Hart G T, Brown D M, Mincer H H
Department of Biologic and Diagnostic Sciences, University of Tennessee College of Dentistry, Memphis, USA.
J Tenn Dent Assoc. 1995 Apr;75(2):25-7.
The previously cited Indiana University School of Dentistry teaching monograph, "The Impact of Tobacco Use and Cessation on Nonmalignant and Precancerous Oral and Dental Diseases and Conditions," reviewed over 800 articles and concluded that tobacco use is strongly associated with many dental and oral mucosal diseases, and may contribute to others. Our study of a relatively small sample of 200 patients, of whom 33 percent were tobacco users, found statistically significant data correlating tobacco use with a higher Decayed, Missing and Filled Index (a measurement of caries and tooth loss experience of patients) and relating periodontal bone loss to smokeless tobacco use. And, while this investigation did not find a statistically significant correlation between smoking and periodontitis severity, there was a data trend in that direction. Conclusions about tooth loss in the Indiana monograph were limited to smokers; however, there was an association of ST use with gingival recession, which can become quite severe in the area in which the smokeless tobacco is placed. It might be theorized that the significantly larger number of missing teeth among ST users in our study is associated with the generally poor oral hygiene and less sophisticated outlook on health care that tobacco users often display. Indeed, of the 65 denture wearers in our study, 7.7 percent were ST users and 40.0 percent were tobacco users of some type. In view of the large amount of data in the scientific literature associating tobacco with dental diseases as summarized by the Indiana monograph, and the position of several groups such as the American Cancer Society that tobacco is one of the risk factors most associated with intraoral cancer, it would appear that dentists have a vested professional interest in promoting tobacco use cessation among their patients. Dentists should take every reasonable opportunity to persuade patients to discontinue the tobacco habit, thus preventing life-threatening malignancies as well as dental diseases.
之前引用的印第安纳大学牙科学院教学专著《烟草使用与戒烟对非恶性和癌前口腔及牙齿疾病与状况的影响》回顾了800多篇文章，得出结论：烟草使用与许多牙齿和口腔黏膜疾病密切相关，还可能与其他疾病有关。我们对200名患者的相对小样本进行的研究发现，其中33%为烟草使用者，有统计学意义的数据表明，烟草使用与更高的龋失补指数（衡量患者龋齿和牙齿缺失情况的指标）相关，并且无烟草使用与牙周骨丧失有关。而且，虽然这项调查未发现吸烟与牙周炎严重程度之间存在统计学意义的相关性，但有朝着这个方向的数据趋势。印第安纳专著中关于牙齿缺失的结论仅限于吸烟者；然而，无烟草使用与牙龈退缩有关，在放置无烟烟草的区域，牙龈退缩可能会相当严重。可以推测，我们研究中无烟草使用者中牙齿缺失数量明显更多，与烟草使用者通常表现出的口腔卫生普遍较差以及对医疗保健的认识不足有关。事实上，在我们研究的65名戴假牙者中，7.7%是无烟草使用者，40.0%是某种类型的烟草使用者。鉴于印第安纳专著总结的科学文献中大量将烟草与牙齿疾病相关联的数据，以及美国癌症协会等几个组织认为烟草是与口腔癌最相关的风险因素之一的立场，牙医在促进患者戒烟方面似乎有既得的专业利益。牙医应抓住每一个合理机会说服患者戒除烟草习惯，从而预防危及生命的恶性肿瘤以及牙齿疾病。
