ASSOCIATION BETWEEN CIGARETTE-SMOKING, BACTERIAL PATHOGENS, AND PERIODONTAL STATUS

THE PURPOSES OF THIS STUDY WERE TO DETERMINE IF: 1) an association exi sts between cigarette smoking and signs of periodontal disease after c ontrolling for the confounding variables of age, sex, plaque, and calc ulus; 2) the prevalence of 5 bacteria commonly associated with periodo ntal disease differs between smokers and non-smokers; and 3) the prese nce of any of these bacteria or smoking are associated with a mean pro ximal posterior probing depth greater-than-or-equal-to 3.5 mm. Plaque, calculus, gingivitis, and probing depth were measured at the proximal surfaces of all teeth in one randomly selected posterior dental sexta nt in 615 adults. Subgingival plaque was sampled from the same sites a nd assayed for the presence of Porphyromonas gingivalis, Actinobacillu s actinomycetemcomitans, Prevotella intermedia, Eikenella corrodens, a nd Fusobacterium nucleatum. A subsample of non-smokers (n = 126), who were similar to smokers (n = 63) with respect to age, sex, plaque, and calculus, was randomly drawn from the original sample. These two grou ps were then compared on the basis of clinical and microbial parameter s. The results indicated that the odds of having a mean probing depth greater-than-or-equal-to 3.5 mm were 5 times greater for smokers than the non-smoker subsample (odds ratio = 5.3; 95% CI = 2.0 to 13.8). No statistically significant difference in the prevalence of any of the b acteria was found between smokers and the non-smoker subsample. Based on logistic regression analyses of each of the 5 bacteria and smoking, mean probing depth greater-than-or-equal-to 3.5 mm was significantly associated with the presence of A. actinomycetemcomitans, P. intermedi a, E. corrodens, and smoking (P < 0.05). For this sample of medically healthy, middle-aged adults, it is concluded that cigarette smoking is a stronger risk indicator for the presence of a mean posterior proxim al probing depth greater-than-or-equal-to 3.5 mm than any of the 5 bac teria.