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Smoking by itself does not cause periodontal disease but it can make it significantly worse

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Since not all smokers develop one or more of these diseases, it is proposed that this disruption of normal physiological balance represents a kind of pathogenetic basic toolkit for the potential development of a range of non-communicable diseases, and that the decision of whether and what disease will develop in an individual is determined by other, individual factors (determinants), such as the genome, epigenome, exposome, microbiome, and others