259210 Smoking and tooth loss associations differ by reason for tooth loss: The Osteoporosis and Periodontal Disease Study, an ancillary study of the Women's Health Initiative Observational Study (WHIOS)

Monday, October 29, 2012 : 2:50 PM - 3:10 PM

Xiaodan Mai, MBBS , Department of Social and Preventive Medicine - School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY
Jean Wactawski-Wende, PhD , Department of Social and Preventive Medicine - School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY
Kathleen Hovey, MS , Department of Social and Preventive Medicine - School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY
Chao-ru Chen, PhD , Department of Social and Preventive Medicine - School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY
Robert Genco, DDS, PhD , Department of Oral Biology - School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY
  
Background: Smoking has been associated with poor oral health and tooth loss. Our study aim was to evaluate the association between smoking history and tooth loss, and determine if this association differed by loss due to caries or periodontal disease (PD). Methods: Smoking and potential confounding variables were obtained via self-administered questionnaires and examinations in 1,106 postmenopausal women participating in an ancillary of the WHIOS. Numbers of teeth present, missing, and reason for missing teeth were recorded during the dental examination. Logistic regression analyses estimated the odds ratio (OR) and 95% confidence intervals (95% CI) of smoking's association with tooth loss overall, and loss due to PD and caries. Results: Smoking history was associated with overall tooth loss. After adjustment for age, education, income, BMI, diabetes history, calcium supplement use and dental visit frequency, women in the heaviest pack-year category (≥ 26 pack-years) compared to never smokers were significantly more likely to report tooth loss (OR=1.82, 95%CI: 1.10-3.00). When stratified according to reason for tooth loss, smoking status, pack-years, and years quit were all significantly associated with increased risk of tooth loss due to PD. For pack-years, the association for tooth loss due to PD for heavy compared to never smokers was OR=6.83 (95% CI: 3.40-13.72). However, no significant associations were found with smoking and tooth loss due to caries. Conclusion: These results suggest a differential etiology of smoking on tooth loss. Smoking cessation programs may target older women where reduction of periodontal associated tooth loss may be most beneficial.

Learning Areas:
Chronic disease management and prevention
Epidemiology

Learning Objectives:
1. Assess the cross-sectional association of smoking and overall tooth loss in postmenopausal women. 2. Evaluate whether the association of smoking and tooth loss differs according to reason for loss, specifically periodontal disease or caries. 3. Formulate potential public health strategies to reducing tooth loss may focus on postmenopausal women with periodontal disease.

Keywords: Oral Health, Smoking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a graduate student in the PhD program in Epidemiology and have worked on this research under the guidance of Dr.Wactawski-Wende, principle investigator of the Buffalo Center of the Women’s Health Initiative and a series of studies on oral health in postmenopausal women. Among my scientific interests has been epidemiology and periodontal disease.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3364.0: Epidemiology of Oral Diseases