The more you smoke, the higher the risk and the more severe the disease. Smokers are much more likely than non-smokers to have tartar form on their teeth, have deeper pockets between the teeth and gums, and lose more of the bone and tissue that support the teeth. In fact, smoking can cause receding gums and bone loss even in the absence of periodontal disease. Studies on how smoking does its dirty work indicate that it has numerous bad effects on the health of gum tissue and the workings of the immune system. For example, smoking suppresses the production of antibodies directed against some of the harmful bacteria, which allows them to flourish more easily.
Smoking also promotes inflammation and increases bone loss.
For these reasons, quitting has become an important part of preventing and managing periodontal disease. Anything that causes changes in the level of female sex hormones puberty, menstruation, pregnancy, menopause, and use of oral contraceptives makes women more susceptible because such changes make the gums more sensitive to irritants and plaque. For example, when progesterone levels are high, say just before menstruation, the blood vessels in gums dilate which increases inflammation. This is why some women experience flares of gingivitis a few days before their period begins. Progesterone, present in oral contraceptives, also blocks the repair of collagen.