Effect of smokeless tobacco use on salivary glutathione levels among chronic periodontitis patients before and after non-surgical periodontal therapy

Introduction: Smokeless tobacco (SLT) jeopardizes periodontal health and also produces an imbalance between reactive oxygen species (ROS) and antioxidants (AO) such as glutathione. Glutathione is an important redox regulator in saliva and its maintenance is essential for periodontal health. Periodontitis patients have a reduced total AO capacity in whole saliva, and periodontal therapy restores the redox balance. Hence, the purpose of this study was to investigate the effects of smokeless tobacco use on saliva glutathione levels in patients with chronic periodontitis and to evaluate these effects after non-surgical periodontal therapy.

Methods: The study included 100 subjects in four groups; healthy, gingivitis, and chronic periodontitis (CP) patients with and without SLT use. Saliva samples were collected, and clinical periodontal parameters were recorded at baseline and at one month after non-surgical periodontal therapy. Glutathione levels were analyzed using spectrophotometry at 412 nm. Statistical analysis was carried out using paired t-test, chi-squared, and analysis of variance (ANOVA).

Results: Mean glutathione values in saliva were found to be lower in periodontitis patients compared to SLT users at baseline and at 1 month post non-surgical periodontal therapy (p<0.001) In addition, non-surgical therapy leads to a highly significant improvement in the glutathione levels in gingivitis, in the CP with and without ST groups (p<0.001).

Conclusions: Successful non-surgical periodontal therapy leads to considerable progress in the redox balance, thus regulating glutathione levels and reducing the effects of SLT on the periodontium. This emphasises the importance of non-surgical therapy, especially among SLT users.

Keywords: antioxidant; glutathione; non-surgical periodontal therapy; periodontitis; reactive oxygen species; smokeless tobacco.