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Indian Journal of Community Medicine

Assessment of Periodontal Status and Loss of Teeth among Smokers and Non- Smokers in Belgaum City

Author(s): Pankaj, A Ankola, L Nagesh, P Tangade, P Hegde

Vol. 32, No. 1 (2007-01 - 2007-03)

Pankaj, A Ankola, L Nagesh, P Tangade, P Hegde

Periodontal diseases are one of the common oral diseases of mankind. No area of world is free from it. Approximately half of the child population and almost entire adult population has some periodontal disease. Many factors play a major role in the degree of response.

Smoking is one of major risk factor for periodontal diseases and early loss of teeth3,4. Smoking affects the oral hygiene, the gingival status, the periodontal status, impairing wound healing, diminished implant stability and increased bone loss compared with non- smokers. Clinical ffindings related to smoking and periodontal disease have been well documented. Alveolar bone loss, tooth mobility, increased probing depth and tooth loss have been reported to the more severe in smokers than in non- smokers1,2.

This article gives a comparative account of periodontal status and loss of teeth among smokers and non smokers of Belgaum city.

Material and Methods

This study included 310 males (150 smokers and 160 non smokers) aged 18-60 years attending dental OPD of JLN Medical College, Belgaum. Community Periodontal Index (CPI) was used as an epidemiological tool to assess periodontal status (bleeding, calculus and pockets). Six segments of teeth (sextants) of each individual were examined (150 individuals = 900 sextants) Loss of teeth due to periodontal reasons was also recorded.

Informed consent was obtained and the purpose of study was explained to the respondent. The oral examination throughout was carried by investigator with the help of plane mouth mirror and a WHO probe. Information about age, income, occupation, level of education, brushing frequency and smoking status was recorded on self designed performa. The data was compiled, tabulated and was subjected to statistical analysis. Z-test was employed to check signifficance between proportions of groups.

Results

Among both smokers and non smokers, 60% were 25 – 44 year old and 25% were 45 – 54 year old. Out of 150 smokers, 45 (30%) smoked 1 – 4 cigarettes per day, 63(42%) smoked 5 – 10 cigarettes perday, 27 (18%) were smoked 11 – 20 cigarettes perday and 15 (10%) smoked more than 20 cigarettes perday.

In smokers out of 900 sextants, 90 were healthly, 127 were bleeding on probing, 341 had calculus, 249 had pockets 4 – 5 mm and 93 had pockets 6 mm or more. In non – smokers out of 960 sextants, 106 were healthy, 138 were bleeding on probing, 467 had calculus, 166 had pockets 4 – 5mm and 83 had pockets 6 mm or more. The difference was statistically signifficant among smokers and non – smokers (Table 1).

Table 1: Comparison between Smokers (S) and Non – smokers (NS) with affected Sextants in Different Age Groups

Age No. of
Sextants
Healthy Bleeding Calculus Pockets
4 – 5 mm
Pocket
≥6mm
  S NS S NS S NS S NS S NS S NS
18 – 24 72 84 9 13 20 19 39 52 4 0 0 0
25 – 34 180 192 25 24 63 72 87 85 5 11 0 0
35 – 44 360 378 38 51 29 39 127 186 152 79 14 23
45 – 54 228 240 18 18 15 8 70 123 65 54 60 37
55 – 60 60 66 0 0 0 0 18 21 23 22 19 23
Total 900 960 90 106 127 138 341 467 249 166 93 83

Z=5.599 p<0.0001

In 18 – 24 years, none of smokers and non – smokers had missing teeth. In 25 – 34 years, 2(3.6%) smokers and 1(2.8%) non – smoker had missing teeth. In 35 – 44 years, 29 (52.8%) smokers and 17(47.2%) non – smokers had missing teeth.

In 45 – 54 years, 17(30.9%) smokers and 14 (38.9%) nonsmokers had missing teeth. In 55 – 60 years, 7 (12.7%) smokers and 4 (11.1%) non – smokers had missing teeth. The difference was statistically signifficant among smokers and non – smokers (Table 2).

Table 2: Age wise occurrence missing teeth due to periodontal disease among smokers and non – smokers

Age in Years Smokers Non Smokers
25 – 34 2 3.6 1 2.8
35 – 44 29 52.8 17 47.2
45 – 54 17 30.9 14 38.9
55 – 60 7 12.7 4 11.1
Total 55
(36.6%)
100 36
(22.5%)
100

Z=2.72 p=0.0066

Discussion

The present study reveals that smoking is a risk factor for periodontal disease and early loss of teeth. Similar ffindings has been reported by other authors3.

In all the age groups, the number of healthy sextants (Score) were lower in smokers than in no – smokers and also gingival bleeding (score 1) was higher in non – smokers than in smokers. These ffindings were in agreement with the data from other studies showing that smokers experience less bleeding than non – smokers3.

In the present study, the calculus scores were similar in both the groups. The proportion of CPfiscore 3 (4 – 5 mm pockets) and 4 (6mm or more) among remaining sextants was higher (27.6 and 10.4%) in smokers than in non smokers (17.3 and 8.6%). The percentage of sextants affected with deep pockets among smokers was 38% compared to nonsmokers 25.9% (p=0.0001). Similar signifficant differences were reported by others5.

Percentage of tooth loss due to periodontal diseases among smokers was signifficantly higher. Similar ffindings were reported by others2.

Acknowledgement

Authors are thankful to all the participants and ShrfiM. D. Mallapur, Lecturer in Statistics, Dept. of Community Medicine, J. N. M. C., Belgaum, for helping with the statistical work.

References

  1. Wilson T. Effects of smoking on the periodontium. Quintessence Int. 1998; 29(4); 265-6.
  2. Holm G. Smoking as an additional risk for tooth loss. J Periodontal. 1994; 65:996-1001.
  3. Linden G. J. Cigarette smoking and periodontal destruction in young adults. J Periodontal. 1994; 65:718-23.
  4. Beck J. D. Prevalence and risk indicators for periodontal attachment loss in population of older community. J Periodontal. 1990; 61:521-28.
  5. Bergstrom J. Tobacco use as a risk factor. J. Periodontal. 1994; 65:545-50.

Deptt. of Community Medicine, JNMC, Belgaum.
Received: 17.05.05

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