Postmenopausal women who have smoked are at much higher risk of losing their teeth than women who never smoked, according to a new study in the Journal of the American Dental Association (March 2013, Vol. 144:3, pp. 252-265).
Conducted by researchers at the University of Buffalo, the study involved 1,106 women who participated in the Buffalo OsteoPerio Study, an offshoot of the Women's Health Initiative (WHI), the largest clinical trial and observational study ever undertaken in the U.S., involving more than 162,000 women across the nation, including nearly 4,000 in Buffalo.
The study is the first to examine comprehensive smoking histories that allowed the researchers to unravel some of the causes behind tooth loss in postmenopausal women who smoked, they noted in a press release.
Smoking has long been associated with tooth loss, but postmenopausal women, in particular, experience more tooth loss than their male counterparts -- regardless of having better oral health practices, such as brushing and flossing and visiting the dentist more frequently.
In the study, heavy smokers -- defined as those who had at least 26 pack-years of smoking -- were nearly twice as likely to report having experienced tooth loss overall and more than six times as likely to have experienced tooth loss due to periodontal disease, compared to those who never smoked.
Participants provided information to researchers using a detailed questionnaire covering smoking history. Each participant also underwent a comprehensive oral examination and reported to the dental examiners reasons for each tooth lost. In some cases, the patient's dental records also were reviewed.
"We found that heavy smokers had significantly higher odds of experiencing tooth loss due to periodontal disease than those who never smoked," explained lead author Xiaodan Mai, a doctoral student in epidemiology. "We also found that the more women smoked, the more likely they experienced tooth loss as a result of periodontal disease."
Cigarette smoke may accelerate periodontal disease, the researchers noted, and other studies suggest that chemicals found in smoke may favor plaque-forming bacteria that could reduce the ability of saliva to be antioxidative. Nicotine also has been shown to reduce bone density and bone mineral factors, while estrogen hormones have been found to be lower among women who smoke.
