title: The association of active and secondhand smoking with oral health in adults: Japan public health center-based study.
abstract: BACKGROUND
  Smoking is one of the major risk factors for oral diseases, and many studies have found that active smoking is closely associated with the prevalence or severity of periodontal disease and fewer remaining teeth. In contrast to the established association between active smoking and oral health, there have been very few studies investigating the effects of secondhand smoking on oral health, and whether secondhand smoking deteriorates oral health has not been fully clarified. The purpose of the present study was to examine whether active and secondhand smoking were associated with the prevalence of severe periodontal disease and number of teeth among Japanese adults.
  
  
  METHODS
  Subjects were 1,164 dentate adults aged 55-75 years as of May 2005 who participated in both the Japan Public Health Center-Based Study Cohort I in 1990 and a dental survey in 2005. The dental survey was implemented in the Yokote health center jurisdiction, Akita Prefecture. Participating subjects completed a self-administered questionnaire and a clinical oral examination. The association of smoking status with prevalence of periodontal disease was analyzed using a logistic regression, and with number of teeth or functional tooth units of natural teeth (n-FTUs) using a generalized linear model.
  
  
  RESULTS
  After adjusting for age, education level, history of diabetes, BMI, alcohol consumption, perceived mental stress, presence of a family dentist, and oral hygiene, the odds ratio (OR) of risk for periodontal disease in male subjects was significantly increased in non-smokers with secondhand smoking only at home (OR = 3.14, 95 % CI: 1.08-9.12, p = 0.036), non-smokers with secondhand smoking both at home and other places (OR = 3.61, 95 % CI: 1.33-9.81, p = 0.012) and current smokers (OR = 3.31, 95 % CI: 1.54-7.08, p = 0.002), compared to non-smokers without secondhand smoking. Further in men, current smokers had significantly fewer numbers of teeth (19.7 ± 6.82) and n-FTUs (4.92 ± 4.12) than non-smokers without secondhand smoking (22.2 ± 6.92, p = 0.014 and 6.56 ± 4.18, p = 0.007). Such significant relationships of smoking status with periodontal disease and dentition were not observed in women.
  
  
  CONCLUSIONS
  The present study indicates that active smoking as well as secondhand smoking may have harmful effects on periodontal health in men. Therefore, it is imperative for health and oral health professionals to enlighten people about the negative influence of smoking, not only on their own health but also on others' health.
authors.affiliation: Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ueno
authors.affiliation: Department of Comprehensive Oral Health Care, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Ohara
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Norie
authors.initials: N
authors.lastname: Sawada
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan ; AXA Department of Health and Human Security, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Manami
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
authors.affiliation: Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kawaguchi
keywords: Active smoking; Dentition; Functional tooth units; Periodontal disease; Secondhand smoking