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Reexamining the association between smoking and periodontitis in the dunedin study with an enhanced analytical approach.
J Periodontol. 2014 Oct; 85(10):1390-7.JP

Abstract

BACKGROUND

Smoking is a major risk factor for periodontal disease. Conventional oral epidemiology approaches have found strong, consistent associations between chronic smoking and periodontal attachment loss (AL) through ages 26, 32, and 38 years, but those statistical methods disregarded the data's hierarchical structure. This study reexamines the association using hierarchical modeling to: 1) overcome the limitations of an earlier approach (trajectory analysis) to the data and 2) determine the robustness of the earlier inferences.

METHODS

Periodontal examinations were conducted at ages 26, 32, and 38 years in the Dunedin Multidisciplinary Health and Development Study. The number of participants examined at those three ages were 913, 918, and 913, respectively. A generalized linear mixed model with a quasi-binomial approach was used to examine associations between chronic smoking and periodontal AL.

RESULTS

At ages 26, 32, and 38, smokers had 3.5%, 12.8%, and 23.2% 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 socioeconomic status had higher AL at ages 32 and 38, but not at age 26. The amount of AL in anterior teeth was less than in premolars and molars. Gingival bleeding was associated with higher AL at ages 26, 32, and 38.

CONCLUSION

The smoking-periodontitis association is observable with hierarchical modeling, providing strong evidence that chronic smoking is a risk factor for periodontitis.

Authors+Show Affiliations

Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24555730

Citation

Zeng, Jiaxu, et al. "Reexamining the Association Between Smoking and Periodontitis in the Dunedin Study With an Enhanced Analytical Approach." Journal of Periodontology, vol. 85, no. 10, 2014, pp. 1390-7.
Zeng J, Williams SM, Fletcher DJ, et al. Reexamining the association between smoking and periodontitis in the dunedin study with an enhanced analytical approach. J Periodontol. 2014;85(10):1390-7.
Zeng, J., Williams, S. M., Fletcher, D. J., Cameron, C. M., Broadbent, J. M., Shearer, D. M., & Thomson, W. M. (2014). Reexamining the association between smoking and periodontitis in the dunedin study with an enhanced analytical approach. Journal of Periodontology, 85(10), 1390-7. https://doi.org/10.1902/jop.2014.130577
Zeng J, et al. Reexamining the Association Between Smoking and Periodontitis in the Dunedin Study With an Enhanced Analytical Approach. J Periodontol. 2014;85(10):1390-7. PubMed PMID: 24555730.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reexamining the association between smoking and periodontitis in the dunedin study with an enhanced analytical approach. AU - Zeng,Jiaxu, AU - Williams,Sheila M, AU - Fletcher,David J, AU - Cameron,Claire M, AU - Broadbent,Jonathan M, AU - Shearer,Dara M, AU - Thomson,W Murray, Y1 - 2014/02/20/ PY - 2014/2/22/entrez PY - 2014/2/22/pubmed PY - 2015/9/16/medline KW - Cannabis KW - cohort studies KW - multilevel analysis KW - periodontal diseases KW - risk factors KW - smoking SP - 1390 EP - 7 JF - Journal of periodontology JO - J Periodontol VL - 85 IS - 10 N2 - BACKGROUND: Smoking is a major risk factor for periodontal disease. Conventional oral epidemiology approaches have found strong, consistent associations between chronic smoking and periodontal attachment loss (AL) through ages 26, 32, and 38 years, but those statistical methods disregarded the data's hierarchical structure. This study reexamines the association using hierarchical modeling to: 1) overcome the limitations of an earlier approach (trajectory analysis) to the data and 2) determine the robustness of the earlier inferences. METHODS: Periodontal examinations were conducted at ages 26, 32, and 38 years in the Dunedin Multidisciplinary Health and Development Study. The number of participants examined at those three ages were 913, 918, and 913, respectively. A generalized linear mixed model with a quasi-binomial approach was used to examine associations between chronic smoking and periodontal AL. RESULTS: At ages 26, 32, and 38, smokers had 3.5%, 12.8%, and 23.2% 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 socioeconomic status had higher AL at ages 32 and 38, but not at age 26. The amount of AL in anterior teeth was less than in premolars and molars. Gingival bleeding was associated with higher AL at ages 26, 32, and 38. CONCLUSION: The smoking-periodontitis association is observable with hierarchical modeling, providing strong evidence that chronic smoking is a risk factor for periodontitis. SN - 1943-3670 UR - https://www.unboundmedicine.com/medline/citation/24555730/Reexamining_the_association_between_smoking_and_periodontitis_in_the_dunedin_study_with_an_enhanced_analytical_approach_ L2 - https://doi.org/10.1902/jop.2014.130577 DB - PRIME DP - Unbound Medicine ER -