Effects of smoking and drinking habits on the incidence of periodontal disease and tooth loss among Japanese males: a 4-yr longitudinal study

Objective: We investigated the risk of periodontal disease and tooth loss, associated with habits of smoking and alcohol consumption, in a longitudinal study. Subjects and Methods: The subjects were 1332 Japanese males, 30 - 59 yr of age, who were free from periodontal disease at the baseline check-up, and who underwent a second check-up 4 yr later. Periodontal disease was diagnosed using the community periodontal index score, based on the clinical probing of pocket depth (4 mm). Smoking and alcohol consumption patterns were evaluated using a self-administered questionnaire. Results: A dose - response relationship was observed between the amount of smoking and the incidence of periodontal disease in each age group. The overall odds ratios (95% confidence intervals), adjusted for age and alcohol, were 1.51 (0.95 - 2.22), 1.58 (1.13 - 2.22) and 2.81 (1.96 - 4.03), among smokers consuming 1 - 19, 20 or 21 or more cigarettes per day, respectively, with a significant linear trend (p < 0.0001). A similar association was found between smoking and tooth loss, except for the 50 - 59-yr-old age group. The adjusted odds ratios were 1.26 (0.60 - 2.64), 2.01 (1.21 - 2.32) and 2.06 (1.23 - 3.48), respectively. A significant linear trend between smoking and tooth loss was also observed (p = 0.01). Ex-smokers showed no significant difference compared with nonsmokers. We also found a significant linear trend between alcohol consumption and tooth loss among 30 - 39 yr-old subjects, while no relationship was observed between alcohol consumption and periodontal disease. Conclusion: Cigarette smoking was found to be an independent risk factor for periodontal disease and tooth loss. Alcohol consumption was a limited risk factor for tooth loss in the younger age group, but was unrelated to periodontal disease. To prevent periodontal disease and tooth loss, health practitioners need to encourage people to stop smoking or not to start.