Alveolar bone loss and tooth loss in male cigar and pipe smokers
Alveolar bone loss and tooth loss in male cigar and pipe smokers
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DOI：
10.14219/jada.archive.1999.0029
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发表时间：
1999-01-01
影响因子：
3.9
通讯作者：
Garcia, RI
中科院分区：
文献类型：
--
作者：
Krall, EA;Garvey, AJ;Garcia, RI
背景。虽然吸烟被认为对口腔健康有害，但吸雪茄和烟斗对牙齿脱落风险、牙槽骨丢失和牙周病的影响尚不清楚。作者进行了这项研究，以确定吸雪茄和烟斗的人是否比不吸烟者面临更大的牙齿脱落和牙槽骨丢失的风险。作者对参与退伍军人事务部牙科纵向研究的 690 名有齿男性进行了研究。受试者不是 VA 患者，他们在私营部门接受医疗和牙科护理。 23 年来，一位经过委员会认证的牙周病医生每三年进行一次临床检查。这些检查包括剩余牙齿的数量、每颗牙齿腐烂和填充表面的数量，以及牙菌斑、牙结石、牙周探诊深度、牙龈出血和牙齿松动度的指标评分。每次检查时均使用 Schei 尺法对口内根尖周 X 光片进行牙槽骨损失评估，该方法以 20% 的增量测量骨高度损失。根据人口统计和口腔卫生措施控制牙齿脱落率和牙槽骨丢失的多变量分析。结果。与不吸烟者相比，吸雪茄者（RR = 1.3，95%置信区间或CI = 1.2, 1.5）、烟斗者（RR = 1.6，95% CI = 1.4, 1.9）和吸烟者（RR = 1.6，95% CI = 1.5, 1.7）牙齿脱落的相对风险（RR）显着升高。中度至重度牙槽骨丢失进展（较基线变化 40% 或更多）的近中和远端部位的百分比在不吸烟者中为 8 +/- 1%（平均值 +/- 标准误差），在雪茄吸烟者中为 16 +/- 3% (P < .05)，在烟斗吸烟者中为 13 +/- 4% (P = 1.7)，在香烟中为 16 +/- 3%吸烟者 (P < .001)。就基线时牙石、牙周探诊深度、牙龈出血或牙齿松动评分为中度至重度的部位百分比而言，吸烟斗和雪茄的人与不吸烟者没有显着差异。与不吸烟者相比，吸烟者的中度至重度牙菌斑积聚部位较少（7 +/- 11 vs. 13 +/- 17，P < .05）。结论。作者发现，抽雪茄或烟斗的男性牙齿脱落的风险更高。吸雪茄的人发生牙槽骨丢失的风险也增加。这些风险升高的程度与吸烟者中观察到的相似。临床意义。与雪茄和烟斗相关的风险增加为针对所有烟草制品吸烟者的吸烟预防和戒烟计划提供了强有力的理由。
Background. While cigarette smoking is recognized as being detrimental to oral health, eht effects of cigar and pipe smoking on tooth-loss risk, alveolar bone loss and periodontal disease are not known. The authors conducted this study to determine whether cigar and pipe smokers were at greater risk of experiencing tooth loss and alveolar bone loss than were nonsmokers.Methods the authors studied 690 dentate men who participate in the Veterans Affairs Dental Longitudinal Study. Subjects are not VA patients, and they receive medical and dental care in the private sector. A board-certified periodontist conducted clinical examinations triennially for 23 years. These examinations included the number of teeth remaining, number of decayed and filled surfaces per tooth, and indicator scores for plaque, calculus, pocket probing depth, gingival bleeding and tooth mobility. Alveolar bone loss was assessed at each examination on intraoral periapical radiographs using the Schei ruler method, which measures loss of bone height in 20 percent increments. Multivariate analyses of tooth-loss rates and alveolar bone loss controlled for demographic and oral hygiene measures.Results. the relative risk, or RR, of tooth loss compared with that of non smokers was significantly elevated in cigar smokers (RR = 1.3, 95 percent confidence interval, or CI, = 1.2, 1.5), pipe smokers (RR = 1.6, 95 percent CI = 1.4, 1.9) and cigarette smokers (RR = 1.6, 95 percent CI = 1.5, 1.7). The percentages of mesial and distal sites with moderate-to-severe progression of alveolar bone loss ( a change of 40 percent or more from baseline) were 8 +/- 1 percent (mean +/- standard error) in nonsmokers, 16 +/- 3 percent in cigar smokers (P < .05), 13 +/- 4 percent in pipe smokers (P = 1.7), and 16 +/- 3 percent in cigarette smokers (P < .001). Pipe and cigar smokers did not differ significantly from nonsmokers with respect to the percentage of sites at baseline with moderate-to-severe scores for calculus, pocket probing depth, gingival bleeding or tooth mobility. Pipe smokers had fewer sites with moderate-to-severe plaque accumulation than did nonsmokers (7 +/- 11 vs. 13 +/- 17, P < .05).Conclusions. The authors found that men who smoke cigars or pipes were at increased risk of experiencing tooth loss. cigar smokers also were at increased risk of experiencing alveolar bone loss. These elevations in risk are similar in magnitude to those observed in cigarette smokers.Clinical Implications. The increases in risk related to cigar and pipe smoking provide a strong rationale for targeting smoking prevention and smoking cessation programs to smokers of all tobacco products.