title: Smoking-attributable periodontal disease in the Australian adult population.
abstract: BACKGROUND
  The extent to which periodontitis is attributable to smoking in Australia has not been examined.
  
  
  OBJECTIVE
  To investigate the smoking-periodontitis relationship and to estimate the public health impact of smoking on periodontitis in Australia.
  
  
  METHODS
  The National Survey of Adult Oral Health 2004-2006 collected nationally representative oral epidemiologic data for the Australian adult population. Examiners measured probing pocket depth (PPD) and gingival recession at three sites per tooth to compute clinical attachment level (CAL). Moderate-severe cases were defined as having: >/=2 interproximal sites (not on same tooth) with >/=4 mm CAL or with >/=5 mm PPD. Smoking status was defined as never-, former- or current-smoker. Current-smokers were further classified into light-, moderate- or heavy-smoker using calculated pack-years. Age, sex and socioeconomic position were examined as potential confounders.
  
  
  RESULTS
  Twenty-three per cent were former-smokers and 15% were current-smokers. Prevalence of periodontitis was 23%. In unadjusted analyses, former- and current-smokers had significantly higher periodontitis prevalence than never-smokers. Relative to non-smokers, adjusted prevalence ratios (95% confidence interval) for periodontitis were as follows: former-smokers: 1.22 (1.03-1.46), moderate-smokers: 1.63 (1.16-2.30); and heavy-smokers: 1.64 (1.27-2.12). The population attributable fraction of smoking for moderate-severe periodontitis was 32% (equivalent to 700,000 adults).
  
  
  CONCLUSIONS
  Smoking has a significant impact on periodontal health of the Australian adults.
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia. loc.do@adelaide.edu.au
authors.forename: Loc G
authors.initials: LG
authors.lastname: Do
authors.forename: Gary D
authors.initials: GD
authors.lastname: Slade
authors.forename: Kaye F
authors.initials: KF
authors.lastname: Roberts-Thomson
authors.forename: Anne E
authors.initials: AE
authors.lastname: Sanders
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000209:etiology; D010512:Periodontal Index; D010518:Periodontitis / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D012923:Social Class