Further evidence that periodontal bone loss increases with smoking and age

Cohort study. COHORT SELECTION: A birth cohort born at the Queen Mary Hospital, Dunedin, New Zealand between 1 April 1972 and 31 March 1973 that are being followed as part of the Dunedin Multidisciplinary Health and Development Study (DMHDS). EXPOSURE MEASUREMENT: Periodontal examinations were conducted at ages 26, 32 and 38, with only half-mouth examinations possible at age 26, but full-mouth examinations undertaken at 32 and 38. Third molars and implants were not included in the periodontal examinations. Tobacco smoking was determined at ages 15, 18, 21, 26, 32 and 38.

Attachment loss (AL).

Generalised linear mixed modelling with a quasi-binomial approach was used to examine associations between chronic smoking and periodontal attachment loss.

Of the 1037 participants initially enrolled in the study, 913 were periodontally examined at age 26, and periodontal data were available for 863 (94.5%) individuals at ages 26, 32, and 38 using listwise deletion. At age 32 and 38 respectively, 918 and 905 (98.6%), and 913 and 869 (95.1%) participants were examined and included in the analysis. Approximately equal numbers of females and males were included. Attachment loss increased in smokers with age. At ages 26, 32 and 38, smokers had 3.5%, 12.8% and 23.2% (respectively) greater AL than non-smokers. Regular cannabis use was associated with greater AL after age 32, but not at age 26. Males had more AL than females. Participants with high plaque scores had consistently greater AL; those who were of persistently low SES (socio-economic status) had higher AL at age 32 and 38, but not at age 26. The amount of AL in anteriors was less than in premolars and molars. Gingival bleeding was associated with higher AL at ages 26, 32 and 38.

This research confirmed the strong association between chronic smoking and periodontal disease.