Researchers Report Cigar, Pipe Smokers Increase Their Risk for Tooth, Supporting Bone Loss

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Researchers Report Cigar, Pipe Smokers Increase Their Risk for Tooth, Supporting Bone Loss

CHICAGO -- Cigar and pipe users may be puffing away their chances of keeping their teeth and supporting bone structure, according to a study reported in the January 1999 issue of The Journal of the American Dental Association.

"While cigarette smoking is recognized as being detrimental to oral health," said lead-author Elizabeth A. Krall, Ph.D., M.P.H., associate professor, Boston University Goldman School of Dental Medicine, "the effects of cigar and pipe smoking on tooth-loss risk, jaw-bone loss and periodontal diseases were not known.

"Cigars and pipes are perceived by many smokers to have fewer health risks than cigarettes," explained Dr. Krall. "However, our findings are the first to clearly demonstrate that men who smoke cigars or pipes are at a greater risk of experiencing tooth loss than are nonsmokers.

Cigar smoking increases According to a 1998 report by the U.S. Department of Health and Human Services, the per capita consumption of cigars in the United States increased dramatically over the past few years. For example, since 1993, cigar sales have increased by 50 percent. In addition, young men and women now are taking up cigar smoking, once associated primarily with older men. More than one-fourth of high-school students reported smoking at least one cigar during 1996. Study conducted over 23 years The study of 690 men, conducted over a 23-year period, revealed that cigar smokers experience tooth loss and alveolar bone loss at rates equivalent to those of cigarette smokers.

Pipe smokers also have a risk of experiencing tooth loss that is similar to that of cigarette smokers. Clinical oral examinations were first performed in 1968 and repeated every three years. The examinations, conducted by a board-certified periodontist, included the number of teeth, decayed and or filled surfaces per tooth. Each tooth was scored for clinical periodontal indicators of plaque, calculus, pocket probing depth, gum inflammation or bleeding, and tooth mobility. Alveolar bone loss was assessed at each dental examination cycle to include a full-mouth series of x-rays and Schei ruler method for bone-height loss. Information on current and past types of tobacco products used, years used, and number of pipefuls and cigars smoked each day were obtained at each examination.

The analysis sample included 50 who smoked cigars exclusively during the follow-up period, 32 men who smoked pipes exclusively, 131 cigarette smokers and 477 who did not smoke during follow-up. The multivariate analysis of tooth-loss and alveolar bone loss controlled for demographic and oral hygiene measures. "The increases in risk related to cigar and pipe smoking provide a strong rationale for targeting smoking prevention and smoking cessation programs to smokers of all tobacco products," the authors concluded. The American Dental Association (ADA) has a long history of fighting tobacco use. In 1964, the ADA first adopted policies to discourage tobacco use and to help dentists educate their patients about the dangers of tobacco use. More information about smoking and oral health care is available at ADA's web site: http://www.ada.org.

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