title: Periodontal disease in relation to smoking and the use of Swedish snus: epidemiological studies covering 20 years (1983-2003).
abstract: OBJECTIVE
  The aim of the present study was to examine how deleterious current smoking and the use of Swedish moist snuff (snus) is for periodontal health compared with non-tobacco users.
  
  
  METHODS
  The studies comprised three epidemiological cross-sectional studies, in 1983, 1993 and 2003, of stratified random samples aged 20, 30, 40, 50, 60 and 70 years. The numbers of dentate participants were 550, 552 and 523, respectively. The participants were examined clinically and radiographically. Diagnostic criteria were the number of teeth, plaque, gingival status, probing pocket depth (PPD) ≥ 4 mm, height of the alveolar bone level and classification by periodontal disease experience. In addition, participants were asked about their tobacco habits.
  
  
  RESULTS
  Multiple logistic regression shows, after adjusting for age, gender and sociodemographic variables, that relative to non-tobacco users, cigarette smokers had statistically significant less gingivitis, a higher frequency of PPD ≥ 4 mm and a higher incidence of severe periodontitis. There was no significant association between gingivitis, frequency of PPD ≥ 4 mm and periodontal disease experience and snus use.
  
  
  CONCLUSIONS
  Cigarette smokers were found to have a statistically significant higher risk of severe periodontitis than non-tobacco users and users of snus. Using snus did not seem to be a risk factor for periodontitis.
authors.affiliation: Center for Oral Health, School of Health Sciences, Jönköping University, Jönköping, Sweden. anders.hugoson@hhj.hj.se
authors.forename: Anders
authors.initials: A
authors.lastname: Hugoson
authors.forename: Margot
authors.initials: M
authors.lastname: Rolandsson
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D005260:Female; D005891:Gingivitis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010514:Periodontal Pocket / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D010518:Periodontitis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D011861:Radiography, Dental; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D055815:Young Adult