Smoking is an important, preventable risk factor for oral and periodontal disease.

Saliva testing is more appropriate to oral disease investigation. Accordingly, we have developed SmokeScreen to measure the salivary levels of nicotine metabolites (Ann Clin Biochem 2000).

In a recent trial, a semi-quantitative measure using a colour chart to give a salivary nicotine metabolite value was made. Each patient undertook a clinical examination to evaluate oral health and completed a questionnaire about their smoking habits. The intervention group also had their saliva assayed with the chair-side test in the treatment room and provided with feedback and information about their smoking. A control group had their saliva measured, but did not receive the result or feedback. Both groups were recalled after 2 months and the process repeated.

In the intervention group, the saliva test confirmed that 21% had quit smoking 40% reduced their nicotine intake and 31% had no change. This compares with the control group where only 6% had stopped, 12% reduced and 69% had no change.

The test results also correlated with a range of oral disease parameters, such as bleeding score, whereas reported cigarette consumption did not.