Wickholm Seppo, Söder Per-Osten, Galanti Maria Rosaria, Söder Birgitta, Klinge Björn
Department of Periodontology, Institute of Odontology, Karolinska Institutet Huddinge, Sweden.
Acta Odontol Scand. 2004 Dec;62(6):333-8. doi: 10.1080/00016350410001801.
The aim of this study was to compare the prevalence of periodontal disease in different groups of tobacco users. Participants (n = 1674) were selected from an initial random sample of residents in the Stockholm region. Socio-demographic characteristics and life-time history of tobacco use were registered in a self-completed questionnaire, followed by a clinical examination. Cumulative life-time tobacco use was analyzed in pack-years and can-years as the exposure of interest. Among participants, 50.8% were females and 49.2% were males. Life-time tobacco use was categorized into four mutually exclusive categories. Approximately, two-thirds of snuff users had combined snuff use with cigarette smoking during their life. Tobacco users had a higher prevalence of periodontal disease compared to never users. Exclusive smokers and mixed users presented the less favorable situation. Unhealthy periodontal conditions increased with increasing exposure to smoking, most evidently at the level of 15 or more pack-years. There was a significant positive association between current or former smoking and periodontal disease (OR = 2.7, CI = 1.7-4.3 and OR = 2.0, CI = 1.2-3.3, respectively) even after adjustment for plaque level. An indication of association was also apparent with former snuff use. Plaque was independently associated with periodontal disease, with a dose gradient. Smoking is associated with periodontal disease independently of plaque. Combining cigarette smoking and snuff use during life does not convey a decreased probability of being diagnosed with periodontal disease compared to smoking exclusively.
本研究的目的是比较不同烟草使用群体中牙周疾病的患病率。参与者（n = 1674）选自斯德哥尔摩地区居民的初始随机样本。通过一份自我填写的问卷记录社会人口学特征和烟草使用的终生史，随后进行临床检查。将累积终生烟草使用量以包年数和罐年数作为感兴趣的暴露因素进行分析。参与者中，50.8%为女性，49.2%为男性。终生烟草使用被分为四个相互排斥的类别。大约三分之二的鼻烟使用者在其一生中同时使用鼻烟和香烟。与从不使用者相比，烟草使用者患牙周疾病的患病率更高。单纯吸烟者和混合使用者的情况更不利。随着吸烟暴露量增加，不健康的牙周状况增多，最明显的是在15个或更多包年数的水平。即使在调整牙菌斑水平后，当前或既往吸烟与牙周疾病之间仍存在显著正相关（OR = 2.7，CI = 1.7 - 4.3；OR = 2.0，CI = 1.2 - 3.3）。既往使用鼻烟也有明显的关联迹象。牙菌斑与牙周疾病独立相关，呈剂量梯度。吸烟与牙周疾病的关联独立于牙菌斑。与单纯吸烟相比，一生中同时使用香烟和鼻烟并不会降低被诊断为牙周疾病的概率。
