Abstract
BackgroundVarious factors affect tooth loss in older age including cigarette smoking; however, evidence regarding the association between smoking and tooth loss during young adulthood is limited. The present study examined the association between cigarette smoking and tooth loss experience among adults aged 20–39 years using linked data from two national databases in Japan.MethodsTwo databases of the National Nutrition Survey (NNS) and the Survey of Dental Diseases (SDD), which were conducted in 1999, were obtained from the Ministry of Health, Labor and Welfare with permission for analytical use. In the NNS, participants received physical examinations and were interviewed regarding dietary intake and health practices including cigarette smoking, whereas in the SDD, participants were asked about their frequency of daily brushing, and received oral examinations by certified dentists. Among 6,805 records electronically linked via household identification code, 1314 records of individuals aged 20 to 39 years were analyzed. The prevalence of 1+ tooth loss was compared among non-, former, and current smokers. Multiple logistic regression models were constructed including confounders: frequency of tooth brushing, body mass index, alcohol consumption, and intake of vitamins C and E.ResultsSmoking rates differed greatly in men (53.3%) and women (15.5%). The overall prevalence of tooth loss was 31.4% (31.8% men and 31.1% women). Tooth loss occurred more frequently among current smokers (40.6%) than former (23.1%) and non-smokers (27.9%). Current smoking showed a significant association with 1+ tooth loss in men (adjusted OR = 2.21 [1.40–3.50], P = 0.0007) and women (1.70 [1.13–2.55], P = 0.0111). A significant positive exposure-related relationship between cigarette smoking status and tooth loss was observed (P for trend < 0.0001 and 0.0004 in men and women, respectively). Current smoking was also associated with the prevalence of decayed teeth (1.67 [1.28–2.20], P = 0.0002).ConclusionAn association between cigarette smoking and tooth loss was evident among young adults throughout Japan. Due to limitations of the available variables in the present databases, further studies including caries experience and its confounders should be conducted to examine whether smoking is a true risk of premature tooth loss in young adults.
Highlights
Various factors affect tooth loss in older age including cigarette smoking; evidence regarding the association between smoking and tooth loss during young adulthood is limited
Smoking status was defined in the questionnaires of the Nutrition Survey (NNS) as: "current smoker", an individual who currently smokes cigarettes daily or occasionally; "former smoker", an individual who has smoked cigarettes at some point in their life, but who currently does not smoke; "nonsmoker", an individual who was an experimental smoker or who has never smoked cigarettes
Subjects with decayed teeth were more likely to be those with lost teeth than those without
Summary
Various factors affect tooth loss in older age including cigarette smoking; evidence regarding the association between smoking and tooth loss during young adulthood is limited. The present study examined the association between cigarette smoking and tooth loss experience among adults aged 20–39 years using linked data from two national databases in Japan. Many studies demonstrated that cigarette smokers have more missing teeth and experience greater rates of tooth loss than non-smokers. Most of these studies regarding the association between smoking and tooth loss concentrated on middle aged and elderly populations and, among them, several studies observed nationally represented population [4,5,6] and longitudinal cohort [7]. The effect of smoking in young adults would be more apparent than that in older adults because the effects of confounding factors, which may be agedependent, would be less apparent
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