Periodontal attachment loss attributable to cigarette smoking in an urban Brazilian population.
OBJECTIVE
The present study estimated the percentages of cases with severe periodontal attachment loss (PAL) attributable to cigarette smoking in a representative adult urban population in southern Brazil.


METHODS
A representative sample comprising 853 dentate individuals (age: 30-103 years) was selected by a multistage, probability sampling method. A full-mouth clinical examination of six sites per tooth was performed and an interview using a structured written questionnaire was undertaken. Cases were defined as individuals with > or =30% teeth with PAL > or =5 mm. A multivariate logistic regression analysis for complex surveys was performed, and adjusted for age, gender, race, socioeconomic status and dental calculus.


RESULTS
The prevalence of cases in this population was 49.7%, or 739,000 subjects. Overall, 50.9% of this adult population, or approximately 757,000 subjects have had a lifetime exposure to cigarette smoking. Multivariate analysis showed that heavy and moderate smokers had a significantly higher risk for PAL > or =5 mm than non-smokers (odds ratio=3.6, 2.0, respectively) after adjusting for the above covariates. We estimated that the number of moderate and heavy smokers with > or =30% teeth with PAL > or =5 mm might be reduced by approximately 28% and 48%, respectively, had they not smoked cigarettes. We project that a smoking cessation program could result in a reduction in the number of cases by up to 12% in this population, or approximately 90,000 potential cases.


CONCLUSIONS
Cigarette smoking was strongly associated with severe attachment loss in this population. A significant percentage of cases may have been prevented if smoking cessation interventions had been implemented. The results support the implementation of population-based smoking cessation programs to reduce the prevalence of severe attachment loss in populations with high level of smoking exposure.
Susin
Cristiano
C
Department of Periodontology, Temple University School of Dentistry, Philadelphia, PA 19140, USA.
Oppermann
Rui V
RV
Haugejorden
Ola
O
Albandar
Jasim M
JM
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D017622:Periodontal Attachment Loss / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D018570:Risk Assessment; D017062:Small-Area Analysis; D012907:Smoking / Q000009:adverse effects*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population