Smoking Away a Healthy Smile

Smoking and lack of exercise found to be risk factors for tooth loss

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Of course good oral hygiene is key in preventing tooth loss, but other lifestyle factors are important too. Healthy teeth may reflect healthy lifestyle choices.

In a recent study, researchers collected survey data on people about tooth loss in relation to lifestyle factors.

The results showed that being a smoker was the greatest risk factor for tooth loss, with a lack of exercise coming in second.

"Quit smoking, stay active and brush your teeth."

Yongwen Jiang, PhD, from the Center for Health Data and Analysis at the Rhode Island Department of Health and Brown University School of Medicine, led an investigation into what factors may impact poor oral health.

“Poor oral health can lead to decreased general health, limited social functioning, and decreased quality of life. Tooth loss is an indicator of poor oral health and may impair physical, psychological, and social functioning and influence self-esteem and communication,” the authors said.

Previous studies have shown tooth loss to be associated with smoking, poor oral hygiene, diabetes, high blood pressure, rheumatoid arthritis, depression, anxiety, obesity, nutrition, alcohol consumption and stress.

For the study, the researchers looked at survey data from 2008 and 2010 of 11,263 adults in Rhode Island. Participants were grouped by age range: 18 to 44 years, 45 to 64 years and 65 and older.

The surveys collected sociodemographic information on income, education, employment status, race/ethnicity, marital status and urban or rural residence.

Participants were asked, “How many of your permanent teeth have been removed because of tooth decay or gum disease?”

Response categories on the survey about tooth loss allowed people to choose from: no teeth lost, 1 to 5 teeth lost, 6 or more but not all teeth lost, or all teeth lost.

The results of the study showed that 58 percent of participants still had all of their teeth, 29 percent had 1 to 5 missing teeth, 9 percent had 6 to 31 missing teeth and 5 percent had none of their original adult teeth.

In the youngest age range, making less than $25,000 per year more than doubled a person’s odds of having no original teeth. Smoking more than tripled the odds of having no original teeth in both the younger and middle age groups, but only doubled the odds in the oldest age group.

Having less than a high school education more than doubled the risk of having no original teeth left, but only in the middle age group.

Overall, the researchers found that people with one of the following eight predictors were most likely to have fewer teeth compared to others in the group: low income, low education, smoking, lack of exercise, obesity, diabetes, disability and no dental insurance.

The researchers said that based on all the evidence, smoking was the greatest predictor of tooth loss in all age groups.

“Smoking is an established risk factor for poor oral health. Cigarette smokers are more likely to have more missing teeth and to experience greater rates of tooth loss than nonsmokers,” said the authors.

The second greatest predictor of tooth loss among young adults was lack of exercise. For middle-aged adults, the second greatest predictor was diabetes.

The authors said that lower income combined with fewer years of education was linked to an increased risk for oral disease. However, they said that fewer years of education was a stronger predictor for tooth loss than low income. 

The authors noted that the surveys were only available to people with landline phones, which may have been a limitation to the study.

“Adults who report risky health behaviors or impaired health may be considered target subpopulations for prevention of tooth loss and promotion of good oral health," concluded the authors.

The authors recommended that dentists and oral hygienists work to educate patients on the risks of tooth loss associated with smoking, lack of exercise and promote good oral hygiene habits.

This study was published in March in Preventing Chronic Disease: Public Health Research, Practice, and Policy, a publication of the Centers for Disease Control and Prevention (CDC).

The chronic Disease Prevention and Health Promotion Programs Cooperative Agreement, the Oral Health Program Centers for Disease Control and Prevention Cooperative Agreement provided funding for this project. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
April 3, 2013
Last Updated:
April 6, 2013