Association between smoking behavior and oral health problems: A national cross-sectional study in Korea

Smoking is a risk factor that significantly affects general and oral health by altering the oral environment, increasing plague build-up, and reducing blood flow in the gums, leading to tooth decay and periodontal disease. Therefore, this study investigated the association between smoking behaviors, such as smoking duration and cessation, and oral health problems.

This study analyzed a secondary dataset of the Korea National Health and Nutrition Examination Survey (2019-2021) that included 6150 men and 7574 women. Individuals were classified as current smokers if they were currently smoking regular cigarettes, heated tobacco products, or electronic cigarettes. Oral health problems included toothaches and chewing difficulties. Multiple logistic regression was used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the association between smoking behavior and oral health problems.

Among participants of both sexes, current smokers had more oral health problems compared with non-smokers (men, AOR=1.60; 95% CI: 1.35-1.89; women, AOR=1.91; 95% CI: 1.33-2.71), as did ex-smokers (men, AOR=1.39; 95% CI: 1.18-1.63; women, AOR=1.47; 95% CI: 1.18-1.83). The longer the smoking cessation period, the lower was the prevalence of oral health problems. Additionally, high pack-years were associated with oral health issues. Regular cigarettes were more likely to cause problems than e-cigarettes (men, AOR=1.56; 95% CI: 1.31-1.86; women, AOR=1.96; 95% CI: 1.53-2.52), while vaping (men, AOR=1.36; 95% CI: 1.05-1.74; women, AOR=1.64; 95% CI: 1.06-2.53) and dual smoking (men, AOR=1.57; 95% CI: 1.14-2.16; women, AOR=1.97; 95% CI: 1.10-3.50) were also associated with oral health issues.

This study confirmed that smoking is strongly associated with oral health problems. Public health efforts should focus on prevention and tailored interventions to support quitting and improve oral health outcomes in both current and ex-smokers.