Multiple Tobacco Product Use and Dental Pain: A Cross-sectional Study

Although individual tobacco products, including new tobacco products, have been associated with adverse oral health outcomes, few studies have examined the association between multiple tobacco product (MTP) use and dental pain as an indicator of current oral health status.

We conducted a cross-sectional study using data from a nationwide internet survey in Japan. The 2023 survey included the outcome variable, current tobacco product use, and most covariates; however, it did not include the number of remaining teeth, an oral health-related covariate relevant to interpreting dental pain. Therefore, we included participants who responded to the 2023 survey and for whom information on remaining teeth was available from the 2022 survey. Current tobacco product use was assessed for 6 product types: cigarettes, heated tobacco products, electronic cigarettes, cigars, pipe/water pipes, and smokeless tobacco. Participants were categorized as having no current product use, single-product use, or MTP use. The outcome was self-reported dental pain within the past week. Covariates were sex, age, education, household income, living alone, marital status, drinking, self-rated health, psychological distress, number of remaining teeth, and daily toothbrushing. We used multivariable modified Poisson regression to estimate adjusted prevalence ratios (aPRs) and 95% CIs.

We analyzed 19,703 participants; the mean age was 50.2 y (SD, 16.9) and 10,165 (51.6%) were men. Overall, 2518 participants (12.8%) reported dental pain within the past week, 2463 (12.5%) used a single tobacco product, and 1040 (5.3%) used MTPs. After adjustment for all covariates, MTP use was associated with a higher prevalence of dental pain (single-product use: aPR, 1.03 [95% CI, 0.92-1.15]; MTP use: aPR, 1.39 [95% CI, 1.25-1.54]).

MTP use was associated with dental pain. Longitudinal studies are needed to clarify the temporal and causal relationships between MTP use and oral health.Knowledge Transfer Statement:The findings of this study suggest that collaboration between policy makers in dental and oral health and those in tobacco control may be important for addressing oral health disparities between tobacco users and nonusers.