Production of volatile sulphur compounds in diseased periodontal pockets is significantly increased in smokers

OBJECTIVE: This study was undertaken in order to test the hypothesis that the consequences of tobacco smoking may include increased synthesis of toxic volatile sulphur compounds in diseased periodontal pockets. DESIGN: A cross-sectional, parallel study comparing groups of smokers and non-smokers with periodontitis and the level of volatile sulphur compounds in the gingival sulci of these subjects. PATIENTS AND METHODS: Levels of volatile sulphur compounds were measured in diseased periodontal sites of 12 smokers and 11 non-smokers using a portable sulphide monitor. Anaerobic and aerobic counts of the total cultivable subgingival microflora of both groups were also determined. RESULTS: The percentage of sites per subject with high levels of sulphides (> or = 10 units) detected in moderate (4-6 mm) and deep (> or = 7 mm) periodontal pockets was found to be significantly higher in smokers, compared to non-smokers (P = 0.040 and P = 0.005, respectively). No significant difference in the microbiological parameters tested were observed between the two groups. CONCLUSIONS: Increased production of volatile sulphur compounds may represent a further mechanism of increased susceptibility to periodontitis in smokers and also help to explain the reported association between smoking and halitosis.