title: Influence of cigarette smoking on the overall perception of dental health among adults aged 20-79 years, United States, 1988-1994.
abstract: OBJECTIVE
  Investigation into the relationship between lifestyle factors (particularly cigarette smoking) and perceived oral health has been limited. Data from the third National Health and Nutrition Examination Survey (NHANES II), 1988-1994, were used to explore this relationship in a large sample of U.S. adults.
  
  
  METHODS
  This study used data on 13,357 dentate participants in NHANES III aged 20-79 years. In NHANES III, information on perceived dental health, sociodemographic attributes, smoking status, frequency of dental visits, dental insurance, and general health perception were collected during a home interview, and oral health status was assessed at a mobile examination center.
  
  
  RESULTS
  Overall, 34.4% of individuals in the study sample reported having an unfavorable perception of their dental health by qualifying it as "fair" or "poor." Furthermore, 46.6% of smokers had an unfavorable dental health perception, compared to 28.3% of non-smokers. An interaction between smoking and race/ethnicity was found in logistic regression modeling. Stratified results show that cigarette smoking was not a significant predictor for an unfavorable dental health perception among individuals who self-identified as Mexican American, but smoking was a significant predictor for an unfavorable dental health perception among those who identified as non-Hispanic black or non-Hispanic white.
  
  
  CONCLUSIONS
  This is the first study to describe the effects of smoking on dental health perception while controlling for examined oral health status. Because perceived dental health is a potential indicator for dental care utilization, a better knowledge of the factors that influence dental health perception is not only important for dental services planning, but also for understanding oral health-related quality of life issues. Additionally, given that smoking may negatively affect dental health perception, these findings have potential implications for smoking cessation activities conducted by dental care providers.
authors.affiliation: Canadian Forces Dental Services, Ottawa, ON, Canada.
authors.forename: Nathalie M
authors.initials: NM
authors.lastname: Morin
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Dye
authors.forename: Tomoko I
authors.initials: TI
authors.lastname: Hooper
mesh_terms: D000328:Adult; D001741:Black or African American / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D003729:Dental Care / Q000706:statistics & numerical data; D003753:Dental Health Surveys; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006285:Health Planning; D006305:Health Status Indicators; D006801:Humans; D007347:Insurance, Dental / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D009749:Nutrition Surveys; D009909:Oral Health; D011237:Predictive Value of Tests; D012907:Smoking / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data