Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA.
J Periodontol. 2017 Dec;88(12):1271-1280. doi: 10.1902/jop.2017.170231. Epub 2017 Jul 28.
The aim of this study is to investigate the impact of alcohol consumption on clinical attachment loss (AL) progression over a period of 5 years.
A multistage probability sampling strategy was used to draw a representative sample of the metropolitan area of Porto Alegre, Brazil. Five hundred thirty-two individuals (209 males and 293 females) aged 18 to 65 years at baseline with no medical history of diabetes and at least six teeth were included in this analysis. Full-mouth periodontal examinations with six sites per tooth were conducted at baseline and after 5 years. Alcohol consumption was assessed at baseline by asking participants about the usual number of drinks consumed in a week. Four categories of alcohol consumption were defined: 1) non-drinker; 2) ≤1 glass/week; 3) >1 glass/week and ≤1 glass/day; and 4) >1 glass/day. Individuals showing at least two teeth with proximal (clinical AL) progression ≥3 mm over 5 years were classified as having disease progression. Multiple Poisson regression models adjusted for age, sex, smoking, socioeconomic status, and body mass index were used to estimate relative risks (RRs) and 95% confidence intervals (CIs).
Overall, individuals who consumed >1 glass/day had 30% higher risk for clinical AL progression (RR = 1.30; 95% CI: 1.07 to 1.58) than non-drinkers. Among males, risk of clinical AL progression for individuals drinking >1 glass/day was 34% higher than non-drinkers (RR = 1.34; 95% CI: 1.09 to 1.64). Never-smoker males drinking ≤1 glass/week had significantly lower risk for clinical AL progression than non-drinkers (RR = 0.52; 95% CI: 0.30 to 0.89), whereas those drinking >1 glass/day had significantly higher risk (RR = 1.50; 95% CI: 1.08 to 1.99). Among females, no association between alcohol consumption and clinical AL progression was observed.
Alcohol consumption increased the risk of clinical AL progression, and this effect was more pronounced in males. Low dosages (≤1.37 g of alcohol/day) of alcohol consumption may be beneficial to prevent periodontal disease progression in males. The impact of alcohol cessation initiatives on periodontal health should be evaluated.
本研究旨在探讨饮酒对临床附着丧失（AL）在 5 年内进展的影响。
采用多阶段概率抽样策略，抽取巴西阿雷格里港大都市区的代表性样本。本分析纳入了基线时年龄在 18 至 65 岁、无糖尿病病史且至少有 6 颗牙齿的 532 名个体（209 名男性和 293 名女性）。在基线和 5 年后进行了全口牙周检查，每颗牙有 6 个位点。在基线时，通过询问参与者每周通常饮用的饮料数量来评估饮酒量。将饮酒量分为以下 4 类：1）不饮酒者；2）每周饮酒量≤1 杯；3）每周饮酒量＞1 杯且≤1 杯/天；4）每天饮酒量＞1 杯。如果至少有 2 颗牙齿的近中（临床 AL）进展≥3mm，在 5 年内被归类为疾病进展。使用多变量泊松回归模型，调整年龄、性别、吸烟状况、社会经济地位和体重指数，估计相对风险（RR）和 95%置信区间（CI）。
总体而言，与不饮酒者相比，每天饮酒量＞1 杯的个体临床 AL 进展的风险高 30%（RR=1.30；95%CI：1.07 至 1.58）。在男性中，每天饮酒量＞1 杯的个体临床 AL 进展的风险比不饮酒者高 34%（RR=1.34；95%CI：1.09 至 1.64）。从不吸烟者中，每周饮酒量≤1 杯的男性临床 AL 进展的风险显著低于不饮酒者（RR=0.52；95%CI：0.30 至 0.89），而每天饮酒量＞1 杯的男性临床 AL 进展的风险显著更高（RR=1.50；95%CI：1.08 至 1.99）。在女性中，饮酒与临床 AL 进展之间未观察到关联。
饮酒增加了临床 AL 进展的风险，且这种影响在男性中更为明显。低剂量（≤1.37g/天）的酒精摄入可能有利于预防男性牙周病的进展。应评估戒酒措施对牙周健康的影响。
