Cigarette smoking and tooth loss in a cohort of older Australians the 45 and Up Study

Background. Data regarding the long-term effects of smoking, smoking cessation and environmental tobacco smoke (ETS) on tooth loss are limited. Methods. The authors collected information about tooth loss and other health-related characteristics from a questionnaire administered to 103,042 participants in the 45 and Up Study conducted in New South Wales, Australia. The authors used logistic regression analyses to determine associations of cigarette smoking history and ETS with edentulism, and they adjusted for age, sex, income and education. Results. Current and former smokers had significantly higher odds of experiencing edentulism compared with never smokers (prevalence odds ratio [OR], 2.51; 95 percent confidence interval [CI], 2.31-2.73 and OR, 1.50; 95 percent CI, 1.43-1.58, respectively). Among former smokers, the risk declined significantly with increasing time since smoking cessation; however, the risk remained elevated even in those who ceased smoking 30 or more years previously compared with that in never smokers (OR, 1.10; 95 percent CI, 1.02-1.19). Furthermore, among never smokers, the OR for edentulism was 1.37 (95 percent CI, 1.17-1.60) in those who reported having exposure to ETS for six or more hours per week versus those who were not exposed to any ETS. Conclusions and Clinical Implications. Although the risk of experiencing tooth loss declines with time since smoking cessation, the effects of smoking may persist for at least 30 years. The effect of ETS requires further investigation.