Background. Severe periodontitis leading to tooth loss is found in 5–15% of most populations worldwide. Aim. The applicability of salivary β-hexosaminidase (β-HEX A%, percentage of β-HEX A isoenzyme to total β-HEX) and β-HEX B% (β-HEX B/β-HEX) indexes was investigated as a possible marker of periodontitis. Methods. Thirty three alcohol-dependent smokers (AS) and 32 healthy controls (C) were enrolled in the study. The activity of β-HEX was measured spectrophotometrically. Results. β-HEX A% was significantly higher and β-HEX B% was lower in AS than in C group. We found a significant correlation between β-HEX A% and gingival index (GI) and an inverse correlation between β-HEX A% and salivary flow (SF), in all groups. Salivary β-HEX A% index in smoking alcoholics at 0.23 had excellent sensitivity (96%) and specificity (91%); the AUC for β-HEX A% was high (0.937). There were no correlations between amount/duration-time of alcohol drinking/smoking and β-HEX A% or β-HEX B%. We found significant correlations between the time period of denture wearing and GI, papilla bleeding index (PBI), and decayed missing filled teeth index (DMFT) and between GI and the amount of smoked cigarettes per day. Conclusion. Bad periodontal state was most likely due to the nicotine dependence. Salivary β-HEX A% is a promising excellent marker for the diagnosis of periodontitis. 1. Introduction Periodontium is a group of specialized tissues that surround and support the teeth and maintain them in the maxillary and mandibular bones, and it consists of four principal components: gingiva, periodontal ligament, cementum, and alveolar bone [1]. The inflammatory state of periodontium is called periodontitis, which is one of the most common oral diseases and is characterized by the loss of connective tissue attachment and bone around the teeth in conjunction with the formation of periodontal pockets due to the apical migration of the junctional epithelium (gingival inflammation and alveolar bone resorption) [2]. Periodontitis is generally described as a multifactorial irreversible and cumulative condition, initiated and propagated by bacteria and host factors. Severe periodontitis leading to tooth loss was found in 5–15% of most populations worldwide. It is known that the oral mucosal surface is the home of numerous normal flora microorganisms (more than 500 different bacterial species are able to colonize the oral biofilm), being the portal of entry for the majority of pathogens. It is also known that salivary proteins participate in the protection of oral tissues, as well as upper
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