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Objective: To examine dental visits among smoking and nonsmoking adults in a nationally representative sample., Methods: Logistic regression analysis was performed, using a sample of 15,250 US adults from the Medical Expenditure Panel Survey Household Component 2000., Results: Current smokers were less likely to report dental visits (32.9%) than were nonsmokers (45.0%) during 2000. Differences were statistically significant even after accounting for other predictors of dental care use., Conclusions: Efforts to optimize the oral health of smokers and reduce serious oral diseases may benefit from addressing this lower use of dental services among smokers.

Background: Cigarette smoking is a significant risk factor for both chronic obstructive pulmonary disease (COPD) and periodontal disease. The goal of this study was to better understand the role of smoking in a possible relationship between periodontal disease and COPD., Methods: The study population consisted of 7,625 participants in the Third National Health and Nutrition Examination Survey (NHANES III) during 1988-1994 who were aged 30 years or older when examined and who received a spirometric examination. The data analysis employed logistic regression models and accounted for the complex sampling design used in NHANES III., Results: After adjustment for potential confounders, there was no statistically significant association between periodontal disease and COPD among former or non-smokers. Current smokers with > or = 4 mm mean loss of attachment had an odds ratio of 3.71 (95% confidence interval: 1.74, 7.89)., Conclusions: These results suggest that cigarette smoking may be a cofactor in the relationship between periodontal disease and chronic obstructive pulmonary disease. The key role played by smoking in the etiology of both periodontal disease and chronic obstructive pulmonary disease suggests that much of the observed increase in risk may actually reflect the exposure to smoking. Additional research into smoking-related effect modification is needed to clarify the role of periodontal disease in the etiology of smoking-related systemic diseases.

Background: Cigarette smoking is a significant risk factor for both coronary heart disease and periodontal disease. The goal of this study was to better understand the role of smoking in the relationship between periodontal disease and heart attack history., Methods: The study population consisted of 5,285 participants in the Third National Health and Nutrition Examination Survey (NHANES) during 1988-1994 and who were age 40 years or older when examined. The data analysis employed logistic regression models and accounted for the complex sampling design used in NHANES., Results: After adjustment for potential confounders, we only found significant associations between periodontal loss of attachment (LOA) and heart attack history for smokers, with odds ratios and 95% confidence interval (CI) of 2.64 (1.48 to 4.71), 3.84 (1.22 to 12.10) and 5.87 (1.91 to 18.00) for those with 2.0 to 2.99, 3.0 to 3.99, and 4 mm or more mean LOA, respectively. When the analysis was stratified by smoking status and tertile of age at heart attack, the statistically significant associations were limited to smokers who had a heart attack between the ages of 25 and 50 years, with odds ratios and 95% Cl associated with increasing mean LOA for this group of 3.29 (1.35 to 8.04), 7.32 (1.60 to 33.51), and 8.04 (1.91 to 18.00), respectively., Conclusions: These results suggest that cigarette smoking is a necessary cofactor in the relationship between periodontal disease and coronary heart disease, and the increase in risk appears to be age dependent. However, the key role played by smoking in the etiology of both periodontal and heart diseases makes it difficult to determine how much of the observed association resulted from periodontal disease.

Abstract Objectives: The objective of this study was to identify variables related to periodontal loss of attachment (LOA). Materials and Methods: The study population consisted of a nationally representative sample of 12,325 US adults who participated in the National Health and Nutrition Examination Survey III. The analyses used survey multinomial logistic regression to account for the complex survey design. Results: The adjusted odds ratio for a mean LOA of 3 mm or more associated with current smoking was 18.55 (95% CI 9.44–36.45) among 20–49-year olds. Among those aged 50 years or more, the odds ratio for a mean LOA of 4 mm or more was 25.64 (13.04–50.40). Prior smoking, untreated decayed surfaces (on both person and site levels), and male gender were also associated with LOA. There was no excess risk observed among non-Hispanic blacks or Mexican-Americans. The adjusted population attributable fractions due to current smoking were 60% for persons aged 20–49 with the worst 10% of LOA (1.58 mm or more), and 47% for those aged 50 plus (LOA of 3.39 mm or more). Conclusion: These results support earlier findings regarding the central role of cigarette smoking in the etiology of periodontal loss of attachment, a role due in large part to the substantial relationship between smoking and severe periodontal disease. [ABSTRACT FROM AUTHOR]

The article comments on the importance of determining confounding and effect modification in research on periodontal and systemic diseases. The putative associations between periodontal disease and systemic diseases is pertinent when dealing with research on smoking for smoking is a major risk factor for both periodontal disease and a number of systemic diseases. As an outcome, it is very difficult to disentangle the effects of smoking and periodontal disease in studies of systemic diseases.