Periodontics · single question

Which of the following is NOT a typical effect of smoking on periodontal health?

  1. Increased gingival bleeding on probing
  2. Alveolar bone loss
  3. Decreased wound healing
  4. Defective collagen formation
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Correct answer: A. Increased gingival bleeding on probing

Smoking paradoxically DECREASES gingival bleeding on probing (BOP) due to nicotine-mediated vasoconstriction, which reduces gingival blood flow and suppresses the vascular inflammatory response. This masking effect is clinically dangerous because dentists rely on BOP to assess periodontal inflammation. Smokers actually have MORE severe periodontitis despite less visible gingival inflammation. Smoking causes: increased alveolar bone loss (through elevated RANKL, reduced osteoblast activity), impaired wound healing (due to ischemia, reduced oxygen tension, and immunosuppression), defective collagen synthesis (nicotine reduces collagen production and increases collagenase activity), and reduced immune response.

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