Smoking is a risk factor for oral diseases and tooth loss. Our aim was to analyze the association between smoking intensity and duration and tooth loss among middle-aged Finnish adults who have enjoyed access to subsidized dental care since childhood.
This study was based on the Northern Finland Birth Cohort 1966 (NFBC1966) Project, a representative sample of Finnish 46-year-olds. Altogether 1946 46-year-olds participated in a survey and comprehensive clinical oral examinations. We measured smoking exposure in pack-years (intensity) and years of smoking (duration) combined with recent smoking status (current, former, occasional or never). We used negative binomial regression models to estimate the unadjusted and adjusted relative risks (RR) with corresponding 95 % confidence intervals (CI) for tooth loss as an outcome. Gender, education, tooth brushing frequency, dental plaque, diabetes and alcohol use served as explanatory variables for the adjusted models.
Smoking intensity associated with tooth loss in an exposure-dependent manner: those with a high number of pack-years had a significantly greater probability of tooth loss than never smokers: 11-20 pack-years (RR?=?1.55, 95 % CI?=?1.15-2.08) and 21 or more pack-years (RR?=?1.78, 95 % CI?=?1.36-2.33). Smoking duration also associated with tooth loss: those who had smoked for several years had a significantly higher probability of tooth loss than never smokers: 21-30 years of smoking (RR?=?1.66, 95 % CI?=?1.29-2.12) and 31 or more years of smoking (RR?=?1.72, 95 % CI?=?1.20-2.45).
We found a clear intensity- and duration-dependent relation between smoking and tooth loss among adults with access to subsidized dental care and in good oral health.
Cites: Int J Dent Hyg. 2015 Nov;13(4):292-30026294114
Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, P.O. Box 5000, Oulu 90014, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 5000, Oulu 90029, Finland. Electronic address: firstname.lastname@example.org.
We investigated the association of impaired glucose metabolism with tooth loss in adults in the Northern Finland Birth Cohort Study 1966 (NFBC1966).
We examined 4394 participants from the 46-year follow-up of the NFBC1966. Self-reported number of teeth as well as insulin and glucose values, taken during a standard oral glucose tolerance test (OGTT), served as the primary study variables. A multinomial logistic regression model served to analyse (unadjusted, smoking-adjusted and fully adjusted) the association between number of teeth (0-24, 25-27, 28-32) and glucose metabolism in women and men.
Among women, type 2 diabetes - whether previously known or detected during screening - pointed to a higher likelihood of 0-24 teeth (fully adjusted OR?=?2.99, 95%CI?=?1.54-5.80) and 25-27 teeth (OR?=?1.91, 95%CI?=?1.18-3.08) than did normal glucose tolerance. Similarly, impaired fasting glucose and impaired glucose tolerance together indicated a higher likelihood of 0-24 teeth (OR?=?1.71, 95%CI?=?1.09-2.69) than did normal glucose tolerance. A similar, statistically non-significant, pattern emerged among men. Number of teeth associated with OGTT insulin and glucose curves as well as with the Matsuda index in both women and men.
Tooth loss strongly associated with impaired glucose metabolism in middle-aged Finnish women.
Despite smoking cessation efforts, cigarette smoking remains a serious general and oral health problem. We aimed to investigate the putative benefits of smoking cessation on dentition and to analyse whether the time elapsed since smoking cessation associated positively with the remaining number of teeth.
This cross-sectional study analyses data from the 46-year follow-up of the Northern Finland Birth Cohort Study 1966 (NFBC1966). A total of 5 540 subjects participated in this cross-sectional study, which utilises both clinical dental examinations and mailed questionnaires. We used the following information on smoking: status (current, former, never), years of smoking (current, former) and years elapsed since smoking cessation (former). Self-reported and clinically measured number of teeth (including third molars) served as alternative outcomes. We used binary logistic regression models to analyse the dichotomised number of teeth ('0-27', '28-32') and then calculated unadjusted and adjusted odds ratios (OR) with 95 % confidence intervals (CI) for the smoking variables (never smoker as the reference). Gender, education, tooth brushing frequency, diabetes and alcohol use served as confounders for the adjusted models.
Ten years or more of smoking associated with tooth loss; this effect was the strongest among men who reported having an ongoing smoking habit (self-reported outcome: adjusted OR?=?1.74, CI?=?1.40-2.16) and the weakest among women classified as former smokers (self-reported outcome: adjusted OR?=?1.27, CI?=?1.00-1.62).
This study shows that smoking has long-term effects on tooth loss even after cessation. The findings support smoking cessation efforts to reduce oral health risks.
Cites: BMC Public Health. 2015 Nov 17;15:114126576994
Cites: J Am Dent Assoc. 2010 Oct;141(10):1242-920884927