Cigarette Smoking and Dental Caries among Professional Truck Drivers in Mexico

Abstract

Background: Professional truck drivers are at high risk of chronic diseases. Further examination of tobacco use and its impact on oral health is warranted – both in terms of the direct association between tobacco use and poor oral health, and in terms of tobacco use being an indicator of poor health behaviors. Objective: To estimate the possible association between smoking and dental caries experience in a population with high tobacco use. Methods: Drivers’ licenses are periodically re-issued by the Mexican government and as part of the licensing process a physical exam takes place. We administered a free, standardized questionnaire together with an oral examination (WHO criteria) included in the physical exam, targeting a random sample of applicants in Mexico City. Results: A total of 824 dentate males (mean age 35.5 ± 10 years) took part in the study, of whom 49.2% were current smokers and 23.2% were former smokers. Caries experience was mean DMFT 8.95 (± 6.05). Only 18.0% of participants had ‘excellent’ or ‘good’ oral hygiene. The prevalence of ‘large’ cavities increased as the number of cigarettes/day increased from 14.6% (1–3 cigarettes/day) to 33.3% (≧10 cigarettes/day). Using multiple linear regressions, we found that older age, poorer oral hygiene, higher education, and greater tobacco exposure were significantly associated with higher caries experience (DMFT). An interaction was observed with oral hygiene and tobacco: drivers that smoked and had ‘poor’ oral hygiene showed the highest number of large cavities and missing teeth. Health promotion interventions are needed in this at-risk population group.

Does Smoking Increase Risk for Caries? A Cross-Sectional Study in an Italian Military Academy

“…Few studies [Axelsson et al, 1998] showed a positive association between caries experience and smoking, without reporting the exact rule of the association. While acknowledging that a large number of missing teeth were due to periodontal disease [Sgan-Cohen et al, 2000;Röthlisberger et al, 2007], it is reasonable to assign responsibility for some of these missing teeth to caries [Aguilar-Zinser et al, 2008]. In the present study the M (missing teeth due to caries) component of DMFS was similar in heavy smokers, light smokers and non-smokers.…”

“…Recently, an association between dental caries and smoking habit has been reported [Aguilar-Zinser et al, 2008;Al-Habashneh et al, 2009], suggesting that smoking has an adverse effect on oral health, both in clinical periodontal parameters and caries risk. Tobacco use could have a role in changes of the bacterial ecology and plaque accumulation [Pihlstrom et al, 2005].…”

Tobacco and dental caries: A systematic review

“…Finally, five studies of dental caries (n = 4) [27][28][29][30] and oral bacteria (n = 1) [31] were included in the qualitative analysis. One of the included studies also described a relationship between tobacco smoking and salivary secretion rate.…”

“…Two studies referred to sub-groups of a population: the Italian Military Academy and professional truck and bus drivers in Mexico [27,29]. The other two described tobacco effects in wider populations: the Rakai District in south-western Uganda [28] and the County of Värmland in Sweden [30].…”

Nicotine promotes Streptococcus mutans extracellular polysaccharide synthesis, cell aggregation and overall lactate dehydrogenase activity

“…Along with lung cancer, vascular stenosis, heart attacks and periodontal disease, dental caries has been reported to be associated with smoking all over the world, including Swedish and US smokers, Mexican truck drivers, Turkey and Japanese children, and Italy military personnel (4)(5)(6)(7)(8)(9). A recent study in Japan demonstrated smokers received more caries/endodontic treatment than non-smokers (10).…”