Substance use and periodontal disease among Australian Aboriginal young adults

Aim To investigate the effects of tobacco, marijuana, alcohol and petrol sniffing on periodontal disease among Australian Aboriginal young adults. Design Cross-sectional nested within a long-standing prospective longitudinal study. Setting Aboriginal communities in Australia's Northern Territory. Participants Members of the Aboriginal Birth Cohort study who were recruited from birth between January 1987 and March 1990 at the Royal Darwin Hospital, Northern Territory, Australia. Data were from wave III, when the mean age of participants was 18 years. Measurements Clinical dental examination and self-report questionnaire. Findings Of 425 participants with complete data, 26.6% had moderate/severe periodontal disease. There was elevated risk of periodontal disease associated with tobacco [prevalence ratio (PR) = 1.59, 95% CI = 1.06-2.40], marijuana (PR = 1.44, 95% CI = 1.05-1.97) and petrol sniffing (PR = 1.83, 95% CI = 1.08-3.11), but not alcohol (PR = 0.92, 95% CI = 0.67-1.27). Stratified analysis showed that the effect of marijuana persisted among tobacco users (PR = 1.47, 95% CI 1.03-2.11). It was not possible to isolate an independent effect of petrol sniffing because all petrol sniffers used both marijuana and tobacco, although among smokers of both substances, petrol sniffing was associated with an 11.8% increased prevalence of periodontal disease. Conclusions This is the first time that substance use has been linked with periodontal disease in a young Australian Aboriginal adult population, and the first time that petrol sniffing has been linked with periodontal disease in any population. The role of substance use in periodontal disease among this, and other, marginalized groups warrants further investigation.