Data on the dose-dependent effects of smoking and smoking cessation on tooth loss are scarce. We hypothesized that smoking has both dose- and time-dependent effects on tooth loss incidence. We used longitudinal data on tobacco use and incident tooth loss in 43,112 male health professionals, between 1986 and 2002. In multivariate Cox models, current smokers of 5 to 14 and 45+ cigarettes daily had a two-fold (HR, 1.94; 95% CI, 1.72, 2.18) and three-fold (HR, 3.05; 95% CI, 2.38, 3.90) higher risk of tooth loss, respectively, compared with never-smokers. Risk decreased with increasing time since cessation, but remained elevated by 20% (95% CI, 16%, 25%) for men who had quit 10+ years before. Current pipe/cigar smokers had a 20% (95% CI, 1.11, 1.30) increased risk of tooth loss compared with never- and former smokers of pipes/cigars.
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References
1.
Ahlqwist M, Bengtsson C, Hollender L, Lapidus L, Osterberg T (1989). Smoking habits and tooth loss in Swedish women. Community Dent Oral Epidemiol17:144–147.
2.
Albandar JM, Streckfus CF, Adesanya MR, Winn DM (2000). Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss. J Periodontol71:1874–1881.
3.
Axelsson P, Paulander J, Lindhe J (1998). Relationship between smoking and dental status in 35-, 50-, 65-, and 75-year-old individuals. J Clin Periodontol25:297–305.
4.
Bergström J, Eliasson S, Dock J (2000). A 10-year prospective study of tobacco smoking and periodontal health. J Periodontol71:1338–1347.
5.
Bergström J, Babcan J, Eliasson S (2004). Tobacco smoking and dental periapical condition. Eur J Oral Sci112:115–120.
6.
Bolin A, Eklund G, Frithiof L, Lavstedt S (1993). The effect of changed smoking habits on marginal alveolar bone loss. A longitudinal study. Swed Dent J17:211–216.
7.
Copeland LB, Krall EA, Brown LJ, Garcia RI, Streckfus CF (2004). Predictors of tooth loss in two US adult populations. J Public Health Dent64:31–37.
8.
Daniell HW (1983). Postmenopausal tooth loss. Contributions to edentulism by osteoporosis and cigarette smoking. Arch Intern Med143:1678–1682.
9.
Dietrich T, Hoffmann K (2004). A comprehensive index for the modeling of smoking history in periodontal research. J Dent Res83:859–863.
10.
Douglass CW, Berlin J, Tennstedt S (1991). The validity of self-reported oral health status in the elderly. J Public Health Dent51:220–222.
11.
Drake CW, Beck JD, Lawrence HP, Koch GG (1997). Three-year coronal caries incidence and risk factors in North Carolina elderly. Caries Res31:1–7.
12.
Eklund SA, Burt BA (1994). Risk factors for total tooth loss in the United States; longitudinal analysis of national data. J Public Health Dent54:5–14.
13.
Fisher MA, Taylor GW, Tilashalski KR (2005). Smokeless tobacco and severe active periodontal disease, NHANES III. J Dent Res84:705–710.
14.
Fure S (2004). Ten-year cross-sectional and incidence study of coronal and root caries and some related factors in elderly Swedish individuals. Gerodontology21:130–140.
15.
Gilbert GH, Duncan RP, Crandall LA, Heft MW, Ringelberg ML (1993). Attitudinal and behavioral characteristics of older Floridians with tooth loss. Community Dent Oral Epidemiol21:384–389.
16.
Gilbert GH, Chavers LS, Shelton BJ (2002). Comparison of two methods of estimating 48-month tooth loss incidence. J Public Health Dent62:163–169.
17.
Hahn P, Reinhardt D, Schaller HG, Hellwig E (1999). Root lesions in a group of 50–60 year-old Germans related to clinical and social factors. Clin Oral Investig3:168–174.
18.
Holm G (1994). Smoking as an additional risk for tooth loss. J Periodontol65:996–1001.
19.
Hujoel PP, del Aguila MA, DeRouen TA, Bergström J (2003). A hidden periodontitis epidemic during the 20th century? Community Dent Oral Epidemiol31:1–6.
20.
Jansson L, Lavstedt S (2002). Influence of smoking on marginal bone loss and tooth loss—a prospective study over 20 years. J Clin Periodontol29:750–756.
21.
Kirkevang LL, Wenzel A (2003). Risk indicators for apical periodontitis. Community Dent Oral Epidemiol31:59–67.
22.
Krall EA, Dawson-Hughes B, Garvey AJ, Garcia RI (1997). Smoking, smoking cessation, and tooth loss. J Dent Res76:1653–1659.
23.
Krall EA, Garvey AJ, Garcia RI (1999). Alveolar bone loss and tooth loss in male cigar and pipe smokers. J Am Dent Assoc130:57–64.
24.
Krall EA, Abreu Sosa C, Garcia C, Nunn ME, Caplan DJ, Garcia RI (2006a). Cigarette smoking increases the risk of root canal treatment. J Dent Res85:313–317.
Linden GJ, Mullally BH (1994). Cigarette smoking and periodontal destruction in young adults. J Periodontol65:718–723.
27.
Palmer RM, Wilson RF, Hasan AS, Scott DA (2005). Mechanisms of action of environmental factors—tobacco smoking. J Clin Periodontol32(Suppl 6):180–195.
28.
Phelan JA, Mulligan R, Nelson E, Brunelle J, Alves ME, Navazesh M, et al. (2004). Dental caries in HIV-seropositive women. J Dent Res83:869–873.
29.
Pitiphat W, Garcia RI, Douglass CW, Joshipura KJ (2002). Validation of self-reported oral health measures. J Public Health Dent62:122–128.
30.
Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, Willett WC (1992). Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol135:1114–1126.
31.
Tomar SL, Asma S (2000). Smoking-attributable periodontitis in the United States: findings from NHANES III. National Health and Nutrition Examination Survey. J Periodontol71:743–751.
32.
Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, et al. (1985). Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol122:51–65.
33.
Ylostalo P, Sakki T, Laitinen J, Jarvelin MR, Knuuttila M (2004). The relation of tobacco smoking to tooth loss among young adults. Eur J Oral Sci112:121–126.
