In the US dentate adult population, prevalence of periodontitis, defined as 2 or more sites with clinical attachment loss of at least 4 millimeters and 1 or more sites with probing depth of 4 millimeters or deeper, was estimated to be 3.6%. 7 This percentage indicates that approximately one half of periodontitis cases could be prevented if cigarette smoking were eliminated, with most of that reduction occurring among people who quit smoking, rather than among nonsmokers exposed to secondhand smoke. 5 The etiologic fraction, that is, the fraction of severe periodontal disease cases in which cigarette smoking exposure plays an etiologic role, 6 has been estimated to be 52.8%. In 2004, the US Surgeon General concluded that the scientific evidence was sufficient to infer a causal relationship between tobacco smoking and periodontitis. 1 Systematic reviews of the evidence have supported a relationship between periodontitis and cardiovascular disease 2, 3 and type 2 diabetes. Also, the underlying infection and complex host immune-modulatory and inflammatory responses that destroy periodontal tissues contribute to several systemic conditions. Periodontitis is a leading cause of tooth loss and an important entity in its own right. Ideally, measurements are made at 6 sites per tooth in a full-mouth assessment of 28 teeth. Attachment level is determined by combined parameters of probing depth and gingival recession at numerous sites in the mouth. Diagnosis is based on signs of destruction of the connective tissues attaching the tooth root to alveolar bone, which is assessed clinically by measuring attachment level. Periodontitis is a chronic condition characterized by inflammation of the supporting tissues of the teeth, resulting in breakdown of the connective tissue attaching the teeth to the alveolar bone and eventually to irreversible loss of that bone. Exposure to secondhand smoke and severe periodontitis among nonsmokers had a dose-dependent relationship. In a binary logistic regression model, adjusted odds of severe periodontitis for those exposed to secondhand smoke 1 to 25 hours per week increased 29% (95% confidence interval = 1.0, 1.7) for those exposed to secondhand smoke 26 hours per week, the odds were twice as high (95% confidence interval = 1.2, 3.4) as for those who were unexposed.Ĭonclusions.

Other outcomes were extent of periodontal probing depths of 4 millimeters or more and extent of clinical attachment levels of 3 millimeters or more. We defined severe periodontitis as 5 or more periodontal sites with probing pocket depth of 5 millimeters or more and clinical attachment levels of 3 millimeters or more in those sites. Exposure was reported as average hours per week in close contact with a smoker in the preceding year.

We undertook a cross-sectional analysis of the Atherosclerosis Risk in Communities study with 2739 lifetime nonsmokers aged 53–74 years, unexposed to other sources of tobacco, who received a complete periodontal examination at visit 4.

We investigated the relationship between secondhand smoke and periodontal disease in nonsmokers.

Binary smoke review