The effect of cigarette smoking on gingival bleeding
The effect of cigarette smoking on gingival bleeding
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DOI：
10.1902/jop.2004.75.1.16
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发表时间：
2004-01-01
影响因子：
4.3
通讯作者：
Glynn, RJ
中科院分区：
文献类型：
--
作者：
Dietrich, T;Bernimoulin, JP;Glynn, RJ
背景资料：本研究的目的是调查吸烟对美国人群中大样本的探诊牙龈出血（BOP）的剂量依赖效应（国家健康与营养调查III）。采用加权多元logistic回归对12个国家的141，967个近中颊部位的探诊出血进行建模，385名个体在所有协变量上都有完整的病例记录。对年龄、性别、种族/民族、缺牙数量、牙齿类型/颌骨、根龋、全冠覆盖率、社会经济状况（贫困/收入比）和调查特征进行了调整。该模型根据是否存在结石（CALC）和增加的探测深度（PD大于或等于4 mm）分层。广义估计方程被用来解释受试者内的依赖网站。结果：吸烟有很强的抑制作用牙龈出血。这种影响在重度吸烟者（> 10支/天）中最强，在前吸烟者中最小。在健康部位（无CALC，PD：3 mm），重度吸烟者与从不吸烟者相比，出血部位的比值比（OR）为0.56（95% CI：0.45 - 0.70）。CALC和/或PD大于或等于4 mm的部位在从不吸烟者中更可能出血（OR：5.7; 95% CI：4.3 - 7.6）。这种关系在重度吸烟者中不太明显（OR：1.3; 95% CI：0.8 - 1.9）。吸烟的影响并没有不同的上颌和下颌磨牙，前磨牙，或切牙。结论：吸烟对牙龈出血探测产生了强烈的，慢性的，剂量依赖性的抑制作用。
Background: The purpose of this study was to investigate the dose-dependent effect of cigarette smoking upon gingival bleeding on probing (BOP) in a large representative sample of the United States population (National Health and Nutrition Examination Survey III).Methods: Weighted multiple logistic regression was used to model bleeding on probing of 141,967 mesio-buccal sites in 12,385 individuals with complete case records on all covariates. Adjustments were made for age, gender, race/ethnicity, number of missing teeth, tooth type/jaw, root caries, full crown coverage, socioeconomic status (poverty/income ratio), and survey characteristics. The model stratified by presence of calculus (CALC) and increased probing depth (PD greater than or equal to4 mm). Generalized estimating equations were used to account for dependence of sites within subjects.Results: Smoking had a strong suppressive effect on gingival bleeding. The effect was strongest in heavier smokers (>10 cigarettes/day) and smallest in former smokers. In healthy sites (no CALC, PD: 3 mm), the odds ratio (OR) of bleeding for sites in heavier smokers compared to never-smokers was 0.56 (95% CI: 0.45-0.70). Sites with CALC and/or PD greater than or equal to4 mm were more likely to bleed in never-smokers (OR: 5.7; 95% CI: 4.3-7.6). This relationship was less evident among heavier smokers (OR: 1.3; 95% CI: 0.8-1.9). The effect of smoking did not differ between maxillary and mandibular molars, premolars, or incisors.Conclusion: Smoking exerts a strong, chronic, and dose-dependent suppressive effect on gingival bleeding on probing.