BackgroundTooth loss impairs oral function. The aim of the present review was to evaluate the causal association between smoking and tooth loss on the basis of high-quality studies.MethodsRelevant literature was searched and screened, and the methodological quality was assessed. Information on the strength of the association between smoking and tooth loss, the dose-response relationship and natural experimental data was collected and evaluated with respect to consistency and study design.ResultsOur literature search yielded 496 citations, and 6 cross-sectional and 2 cohort high-quality studies examining 58,755 subjects in four countries. All studies reported significant associations, although the strength of the association was usually moderate. Four studies reported dose-response relationships between exposure to smoking and the risk of developing tooth loss. A decrease in the risk of tooth loss for former smokers was evident in six studies. Interpretation of evidence for each element was consistent, despite some shortcomings regarding study type and population.ConclusionsBased on the consistent evidence found with the existing biological plausibility, a causal association between smoking and tooth loss is highly likely. Further studies using a cohort design and different populations are necessary to confirm this association.
The present study investigated the association of lifestyles to periodontal health status of workers in a manufacturing company in Japan. In a annual health checkup, periodontal health status was assessed by using the Community Periodontal Index (CPI) criteria and analysed by modified Miller's CPI score. Lifestyle information was also obtained by a self-administered questionnaire. Bivariate and multivariate analyses were used to examine the relationship between lifestyle and oral health care variables and 2 indicators of periodontal health status. These were the modified Miller's CPI score and the probability of subjects in the upper 25th percentile of CPI distribution as an indicator of poor periodontal health. The modified Miller's CPI score was found to increase with age, but to vary according to the workers' lifestyles. In bivariate analyses, significant variables were age, smoking, alcohol consumption, toothbrushing frequency, toothbrushing method, and use of interdental cleaners. In multivariate analyses, age, smoking, and use of interdental cleaners had significantly independent effects. Amount of smoking or alcohol consumption was associated with periodontal health status. Excessive use of alcohol may contribute to the development of periodontal disease, although further investigations are required to confirm this finding. The data from this study indicate that lifestyles which include smoking and insufficient oral health care have an independent association with periodontal disease.
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