Nutrition Examination Survey. Journal of Periodontology. 2000;71(5):743-51.

Kumar PS, Matthews CR, Joshi V, de Jager M, et al. Tobacco smoking affects bacterial acquisition and colonization in oral biofilms. Infection and Immunity. 2011;79(11):4730-8.

Natto S, Baljoon M, Bergstrom J. Tobacco smo­king and periodontal health in a Saudi Arabian popu­lation. Journal of Periodontology. 2005;76(11):1919-26.

Researchers find link between tobacco use and viral infection that causes oral cancers; 2014. Available from:­leases/researchers_find_link_between_tobacco_use_and_viral_infection_that_causes_oral_cancers.

Mishra S,MishraMB. Tobacco: Its historical, cultural, oral, and periodontal health association. Journal of International Society of Preventive & Community Dentistry. 2013;3(1):12-18.

Antolin K. Comparison of bacterial growth in the oral cavity between tobacco consumers and non-tobacco users.Saint Martin’s University Biol. J. 2006;1(1):175-84.

Brook I. The impact of smoking on oral and nasopharyngeal bacterial flora. Journal of Dental Re­search. 2011;90(6):704-710.

Bornigen D, Ren B, Pickard R, Li J, Ozer E, Hart­mann EM, et al. Alterations in oral bacterial communities are associated with risk factors for oral and oropharyngeal cancer. Scientific Reports. 2017:7(1):17686.

Bardell D. Viability of six species of normal oro­pharyngeal bacteria after exposure to cigarette smoke in vitro. Microbios. 1981;32(127):7-13.

Ertel A, Eng R, Smith SM. The differential effect of cigarette smoke on the growth of bacteria found in humans. Chest. 1991;100(3):628-30.

Madhushankari GS, Yamunadevi A, Selvamani M, Kumar KPM, Basandi PS. Halitosis – An overview: Part-I – Classification, etiology, and pathophysiology of halitosis. Journal of Pharmacy BioAllied Sciences. 2015;7(Suppl 2):S339-43.

Porter SR, Scully C. Oral malodour (halitosis). British Medical Journal. 2006;333(7569):632-5.

Moslemi-Haghighi F, Rezaei I, Ghaffarinejad F, Lari R, Pouya F. Comparison of physical fitness among smoker and non-smoker men. Addiction & Health. 2011;3(1-2):15-19.

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