The Gapped Smile from Heavy Smoking

Periodontal disease may cause tooth loss in heavily smoking postmenopausal women

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) One consequence to smoking cigarettes is losing teeth. Women who are past menopause aren't free from that consequence: the heavier the smoker, the more likely they may be to lose their pearly whites.

Tooth loss from gum disease was higher among postmenopausal women who heavily smoked compared to women who never smoked, according to a recently published study.

Based on the findings, researchers suggested that strategies focus on smoking prevention to keep gum disease to a minimum among postmenopausal women in the United States.

"Put the cigarette down."

As the first study of its kind, researchers aimed to see whether smoking was related to tooth loss in postmenopausal women.

The study, led by Xiaodan Mai, a doctoral student in the Department of Social and Preventive Medicine at the University at Buffalo, The State University of New York, included more than 1,100 postmenopausal women who participated in the Women's Health Initiative Observational Study.

The women, who were primarily white and had completed some college education, reported whether or not they smoked or had smoked in the past.

Women were categorized based on the number of pack-years they smoked.

Pack-years is a measure of the number of cigarette packs smoked each day times the number of years spent smoking.

The categories included those who never smoked, were light smokers (at less than eight pack-years), moderate smokers (eight to 25 pack-years) and heavy smokers (smoked more than 26 pack-years).

Each of the participants had an oral examination by trained dental examiners who tracked how many teeth they had. If teeth were missing, women reported why the teeth were missing.

The reasons for missing teeth included having cavities, accident or trauma, orthodontic procedure, eruption problems, root canals and periodontal disease.

In periodontal disease, or gum disease, the gums are inflamed and teeth are covered with plaque from bacteria buildup.

About half the participants never smoked and about 17 percent were heavy smokers. Less than half were currently receiving menopausal hormone therapy.

Researchers compared tooth loss to the women's smoking status and adjusted for age, education, income and medical history.

Researchers found that heavy smokers were almost twice as likely to report losing teeth compared to women who never smoked.

"In our study, current smokers did not have higher odds of experiencing tooth loss compared with never smokers, which is in contrast with the results of the majority of reports in the literature...," researchers wrote in their report.

"However, it is important to note that the prevalence of current smoking in our study tended to be lower than that reported in other cohorts of women, and this could account in part for the discrepant findings," they continued.

Tooth loss was linked with women's smoking status and the number of years since they quit smoking, if they had quit. In addition, the number of packs smoked per day, years spent smoking and pack-years was also linked to tooth loss.

Looking at the number of pack-years alone, heavy smokers were almost seven times more likely to lose teeth as those who never smoked.

According to researchers, gum disease could progress faster by smoking cigarettes. Smoke is toxic to bone mineral content and could change the protective properties of the mouth and saliva. Cavities, or caries, were not examined in the study.

"Caries and periodontal disease account for a large proportion of missing teeth in adult populations," researchers wrote.

"Although caries is a major reason for tooth loss across all age groups, periodontal disease is a particularly important reason among older adults."

The authors noted that smoking might not be the cause of the tooth decay. The reason behind tooth decay is still not known.

In addition, researchers studied women who had good oral hygiene, so the findings may not be apply to other populations. Future research should include larger populations.

The study was published March 1 in the Journal of the American Dental Association.

Funding and support for the study was provided by the National Institute of Dental and Craniofacial Research, National Institutes of Health, US Army, Medical Research and Materiel Command and the National Heart Lung and Blood Institute.

Reviewed by: 
Review Date: 
March 4, 2013
Last Updated:
March 5, 2013