During a recent in-office team workshop, we were discussing nicotine use and its dramatic effects on the progression of periodontal disease. To help the team fully understand the consequences of nicotine use, we talked about vasoconstriction and how smoking masks the true level of periodontal infection. The vasoconstrictive properties of smoking reduce blood flow and, in turn, oxygen to the tissue, resulting in gums that do not bleed or have reduced bleeding. Smoking patients have pockets th...