Environmental tobacco smoke and periodontal disease in the United States

Objectives. Cigarette smoking is a leading risk factor for periodontal dise ase. This cross-sectional study investigated the relation between environme ntal tobacco smoke (ETS) and periodontal disease in the United States. Methods. Data were obtained from the Third National Health and Nutrition Ex amination Survey (1988-1994). The outcome was periodontal disease, defined as 1 or more periodontal sites with attachment loss of 3 mm or greater and a pocket depth of 4 mm or greater at the same site. Exposure to ETS at home and work was self-reported. The study analyzed 6611 persons 18 years and o lder who had never smoked cigarettes or used other forms of tobacco. Results. Exposure to ETS at home only, work only, and both was reported by 18.0%, 10.7%, and 3.8% of the study population, respectively. The adjusted odds of having periodontal disease were 1.6 (95% confidence interval= 1.1, 2.2) times greater for persons exposed to ETS than for persons not exposed. Conclusions. Among persons in the United States who had never used tobacco, those exposed to ETS were more likely to have periodontal disease than wer e those not exposed to ETS.