Smoking
as a Risk Factor for Periodontitis
The Centers for Disease Control and Prevention
(CDC) have conducted several comprehensive surveys of the
health status of Americans. Referred to as National Health
and Nutrition Examination Surveys (NHANES), these
studies record a large number of health findings and health-related
behaviors that provide a measure of the health of the nation.
Included in NHANES is an oral examination, with clinical
assessment of periodontal disease. Since cigarette smoking
is also recorded, Tomar and Asma from the CDC used data from
the most recent NHANES to examine the cigarette smoking-periodontitis
relationship.
The information from NHANES III, collected
from 1988 to 1994, was used in this analysis. Data was available
from a total of 12,329 individuals who were 318 years of
age. Periodontitis was defined as at least 1 site with probing
depth and attachment loss of 34 mm. Smoking was stratified
into 3 levels. Current smokers were individuals who smoked
at the time of their exam and had smoked 3100 cigarettes
during their lifetime. Former smokers were individuals who
did not smoke at the time of their exam but had smoked 3100
cigarettes. Non-smokers were individuals who did not smoke
at the time of their exam and had smoked < 100 cigarettes
during their lifetimes.
The data indicated that current smokers and
former smokers were 4 times and 1.7 times as likely, respectively,
than non-smokers to have periodontitis. For current smokers,
there was a dose-dependent relationship of cigarettes smoked
per day to the odds of having periodontitis. For example,
if someone smoked 29 cigarettes per day, they were 2.8 times
as likely as non-smokers to have periodontitis. The odds
increased to almost 6 times as likely if the person smoked
331 cigarettes per day (see Table 1). Lastly, calculations
indicated that approximately 42% of all cases of periodontitis
in the United States were related to current smoking and
11% were related to former smoking.
| Table 1. Occurrence of periodontitis associated
with smoking: effects if increasing exposure. |
|
Number of cigarettes per day
|
Odds
|
|
<10
|
2.8
|
|
10-19
|
3.0
|
|
20
|
4.7
|
|
21-30
|
5.1
|
|
>30
|
5.9
|
|
All
|
4.0
|
This report is noteworthy for the large number
of individuals who were studied and the assignment of a percentage
of all periodontitis cases to smoking.
Tomar SL, Asma S.
• Association
of Smoking and Periodontal Disease
• Subgingival
Oxygen Levels and Smoking
• Smoking
and Periodontal Bacteria
• Bone
Mineral Density, Smoking and Alveolar Bone Loss |
