Department of Preventive and Community Dentistry, Osaka Dental University, 8-1 Kuzuhahanazono-cho, Hirakata, Osaka, 573-1121, Japan.
Graduate School of Dentistry (Department of Preventive and Community Dentistry), Osaka Dental University, Osaka, Japan.
BMC Oral Health. 2022 Sep 2;22(1):372. doi: 10.1186/s12903-022-02397-7.
This study aims to evaluate the association between smoking habits and dental care utilization and cost in individuals registered with the Japan Health Insurance Association, Osaka branch.
We used the administrative claims database and specific medical check-up data and included 226,359 participants, who visited dental institutions, underwent dental examinations, and underwent specific medical checkups, with smoking data from April 2016 to March 2017. We calculated propensity scores with age, gender, exercise, eating habits, alcohol intake, and sleep. We also compared dental care utilization with the total cost of each procedure.
According to propensity score matching, 62,692 participants were selected for each group. Compared to non-smokers, smokers were younger, and a higher proportion were men. Smokers tended to skip breakfast, have dinner just before bed, and drink alcohol. After adjusting for potential confounding factors with propensity score matching, the mean annual dental cost among smokers was significantly higher than non-smokers. The prevalence of pulpitis, missing teeth, and apical periodontitis were higher among smokers than non-smokers, while inlay detachment, caries, and dentine hypersensitivity were higher among non-smokers.
This study suggests that smokers have higher dental cost consisted of progressive dental caries, missing teeth, and uncontrolled acute inflammation that necessitated the use of medications. It is suggested that smokers tend to visit the dentist after their symptoms become severe.
本研究旨在评估日本健康保险协会大阪分会注册者的吸烟习惯与口腔保健利用和成本之间的关联。
我们使用了行政索赔数据库和特定医疗检查数据，纳入了 2016 年 4 月至 2017 年 3 月期间有吸烟数据、就诊于牙科机构、接受过牙科检查和特定医疗检查的 226359 名参与者。我们计算了年龄、性别、运动、饮食习惯、饮酒和睡眠的倾向评分。我们还比较了每种治疗程序的口腔保健利用情况和总费用。
根据倾向评分匹配，每个组选择了 62692 名参与者。与不吸烟者相比，吸烟者年龄较小，男性比例较高。吸烟者往往不吃早餐，睡前吃晚餐，饮酒。在调整了倾向评分匹配的潜在混杂因素后，吸烟者的年平均口腔保健费用明显高于不吸烟者。吸烟者的牙髓炎、缺牙和根尖周炎患病率高于不吸烟者，而不吸烟者的嵌体脱落、龋齿和牙本质过敏症患病率较高。
本研究表明，吸烟者的口腔保健费用较高，这是由于进行性龋齿、缺牙和不受控制的急性炎症导致需要使用药物治疗。这表明吸烟者往往在症状加重后才去看牙医。
