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Tobacco smoking is significantly associated with periodontal disease due to its harmful effects on the oral environment. Smoking compromises the immune response, which can impair the body's ability to fight infections, including those that cause periodontal disease. The toxins in tobacco smoke can also harm the tissues in the gums, contribute to inflammation, and ultimately lead to the breakdown of the supportive structures around the teeth.

Additionally, smoking impairs blood flow to the gums, reducing healing capacity and worsening the condition of the periodontal tissues. Smokers typically have a higher prevalence and severity of periodontal disease compared to non-smokers, making it a prominent oral condition linked to tobacco use.

While other conditions like halitosis (bad breath) and tooth decay can also be influenced by tobacco use, the direct link between smoking and the progression of periodontal disease is particularly notable and well-documented in clinical studies. Normal gingival health, of course, would not be associated with tobacco smoking, as smoking is known to negatively impact periodontal status.