Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA.
Department of Periodontics, Dental College, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia.
J Periodontol. 2019 Jan;90(1):16-25. doi: 10.1002/JPER.18-0183. Epub 2018 Sep 27.
The aims of this study were to analyze the periodontal conditions among non-smokers, former smokers and current smokers in the two National Health and Nutrition Examination Surveys (NHANES) acquired between 2009 to 2012 and determine the association between time since quitting smoking and periodontal status.
Smoking status and periodontal examination data from NHANES 2009 to 2010 and 2011 to 2012 were analyzed. Respondents included in the analysis were aged ≥18 years, had undergone a complete NHANES Oral Health - Periodontal Exam with all measurements recorded as required for the periodontal classification algorithm, and had complete data from the NHANES Smoking - Cigarette Use questionnaire. Logistic regression was conducted with time since quitting as the exposure and presence of periodontitis as the outcome, and included adjustment for confounders.
Smoking status was significantly associated with periodontal status (Chi-square; P < 0.0001). The rate of periodontitis was highest among smokers (35%), compared with former smokers (19%) and never smokers (13%). Among former smokers, after adjusting for confounders, each additional year since quitting smoking was associated with a significant reduction in the odds ratio (OR) for periodontitis by 3.9% (OR for each year 0.961, 95% confidence interval 0.948 to 0.975).
Among former smokers, a longer time since quitting smoking was associated with a lower likelihood of periodontitis. Consequently, dental practitioners have a public health mandate to help their patients quit smoking. Future research should determine the best strategies for facilitating smoking cessation in dental patients.
本研究旨在分析 2009 年至 2012 年两次全国健康和营养检查调查(NHANES)中不吸烟者、前吸烟者和现吸烟者的牙周状况,并确定戒烟时间与牙周状况之间的关系。
分析了 NHANES 2009 年至 2010 年和 2011 年至 2012 年的吸烟状况和牙周检查数据。分析中纳入的受访者年龄≥18 岁,接受了完整的 NHANES 口腔健康-牙周检查,所有测量值均按牙周分类算法的要求记录,并完整填写了 NHANES 吸烟-香烟使用调查问卷。以戒烟时间作为暴露因素,牙周炎的存在作为结局,采用 logistic 回归进行分析,并对混杂因素进行了调整。
吸烟状况与牙周状况显著相关(卡方检验;P<0.0001)。吸烟者(35%)牙周炎的发病率最高,其次是前吸烟者(19%)和从不吸烟者(13%)。在前吸烟者中,在校正混杂因素后,每增加一年戒烟时间,牙周炎的比值比(OR)显著降低 3.9%(每年 OR 为 0.961,95%置信区间为 0.948 至 0.975)。
在以前的吸烟者中,戒烟时间越长,牙周炎的可能性越低。因此,牙科医生有公共卫生的任务,帮助他们的患者戒烟。未来的研究应该确定促进牙科患者戒烟的最佳策略。