J Am Dent Assoc. 2019 May;150(5):332-344.e2. doi: 10.1016/j.adaj.2018.12.004. Epub 2019 Mar 25.
Few studies consider simultaneously the oral health implications of nontraditional tobacco products and tobacco-use patterns. The authors aimed to evaluate self-reported gingival disease among cigarette smokers and users of other types of tobacco products.
The authors used survey-weighted multivariable logistic regression to assess associations between different tobacco products, use patterns (for example, dual or multiple tobacco product use or product switching); and lifetime history of gingival disease diagnosis and treatment. They used the nationally representative (US) Population Assessment of Tobacco and Health study's Wave 1 (2013-2014) adult data (N = 32,320).
Overall, 12.1% of participants self-reported gingival disease diagnosis, and 19.1% reported receiving treatment. Groups with the highest adjusted relative odds for diagnosis (reference, lifetime tobacco never users) were pipe users (2.7; 95% confidence interval [CI], 1.3 to 5.3), e-cigarette users (2.9; 95% CI, 1.9 to 4.5), multiple tobacco product users (2.8; 95% CI, 2.4 to 3.4), and recent (< 12 months) quitters (2.8; 95% CI, 2.0 to 3.8). Similarly, odds of treatment report were highest among pipe users (2.3; 95% CI, 1.3 to 4.1), e-cigarette users (2.3; 95% CI, 1.3 to 4.1), multiple tobacco product users (1.6; 95% CI, 1.4 to 1.9), and recent quitters (1.7; 95% CI, 1.3 to 2.2).
Numerous tobacco-use patterns were associated with worse periodontal health compared with tobacco never users. These findings are consistent with previous biological and epidemiologic evidence linking tobacco use to poor periodontal health.
Dental clinicians should anticipate various tobacco-use patterns among their patients, all of which may impact oral health. Oral health care professionals should remain informed of, screen for, and address the use of all tobacco products in practice.
很少有研究同时考虑非传统烟草制品和烟草使用模式对口腔健康的影响。作者旨在评估香烟吸烟者和其他类型烟草制品使用者的自我报告牙龈疾病。
作者使用调查加权多变量逻辑回归来评估不同烟草制品、使用模式(例如双重或多种烟草制品使用或产品转换)以及终生牙龈疾病诊断和治疗史之间的关联。他们使用具有全国代表性(美国)的人口烟草和健康评估研究的第 1 波(2013-2014 年)成人数据(N=32320)。
总体而言,12.1%的参与者自我报告了牙龈疾病的诊断,19.1%报告了治疗。调整后的相对优势比最高的诊断组(参考,终生不吸烟的人)为烟斗使用者(2.7;95%置信区间[CI],1.3 至 5.3)、电子烟使用者(2.9;95%CI,1.9 至 4.5)、多种烟草制品使用者(2.8;95%CI,2.4 至 3.4)和近期(<12 个月)戒烟者(2.8;95%CI,2.0 至 3.8)。同样,烟斗使用者(2.3;95%CI,1.3 至 4.1)、电子烟使用者(2.3;95%CI,1.3 至 4.1)、多种烟草制品使用者(1.6;95%CI,1.4 至 1.9)和近期戒烟者(1.7;95%CI,1.3 至 2.2)报告治疗的可能性最高。
与从不吸烟的人相比,许多烟草使用模式与牙周健康状况恶化有关。这些发现与以前将烟草使用与牙周健康不良联系起来的生物学和流行病学证据一致。
牙科临床医生应该在患者中预测各种烟草使用模式,所有这些模式都可能影响口腔健康。口腔保健专业人员应随时了解、筛查并在实践中解决所有烟草制品的使用问题。