Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY 14214, USA.
J Am Dent Assoc. 2013 Mar;144(3):252-65. doi: 10.14219/jada.archive.2013.0112.
Smoking is associated with tooth loss. However, smoking's relationship to the specific reason for tooth loss in postmenopausal women is unknown.
Postmenopausal women (n = 1,106) who joined a Women's Health Initiative ancillary study (The Buffalo OsteoPerio Study) underwent oral examinations for assessment of the number of missing teeth, and they reported the reasons for tooth loss. The authors obtained information about smoking status via a self-administered questionnaire. The authors calculated odds ratios (ORs) and 95 percent confidence intervals (CIs) by means of logistic regression to assess smoking's association with overall tooth loss, as well as with tooth loss due to periodontal disease (PD) and with tooth loss due to caries.
After adjusting for age, education, income, body mass index, history of diabetes diagnosis, calcium supplement use and dental visit frequency, the authors found that heavy smokers (≥ 26 pack-years) were significantly more likely to report having experienced tooth loss compared with never smokers (OR = 1.82; 95 percent CI, 1.10-3.00). Smoking status, packs smoked per day, years of smoking, pack-years and years since quitting smoking were significantly associated with tooth loss due to PD. For pack-years, the association for heavy smokers compared with that for never smokers was OR = 6.83 (95 percent CI, 3.40 -13.72). The study results showed no significant associations between smoking and tooth loss due to caries.
Smoking may be a major factor in tooth loss due to PD. However, smoking appears to be a less important factor in tooth loss due to caries. Further study is needed to explore the etiologies by which smoking is associated with different types of tooth loss. Dentists should counsel their patients about the impact of smoking on oral health, including the risk of experiencing tooth loss due to PD.
吸烟与牙齿缺失有关。然而，吸烟与绝经后妇女牙齿缺失的具体原因之间的关系尚不清楚。
参加妇女健康倡议辅助研究（布法罗骨牙周研究）的绝经后妇女（n=1106）接受了口腔检查，以评估缺失牙齿的数量，并报告了牙齿缺失的原因。作者通过自我管理的问卷获取了关于吸烟状况的信息。作者通过逻辑回归计算了比值比（ORs）和 95%置信区间（CIs），以评估吸烟与整体牙齿缺失以及牙周病（PD）引起的牙齿缺失和龋齿引起的牙齿缺失的关系。
在调整了年龄、教育程度、收入、体重指数、糖尿病诊断史、钙补充剂使用情况和看牙医频率后，作者发现重度吸烟者（≥26 包年）报告牙齿缺失的可能性明显高于从不吸烟者（OR=1.82；95%CI，1.10-3.00）。吸烟状况、每天吸烟包数、吸烟年数、吸烟包年数和戒烟年限与 PD 引起的牙齿缺失显著相关。对于吸烟包年数，与从不吸烟者相比，重度吸烟者的关联为 OR=6.83（95%CI，3.40-13.72）。研究结果表明，吸烟与龋齿引起的牙齿缺失之间无显著关联。
吸烟可能是 PD 引起牙齿缺失的一个主要因素。然而，吸烟在龋齿引起的牙齿缺失中似乎是一个不太重要的因素。需要进一步研究探索吸烟与不同类型牙齿缺失相关的病因。牙医应该就吸烟对口腔健康的影响（包括因 PD 而导致牙齿缺失的风险）为患者提供咨询。
