SMOKING, SMOKING CESSATION, AND TOOTH LOSS

Smoking is associated with an increased risk of tooth loss, but it is not known if this risk decreases significantly when individuals quit s moking. The objectives of this study were to describe the rates of too th loss by smoking status in two populations of medically healthy men and women. Among the men, rates of tooth loss and edentulism in relati on to smoking cessation were also evaluated. The subjects were drawn f rom a group of 584 women (aged 40 to 70) recruited from the Boston, MA , area and a separate population of 1231 male veterans (aged 21 to 75) who participated in the VA Dental Longitudinal Study in Boston. In cr oss-sectional baseline analyses, current cigarette smokers of either s ex had significantly more missing teeth than never-smokers or former s mokers. Former smokers and pipe or cigar smokers tended to have an int ermediate number of missing teeth. Current male smokers had more teeth with calculus, but the differences in plaque, tooth mobility, probing depth > 2 mm, filled and decayed teeth, and bleeding on probing by sm oking history were not significant. Prospective observations of 248 wo men (mean follow-up time = 6 +/- 2 years) and 977 men (mean = 18 +/- 7 years) indicated that individuals who continued to smoke cigarettes h ad 2.4-fold (men) to 3.5-fold risk (women) of tooth loss compared with non-smokers. The rates of tooth loss in men were significantly reduce d after they quit smoking cigarettes but remained higher than those in nonsmokers. Men who smoked cigarettes had a 4.5-fold increase in risk of edentulism, and this risk also decreased upon smoking cessation. T hese findings indicate that the risk of tooth loss is greater among ci garette smokers than among non-smokers. Smoking cessation significantl y benefits an individual's likelihood of tooth retention, but it may t ake decades for the individual to return to the rate of tooth loss obs erved in non-smokers.