Krall Elizabeth A, Dietrich Thomas, Nunn Martha E, Garcia Raul I
Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Veterans Affairs Normative Aging Study and Dental Longitudinal Study, VA Boston Healthcare System, Boston, Mass 02118, USA.
Prev Chronic Dis. 2006 Oct;3(4):A115. Epub 2006 Sep 15.
Little is known about the effect of cigarette smoking cessation on risk of tooth loss. We examined how risk of tooth loss changed with longer periods of smoking abstinence in a prospective study of oral health in men.
Research subjects were 789 men who participated in the Veterans Administration Dental Longitudinal Study from 1968 to 2004. Tooth status and smoking status were determined at examinations performed every 3 years, for a maximum follow-up time of 35 years. Risk of tooth loss subsequent to smoking cessation was assessed sequentially at 1-year intervals with multivariate proportional hazards regression models. Men who never smoked cigarettes, cigars, or pipes formed the reference group. Hazard ratios were adjusted for age, education, total pack-years of cigarette exposure, frequency of brushing, and use of floss.
The hazard ratio for tooth loss was 2.1 (95% confidence interval [CI], 1.5-3.1) among men who smoked cigarettes during all or part of follow-up. Risk of tooth loss among men who quit smoking declined as time after smoking cessation increased, from 2.0 (95% CI, 1.4-2.9) after 1 year of abstinence to 1.0 (95% CI, 0.5-2.2) after 15 years of abstinence. The risk remained significantly elevated for the first 9 years of abstinence but eventually dropped to the level of men who never smoked after 13 or more years.
These results indicate that smoking cessation is beneficial for tooth retention, but long-term abstinence is required to reduce the risk to the level of people who have never smoked.
关于戒烟对牙齿脱落风险的影响，人们了解甚少。在一项针对男性口腔健康的前瞻性研究中，我们研究了牙齿脱落风险如何随着戒烟时间的延长而变化。
研究对象为789名男性，他们参与了1968年至2004年的退伍军人管理局牙科纵向研究。每3年进行一次检查，确定牙齿状况和吸烟状况，最长随访时间为35年。使用多变量比例风险回归模型，每隔1年依次评估戒烟后牙齿脱落的风险。从不吸烟（包括香烟、雪茄或烟斗）的男性作为参照组。风险比根据年龄、教育程度、香烟暴露总包年数、刷牙频率和使用牙线情况进行了调整。
在随访期间全部或部分时间吸烟的男性中，牙齿脱落的风险比为2.1（95%置信区间[CI]，1.5 - 3.1）。戒烟男性的牙齿脱落风险随着戒烟后时间的增加而下降，从戒烟1年后的2.0（95% CI，1.4 - 2.9）降至戒烟15年后的1.0（95% CI，0.5 - 2.2）。在戒烟的前9年，风险仍显著升高，但在13年或更长时间后最终降至从不吸烟男性的水平。
这些结果表明，戒烟对保留牙齿有益，但需要长期戒烟才能将风险降低到从未吸烟人群的水平。
