Tobacco smoking significantly influences periodontal health and disease, having adverse effects on oral health and dental care. The health consequences of tobacco use are worsening globally, particularly those caused by cigarette smoking. Smoking is associated with an increased rate of periodontal attachment loss, periodontal pocket formation, and periodontal bone loss. Although gingivitis and periodontitis are caused by bacterial infection, smoking has been shown to be a strong risk marker and likely a risk factor for the development and progression of periodontal disease (Tonetti, 1998). When smoking's role in periodontal disease was first discovered, it was believed to be linked to plaque (Arno et al., 1958). However, Bergstrom et al. (1991) concluded that smoking is a risk factor even for individuals with good oral hygiene. Moreover, the combined effect of smoking and plaque infection is likely to be more destructive than either factor alone.