Smoking Affects Diagnostic Salivary Periodontal Disease Biomarker Levels in Adolescents

Background: The effects of smoking on periodontal biomarkers in adolescents are unknown. This study investigates matrix metalloproteinase (MMP)-8 and polymorphonuclear leukocyte elastase levels in saliva together with periodontal health indices accounting for body mass index and smoking in a birth cohort from Finland. Methods: The oral health of boys (n = 258) and girls (n = 243) aged 15 to 16 years was examined clinically. Health habits were assessed by questionnaire. Saliva samples were collected and analyzed by immunofluorometric and peptide assays for MMP-8 levels and polymorphonuclear leukocyte elastase activities, and investigated statistically with the background factors. Results: Median MMP-8 values of male smokers were 112.03 mu g/l compared to 176.89 mu g/l of non-smokers (P = 0.05). For female smokers corresponding values were 170.88 mu g/l versus 177.92 mu g/l in non-smokers (not statistically significant). Elastase values in male smokers were 5.88 x 10(-3) Delta OD405/h versus 11.0 x 10(-3) Delta OD405/h in nonsmokers (P = 0.02), and in female smokers 9.16 x 10(-3) Delta OD405/h versus 10.88 x 10(-3) Delta OD405/h in non-smokers (P = 0.72). The effect was strengthened by high pack-years of smoking (MMP-8, P = 0.04; elastase, P = 0.01). Both biomarkers increased with gingival bleeding. However, statistically significant associations were observed with bleeding on probing and MMP-8 (P = 0.04); MMP-8 was suggestively associated with probing depth (P = 0.09) in non-smoking boys. In smokers with calculus, MMP-8 increased after adjusting with body mass index (P = 0.03). No corresponding differences were seen in girls. Conclusions: Smoking significantly decreased both biomarkers studied. Compared to girls, boys seem to have enhanced susceptibility for periodontitis as reflected in salivary MMP-8 values. J Periodontol 2010;81:1299-1307.