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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (6): 1144-1149. doi: 10.19723/j.issn.1671-167X.2019.06.029

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Correlation between cigarette smoking and periodontal status: A survey on the population of a community above 35-year-old in Beijing

Yi-fan YANG,Qing-xian LUAN()   

  1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2017-10-10 Online:2019-12-18 Published:2019-12-19
  • Contact: Qing-xian LUAN E-mail:kqluanqx@126.com

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Abstract:

Objective: To survey the cigarette smoking status and periodontal status, and to study the correlation between cigarette smoking and periodontal status.Methods: Questionnaires were distributed (including self-assessed periodontal status, such as bleeding while brushing teeth, oral odor, tooth loosen-ing, gum swelling, etc.) and clinical periodontal examinations performed for parameters including probing depth (PD), bleeding index (BI), attachment loss (AL), plaque index (PLI) and amount of teeth loss, which was recorded in the population above 35 years of a community in Beijing. A total of 974 subjects were recruited in the study. The population was divided into current smokers and non-smokers, and the differences of self-assessed periodontal status and periodontal parameters between the groups analyzed.Results: The smokers had significantly less bleeding during toothbrushing, and in the meantime, had significantly more self-reported tooth loosening compared with the non-smokers. The smokers brushed their teeth less than the non-smokers (P<0.05). The self-reported gum swelling and oral odor had no significant difference between the smokers and non-smokers. The smokers had 0.565 times and 1.572 times the risk of bleeding during toothbrushing, self-reported tooth loosening and from Logistic regression analyses, respectively (P<0.05). The mean PD, AL, PLI and the amount of tooth loss of the smokers were significant higher than the non-smokers (P<0.05). However, the mean BI of the smokers was slightly less than the non-smokers’ (1.93±0.540 vs. 1.94±0.512, P=0.707). The smokers had 2.129 times, 1.698 times and 1.933 times the risk of the mean PD>3 mm, the mean AL>3 mm, and the amount of tooth loss above 8, respectively compared with the non-smokers (P<0.05) from Logistic regression analyses.Conclusion: The self-assessed periodontal status is different between smokers and non-smokers in the population of a community in Beijing. Smokers have less bleeding during toothbrushing but no significant difference with BI. Smokers also have more self-reported tooth loosening. Compared with non-smokers, smokers have more severe periodontal destruction.

Key words: Smoking, Periodontal index, Diagnostic self evaluation, Periodontal diseases, Community population

CLC Number: 

  • R781.4

Table 1

The characteristics of the smokers and non-smokers"

Variables Smokers (n=207) Non-smokers (n=785) P
Demographic variables, systemic status
Age/years, median (min, max) 63 (36, 83) 65 (37, 85) <0.001
Gender, n (%) <0.001
Male 188 (91.3) 297 (38.7)
Female 18 (8.70) 471 (61.3)
Education, n (%) 0.229
Primary school 49 (23.8) 225 (29.4)
Middle school 123 (59.7) 410 (53.6)
College 34 (16.5) 130 (17.0)
Income per month, n (%) 0.054
≤1 000 yuan 56 (27.2) 220 (28.6)
>1 000 yuan, ≤2 000 yuan 124 (60.2) 487 (63.4)
>2 000 yuan, ≤4 000 yuan 25 (12.1) 51 (6.6)
>4 000 yuan 1 (0.50) 10 (1.3)
Diabetes mellitus, n (%) 58 (31.7) 260 (37.4) 0.156
Taking antibiotics in three months, n (%) 28 (13.6) 132 (17.2) 0.216
Self-assessment and behavior
Bleeding while brushing, n (%) 48 (24.6) 248 (33.4) 0.019
Teeth loosening, n (%) 126 (64.0) 406 (54.7) 0.020
Oral odor, n (%) 85 (43.1) 265 (35.8) 0.057
Gum swelling, n (%) 70 (35.5) 236 (31.8) 0.321
Frequency of toothbrushing, n (%) <0.001
None 14 (7.1) 30 (4.1)
Once per day 104 (52.8) 290 (39.2)
Twice per day 77 (39.1) 389 (52.6)
Three times per day 2 (1.0) 31 (4.2)
Clinical parameters
PD/mm, median (min, max) 2.92 (1.48, 6.19) 2.54 (1.08, 11.50) <0.001
AL/mm, median (min, max) 2.79 (0.29, 13.00) 2.44 (0.04, 11.00) <0.001
BI, x?±s 1.93±0.54 1.94±0.51 0.707
PLI, median (min, max) 1.71 (0.70, 3.58) 1.67 (0.50, 3.38) 0.085
Amount of tooth loss, median (min, max) 5 (0, 28) 4 (0, 28) 0.111

Table 2

The adjusted odds ratios (95% confidence interval) of smoking to self-assessed periodontal status from Logistic regression analyses"

Covariates Bleeding while brushing Teeth loosening Frequency of toothbrushing>1
Smoke 0.565 (0.361, 0.886)* 1.527 (1.019, 2.289)* 0.743 (0.496, 1.113)
Age 0.937 (0.917, 0.956)△ 1.019 (1.000, 1.038) 0.987 (0.968, 1.006)
Gender 0.986 (0.694, 1.400) 0.804 (0.580, 1.115) 2.270 (1.614, 3.192)△
Education (reference: college)
Primary school 1.047 (0.618, 1.774) 1.232 (0.763, 1.988) 0.276 (0.167, 0.455)△
Middle school 0.982 (0.639, 1.511) 1.247 (0.837, 1.857) 0.791 (0.524, 1.196)
Income per month(reference: >4 000 yuan)
≤1 000 yuan 0.975 (0.237, 4.003) 2.392 (0.567, 10.082) 0.830 (0.193, 3.575)
>1 000 yuan, ≤2 000 yuan 0.838 (0.209, 3.359) 2.074 (0.503, 8.558) 1.064 (0.252, 4.489)
>2 000 yuan, ≤4 000 yuan 0.765 (0.174, 3.368) 1.399 (0.313, 6.263) 1.052 (0.229, 4.825)
Diabetes mellitus 1.478 (1.076, 2.028)* 1.076 (0.799, 1.448) 1.080 (0.795, 1.468)
Taking antibiotics in 3 months 1.001 (0.669, 1.498) 1.597 (1.088, 2.345)* 1.198 (0.814, 1.764)

Table 3

The adjusted odds ratios (95% confidence interval) of smoking to clinical periodontal status from Logistic regression analyses"

Covariates PD>3 mm AL>3 mm PLI>1.7 Amount of tooth loss>8
Smoke 2.129 (1.415, 3.203)△ 1.698 (1.035, 2.784)* 1.157 (0.791, 1.693) 1.933 (1.234, 3.028)#
Age 1.004 (0.983, 1.025) 1.075 (1.050, 1.100)△ 1.001 (0.983, 1.019) 1.135 (1.105, 1.166)△
Gender 0.631 (0.439, 0.908)* 1.074 (0.736, 1.568) 1.212 (0.884, 1.661) 0.861 (0.596, 1.243)
Education, ref (college)
Primary school 1.410 (0.823, 2.415) 1.200 (0.686, 2.097) 0.894 (0.564, 1.419) 2.014 (1.181, 3.436)#
Middle school 1.339 (0.849, 2.111) 1.380 (0.875, 2.178) 1.229 (0.833, 1.811) 1.686 (1.028, 2.764)*
Income per month, ref (>4 000 yuan)
≤1 000 yuan P>0.999 1.028 (0.237, 4.461) 1.746 (0.417, 7.301) 1.505 (0.150, 15.146)
>1 000 yuan, ≤2 000 yuan P>0.999 1.082 (0.257, 4.561) 1.688 (0.411, 6.929) 1.497 (0.151, 14.829)
>2 000 yuan, ≤4 000 yuan P>0.999 1.221 (0.260, 5.735) 1.779 (0.401, 7898) 1.723 (0.159, 18.618)
Diabetes mellitus 1.575 (1.137, 2.180)# 1.192 (0.836, 1.700) 1.162 (0.874, 1.544) 1.842 (1.321, 2.569)△
Taking antibiotics in 3 months 0.666 (0.429, 1.034) 1.376 (0.899, 2.104) 0.877 (0.611, 1.259) 0.741 (0.473, 1.161)
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