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Tobacco products could exerts effect on the host response both locally at higher 

concentrations due to direct exposure to cigarette smoke and systematically at lower 

concentrations due to circulation of tobacco products in the bloodstream, saliva, and so on. In

general, two types of change in the host response due to smoking could lead to increased

 periodontal destruction : 1. Tobacco smoking could impair the normal function of the host

response in neutralizing infection and . Tobacco smoking could overstimulate the host to

destroy the surrounding healthy tissue. !igarette smoking may exert both of these type of effects

on the host response.

"everal line of evidence demonstrate the effects of smoking on impairing the normal

function of the host response. #or example, smokers have decreased amounts of salivary

antibodies $Ig%, which is necessary to neutralize bacteria in the mouth& and a decreased serum

Ig' antibody response to  Prevotella intermedia  and Fusobacterium nucleatum. In addition to

this general decrease in antibodies, smokers also have decrease in specific subtypes of antibodies

that may be of particular importance in dealing with the most potentially harmful periodontal

 bacteria. These depressed antibodies include Ig' and antibodies to more harmful strains of 

(orphyromonas gingivalis. In addition, smokers appear to have fewer heler T lymphocytes,

which are necessary in combating a variety of infections.

)ne of the most extensively studied cells in the host response is the neutrophil. *hole

tobacco smoke has been shown to impair both oral and peripheral $blood& neutrophil chemotaxis

and phagocytosis. "imilar effects have been observed with higher concentratons of individual

tobacco component such as nicotine, acrolein, and cyanide.

+vidence also supports the role of smoking in overstimulating the host response, resulting

in destruction of the surrounding periodontal tissues. #or example, while smoke exposure may

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impair the neutrophils ability to combat periodontal microorganism, it also may stimulate the

release of oxidative burst products and enzymes that could break down periodontal tissue. "moke

may also promote an accumulation of neutrophils in periodontal tissues by stimulating a change

in the level of adhesion moleculs that control the migration and accumulation of neutrophils and

other inflammatory cells in tissue.

(roduk tembakau bisa memberikan efek pada respon host baik secara lokal pada

konsentrasi yang lebih tinggi karena kontak langsung dengan asap rokok dan secara sistematis

 pada konsentrasi rendah karena peredaran produk tembakau dalam aliran darah, air liur, dan

sebagainya. "eluruh asap tembakau telah terbukti merusak baik oral dan kemotaksis perifer 

$darah& neutrofil dan fagositosis. "ecara umum, dua -enis perubahan dalam respon host karena

merokok yang dapat menyebabkan kerusakan periodontal meningkat, yaitu : tembakau pada

rokok dapat mengganggu fungsi normal dari respon host dalam menetralisir infeksi dan

tembakau pada rokok bisa merangsang host secara berlebih untuk menghancurkan -aringan sehat

disekitarnya.

(erokok mengalami penurunan -umlah antibodi saliva $Ig%, yang diperlukan untuk 

menetralkan bakteri di dalam mulut& dan menurunnya serum antibodi Ig' untuk respon terhadap

 Prevotella intermedia  dan Fusobacterium nucleatum. "elain penurunan antibodi, perokok -uga

memiliki penurunan subtipe spesifik antibodi yang mungkin penting dalam menangani bakteri

yang paling berpotensi membahayakan periodontal. (enurunan antibodi, termasuk Ig' dan

antibodi untuk strain lebih berbahaya dari  Porphyromonas gingivalis. "elain itu, perokok 

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memiliki limfosit T-helper   yang lebih sedikit, yang diperlukan dalam memerangi berbagai

infeksi.

ukti -uga mendukung peran merokok dalam merangsang respon host secara berlebihan,

yang mengakibatkan kerusakan -aringan periodontal sekitarnya. (aparan asap dapat mengganggu

kemampuan neutrofil untuk memerangi mikroorganisme periodontal, -uga dapat merangsang

 pelepasan oksidatif dari produk dan enzim yang bisa menghancurkan -aringan periodontal. %sap

 -uga dapat meningkatkan akumulasi neutrofil dalam -aringan periodontal dengan merangsang

 perubahan pada tingkat molekul adhesi yang mengontrol migrasi dan akumulasi neutrofil serta

sel/sel inflamasi lainnya dalam -aringan.