Abstract
Cigarette smoking contributes to poor oral health and dental discoloration. Therefore, stopping smoking may translate into measurable amelioration of dental shade indices. We compared dental shade parameters by digital spectrophotometry among current, former, and never smokers and verified their repeatability at 7 and 30 days. Dental shade parameters (CIE L*a*b* and corresponding whiteness index for dentistry-WID) were measured in current, former, and never smokers with a digital spectrophotometer (Vita Easyshade V) on three separate study visits: at baseline (day 0), at day 7, and day 30. Dental shade parameters were analyzed in 18 current, 18 former, and 20 never smokers. The repeatability of shade parameters was consistent in current, former, and never smokers. L*, a*, b*, and WID show significant short and long-term repeatability (p < 0.0001, by regression analyses). The mean (± SD) WID score of 13.42 (± 4.9) in current smokers was significantly lower compared to the WID score of 20.38 (± 5.3) in never smokers (p = 0.001). No significant differences were observed between current and former smokers and between former smokers and former smokers. Dental shade measurements by digital spectrophotometry were highly reproducible and showed that teeth whiteness of current smokers is substantially inferior compared to never smokers. Objective discrimination of dental shade can be a valuable regulatory science endpoint for investigating oral hygiene and dental aesthetics of consumer care products, smoking cessation medications, and tar-free tobacco products (e-cigarettes, heated tobacco products, oral nicotine products) for cigarette substitution.Clinical trial registration: the study was not registered in ClinicalTrials.gov considering that it is a pilot study, parts of a larger project with ID: NCT04649645
Highlights
Cigarette smoking is known to contribute to poor oral health and tooth discoloration [1, 2]
61 subjects were enrolled in this study, of which 5 participants were excluded from statistical analysis after failing to attend their short- or long-term follow-up visit
The L*values were similar, and no significant difference was observed among the three study groups (p = 0.475)
Summary
Cigarette smoking is known to contribute to poor oral health and tooth discoloration [1, 2]. The particulate matter of cigarette combustion (known as “tar”) contains pigments that can stain and discolor human tissue, including skin, fingernails, and teeth [3–5]. The extent of smokerelated discoloration of the teeth may depend on the intensity and duration of exposure to cigarette smoke [6, 7]. Teeth color and appearance vary widely [9]; human eye perception, lighting conditions, tooth translucency and opacity, and individual differences in tooth color can contribute to this variability. Teeth’ visual color determination varies significantly, leading to inaccurate evaluation [10, 11], and tooth shade guides have been introduced to minimize variability. Studies with tooth shades guide have shown poor inter-observer correspondence [12, 13] with only 25–35% accuracy for human visual determination of teeth shades [14, 15]. Human shade evaluation cannot be considered for high-quality analysis and research applications, and more precise and reproducible techniques are required
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