title: Tobacco smoking and periodontal bone height in a Saudi Arabian population.
abstract: OBJECTIVE
  To study the association between tobacco smoking, in particular water pipe smoking, and periodontal bone height.
  
  
  METHODS
  A study sample of 355 individuals in the age range 17-60 years was recruited from Jeddah, Saudi Arabia. The smoking behavior was registered through a questionnaire during interview. Participants were stratified into water pipe smokers (33%), cigarette smokers (20%), mixed smokers (19%) and non-smokers (28%). The periodontal bone height was measured from digital panoramic radiographs mesially and distally to each tooth and expressed as a percentage of the root length.
  
  
  RESULTS
  The mean periodontal bone height was 76.2% for water pipe smokers, 75.8% for cigarette smokers, 80.2% for mixed smokers and 80.9% for non-smokers. The association between smoking and mean bone height was statistically significant controlling for age (p<0.001). The association between life-time smoking exposure and mean bone height controlling for age was statistically significant in water pipe smokers and cigarette smokers (p<0.01). The prevalence of bone loss in excess of 30% of the bone height was 27% in water pipe smokers, 24% in cigarette smokers, 9% in mixed smokers and 6% in non-smokers. The prevalence was significantly greater in water pipe smokers and cigarette smokers compared with non-smokers (p<0.001). The relative risk of periodontal bone loss associated with water pipe and cigarette smoking after adjustment for age was 3.5-fold and 4.3-fold elevated, respectively, compared with non-smoking (p<0.01).
  
  
  CONCLUSIONS
  An association between tobacco smoking and periodontal bone height reduction is observed. The impact of water pipe smoking is of the same magnitude as that of cigarette smoking.
authors.affiliation: Karolinska Institutet, Institute of Odontology, Stockholm, Sweden. Suzan_natto@hotmail.com
authors.forename: Suzan
authors.initials: S
authors.lastname: Natto
authors.forename: Mostafa
authors.initials: M
authors.lastname: Baljoon
authors.forename: Jan
authors.initials: J
authors.lastname: Bergström
mesh_terms: D000293:Adolescent; D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000473:pathology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007571:Jaw Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012529:Saudi Arabia; D012907:Smoking / Q000009:adverse effects*