Cigar, pipe, and cigarette smoking as risk factors for periodontal diseaseand tooth loss

Background: Our purpose was to test the hypotheses that cigar and pipe smok ing have significant associations with periodontal disease and cigar, pipe, and cigarette smoking is associated with tooth loss. We also investigated whether a history of smoking habits cessation may affect the risk of period ontal disease and tooth loss. Methods: A group of 705 individuals (21 to 92 years-old) who were among vol unteer participants in the ongoing Baltimore Longitudinal Study of Aging we re examined clinically to assess their periodontal status and tooth loss. A structured interview was used to assess the participants' smoking behavior s with regard to cigarettes, cigar, and pipe smoking status. For a given to bacco product, current smokers were defined as individuals who at the time of examination continued to smoke daily. Former heavy smokers were defined as individuals who have smoked daily for 10 or more years and who had quit smoking. Non-smokers included individuals with a previous history of smokin g for less than 10 years or no history of smoking. Results: Cigarette and cigar/pipe smokers had a higher prevalence of modera te and severe periodontitis and higher prevalence and extent of attachment loss and gingival recession than non-smokers, suggesting poorer periodontal health in smokers. In addition, smokers had less gingival bleeding and hig her number of missing teeth than non-smokers. Current cigarette smokers had the highest prevalence of moderate and severe periodontitis (25.7%) compar ed to former cigarette smokers (20.2%), and non-smokers (13.1%). The estima ted prevalence of moderate and severe periodontitis in current or former ci gar/pipe smokers was 17,6%. A similar pattern was seen for other periodonta l measurements including the percentages of teeth with greater than or equa l to5 mm attachment loss and probing depth, greater than or equal to3 mm gi ngival recession, and dental calculus. Current, former, and non- cigarette smokers had 5.1, 3,9, and 2.8 missing teeth, respectively. Cigar/pipe smoke rs had on average 4 missing teeth. Multiple regression analysis also showed that current tobacco smokers may have increased risks of having moderate a nd severe periodontitis than former smokers. However, smoking behaviors exp lained only small percentages (<5%) of the variances in the multivariate mo dels. Conclusion: The results suggest that cigar and pipe smoking may have simila r adverse effects on periodontal health and tooth loss as cigarette smoking . Smoking cessation efforts should be considered as a means of improving pe riodontal health and reducing tooth loss in heavy smokers of cigarettes, ci gars, and pipes with periodontal disease.