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Oral Changes Associated with Tobacco Use The evidence is overwhelming that smoking contributes to periodontal disease and that continued smoking results in a reduced response to periodontal treatment

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Poor oral hygiene practices, especially the use of fingers or neem sticks for brushing, and horizontal brushing techniques, were significantly associated with worse periodontal outcomes, likely due to inadequate plaque removal and soft tissue trauma ( Our regression and structural equation models (SEM) further reinforced these associations, showing that demographic factors, tobacco type, duration, and frequency of use, and brushing methods collectively explained over 60% of the variance in gingival recession and nearly 37% of the variance in probing depth, demonstrating a strong explanatory power