Offenbacher S, Weathers D R
J Oral Pathol. 1985 Feb;14(2):169-81. doi: 10.1111/j.1600-0714.1985.tb00480.x.
The use of smokeless tobacco (ST) products, such as snuff and chewing tobacco, was investigated in a school population of 565 males with a mean age of 13.8 years. All students completed a tobacco usage questionnaire and were given intraoral examinations by a team of dentists to determine the possible relationship of ST usage to the presence of gingivitis, gingival recession, mucosal pathology and caries. The overall prevalence of ST usage was 13.3%, which was much higher than the 1.4% prevalence of cigarette smoking. Pairwise chi square analysis revealed that there was no relationship between ST usage and the prevalence of gingivitis, but that the prevalence of gingival recession was significantly elevated in ST users, P less than 0.001. The odds of having gingival recession were 9 times greater in the students using smokeless tobacco as compared to healthy, non-user cohorts. ST usage did not affect the prevalence of gingival recession in students without gingivitis. The frequency of occurrence of soft tissue pathology was significantly elevated, about 6-fold in students who used smokeless tobacco, as compared to non-users, P less than 0.01. This was principally due to the increased prevalence of white mucosal lesions in smokeless tobacco users. However, there was no attributable risk for mucosal pathology in ST users who were free of gingivitis. Similarly, the use of smokeless tobacco was associated with a 1.6-fold elevation in mean DMF in students with gingivitis, P less than 0.001, but this increase in caries experience was not seen in ST users who were free of gingivitis. In summary, in students with clean mouths that were free of gingivitis, the use of smokeless tobacco was not associated with a change in the prevalence of gingival recession, mucosal pathology, or in the mean DMF score. In contrast, smokeless tobacco usage was a significant risk factor in individuals with co-existing gingivitis, associated with a marked increase in the prevalence of gingival recession, mucosal pathology and caries experience.
在一个由565名平均年龄为13.8岁的男性组成的学校群体中，对无烟烟草（ST）产品（如鼻烟和嚼烟）的使用情况进行了调查。所有学生都完成了一份烟草使用调查问卷，并由一组牙医进行口腔检查，以确定ST使用与牙龈炎、牙龈退缩、黏膜病变和龋齿之间的可能关系。ST的总体使用率为13.3%，远高于1.4%的吸烟率。成对卡方分析显示，ST使用与牙龈炎患病率之间没有关系，但ST使用者的牙龈退缩患病率显著升高，P小于0.001。与健康的非使用者群体相比，使用无烟烟草的学生出现牙龈退缩的几率高9倍。ST使用对无牙龈炎的学生的牙龈退缩患病率没有影响。与非使用者相比，使用无烟烟草的学生软组织病变的发生频率显著升高，约为6倍，P小于0.01。这主要是由于无烟烟草使用者白色黏膜病变的患病率增加。然而，在没有牙龈炎的ST使用者中，黏膜病变没有可归因风险。同样，无烟烟草的使用与患有牙龈炎的学生的平均DMF升高1.6倍有关，P小于0.001，但在没有牙龈炎的ST使用者中没有观察到龋齿经历的这种增加。总之，在口腔清洁且无牙龈炎的学生中，无烟烟草的使用与牙龈退缩患病率、黏膜病变或平均DMF评分的变化无关。相比之下，无烟烟草的使用是同时患有牙龈炎的个体的一个重要危险因素，与牙龈退缩患病率、黏膜病变和龋齿经历的显著增加有关。
