|Year : 2019 | Volume
| Issue : 2 | Page : 50-52
Association between smoking and dental caries among people of Dhanbad district, Jharkhand, India
Animesh K Shivam, Farrukh Azam
Department of Dentistry, Patliputra Medical College and Hospital, Dhanbad, Jharkhand, India
|Date of Web Publication||29-Aug-2019|
Dr. Animesh K Shivam
Department of Dentistry, Patliputra Medical College and Hospital, Dhanbad 828127, Jharkhand.
Source of Support: None, Conflict of Interest: None
Introduction: Smoking as a public health problem harms one’s general and oral well-being, leading to increased morbidity and mortality. Aim: The aim of this study was to find out the association between dental caries and smokers (current and past) with nonsmokers among people of Dhanbad District, Jharkhand, India. Materials and Methods: The present cross-sectional study was conducted among 1364 (448 smokers, 440 past smokers, and 446 nonsmokers), and the patients were divided among three age groups (35–44, 45–60, and >60 years). Results: It was revealed that the highest mean decayed missing and filled teeth was seen among smokers (3.65 ± 5.78) followed by past smokers (3.01 ± 2.66) and nonsmokers (3.01 ± 2.66). Conclusion: Efforts are required by clinicians to educate people about the ill-effects of tobacco and provide tobacco cessation counseling to reduce the burden of morbidity and mortality caused by tobacco.
Keywords: Caries, DMFT, tobacco
|How to cite this article:|
Shivam AK, Azam F. Association between smoking and dental caries among people of Dhanbad district, Jharkhand, India. Int J Oral Care Res 2019;7:50-2
|How to cite this URL:|
Shivam AK, Azam F. Association between smoking and dental caries among people of Dhanbad district, Jharkhand, India. Int J Oral Care Res [serial online] 2019 [cited 2019 Sep 21];7:50-2. Available from: http://www.ijocr.org/text.asp?2019/7/2/50/265817
| Introduction|| |
Tobacco use is one of the greatest epidemic threats to public health globally. Approximately one-third of the adult population in the world use tobacco either in smoking, chewing, or any other forms and about half of them die prematurely. Due to severe addiction to nicotine, 4.9 million people died in the year 2000 worldwide as per the estimate by the World Health Organization. Approximately 7 million people are killed annually by tobacco use, which is assumed to increase to 10 million with 70% deaths occurring in low- and middle-income countries.
Dental caries (DC) is the most prevalent pandemic chronic noncommunicable disease affecting any age group and is dependent on a number of factors such as lifestyle, socioeconomic and sociodemographic gradients, and the tobacco use. Although it is regarded currently as preventable disease with the regular oral hygiene habits, frequent fluoride usage, and less intake of sugars as major recommendations, it is still effecting the quality of life of many individuals of low- and high-income countries.,, One of the effects of smoking is DC, which can progress to complete tooth decay if left unchecked. This condition is undesired and severely compromises the oral health status of the individual. Moreover, DC is often a disease that goes undetected until the patient complains of pain in his oral cavity. A thorough literature search around the geographic location of Jharkhand found little or no data associating the relationship between smoking and DC.
Hence, this study was conducted with the aim to find out the association between DC and smokers (current and past) with nonsmokers among people of Dhanbad District, Jharkhand, India.
| Materials and Methods|| |
The present cross-sectional study was conducted among 1364 (448 smokers, 440 past smokers, and 446 nonsmokers) people visiting Patliputra Medical College and Hospital in Dhanbad, Jharkhand, from March 1, 2015, to December 31, 2015. Prior to conduction of the study, ethical consent was obtained. The patients were assured of the confidentiality of their data and demographic details, and DMFT status was entered in a pretested, pre-validated questionnaire by an assistant who stood close to the examiner during the study. The study was conducted by two standardized examiners.
Inclusion criteria included smokers, past smokers, and nonsmokers aged more than 35 years. For inclusion in the past smoker’s category, it was essential that the patient reported of quitting smoking for more than 2 years. Patients suffering from any systemic diseases were excluded from the study to avoid the presence of confounding factor(s). Sample size calculation was performed by a certified statistician who estimated the sample as 396–400 people in each group. Therefore, to include maximum number of people in each group, the target sample was kept at 480 as to compensate for loss of data due to improper recording and various other factors. The study followed a convenience sampling, and the modified DMFT index was used to record the DMFT status of the patient. The examinations were carried out using a community periodontal index of treatment needs probe and mouth mirrors in the dental chair using artificial light. Descriptive statistics were applied, and the t test, calculation of odds ratio (OR), and logistic regression were applied to find out association, if any using SPSS 22.0 software.
| Result|| |
In the study, it was seen that although almost an equal number of people were seen in all the groups, the youngest population was seen in the current smoker group (154, 34.3%) whereas the oldest population were seen in the nonsmoker group (217, 48.5%). The majority of the population in all three groups was males and the highest percentage of people in all the three groups reported brushing once a day. The highest number of people in the nonsmoking group also reported brushing once a day (27, 6%). Continuing the same trend, the maximum number of patients who visited a dentist before belonged to the nonsmoker group (153, 30.2%).
The mean DMFT among current smokers, past smokers, and nonsmokers is shown in [Table 1]. It was observed that the highest mean DMFT was seen among smokers (3.65 ± 5.78) followed by past smokers (3.01 ± 2.66) and nonsmokers (3.01 ± 2.66), which was found to be significant (P = 0.02). Another observation was the highest number of decayed, missing teeth that were seen in current smokers (3.80 ± 7.6, 3.08 ± 4.3) with the lowest number of filled teeth (0.96 ± 1.2). An almost equal amount of missing teeth was seen among past smokers (2.64 ± 3.9) and nonsmokers (2.54 ± 6.6) whereas past smokers showed the highest number of mean filled teeth (1.2 ± 2.1), with analysis showing a nonsignificant value.
|Table 1: The mean DMFT among current smokers, past smokers, and nonsmokers|
Click here to view
[Table 2] depicts the mean DMFT among the three age groups. It was observed that the highest mean DMFT was seen among the age group of 35–44 years (3.82 ± 2.4), which was significant as compared to past smokers and nonsmokers. OR analysis revealed that as compared to nonsmokers, current smokers and past smokers were 1.6 and 1.1, respectively. Given the multiplicity of factors affecting the DMFT index, multiple regression analysis was performed [Table 3]. Significant difference was seen between smoking (0.01) and age (0.02). It was generally observed that DC increased with age among smokers.,
|Table 3: Multiple regression analysis linking DMFT with other parameters (nonsignificant values have been omitted)|
Click here to view
| Discussion|| |
This study was performed with the aim to find out the association between DC and smokers (current and past) and comparison with nonsmokers among people of Dhanbad region. The study revealed that the mean DMFT in smokers was 3.65 ± 5.78 and 3.01 ± 2.66 in past smokers, and 2.31 ± 1.81 among nonsmokers.
The mean DMFT recorded among smokers of this study (3.65 ± 5.78) is lower as compared to Aguilar-Zinser et al. (8.80 ± 6.56) and Badel et al. (7.32), and in slight agreement with Rooban et al. (4.09). Such variations can be attributed to differences in smoking practices (hookah, bidi, etc.) and genetic makeup of individuals that differ across the globe. Also, the difference of mean DMFT among smokers and nonsmokers was found to be significant (P = 0.02) as supported by Badel et al. and Shalini et al. The results of Hart et al. disagreed and stated that no significant difference was seen among DMFT status of smokers and nonsmokers.
The findings of this study also revealed that smokers were 1.6 times more likely to get caries as compared to nonsmokers. This is in agreement to the study by Campus et al. (OR: 1.8). Other confounding factors that can lead to DC are related to dietary changes and exposure to fluoridated drinking water.
This study is also prone to certain limitations. First, both social desirability bias and recall bias among previous smokers regarding the time of their smoke-free period might have been underreported. Second, the results of studies with convenience sampling are difficult to extrapolate for the general population. However, the aim of this study was to provide an insight to the current status of DC among smokers in this region to render information for future studies.
| Conclusion|| |
To tackle the menace of tobacco smoking, it is important that a multispectral approach be drafted and the people should be educated, motivated, and reenforced regarding the ill-effects of tobacco on general as well as one’s oral health.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
World Health Organization. The World Health Report 2002. Reducing Risks, Promoting Healthy Life. Geneva, Switzerland: World Health Organization; 2002. p. 1-248.
World Health Organization. WHO Global Health Days. World No Tobacco Day. 31 May 2017. Available from: http://www.who.int/campaigns/ no-tobacco-day/2017/event/en/. [Last accessed on 2018 Dec 30].
Beaglehole R, Benzian H, Crail J, Mackay J The Oral Health Atlas—Mapping a Neglected Global Health Issue. Cointrin, Geneva, Switzerland: FDI World Dental Federation; 2009.
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005;83:661-9.
Ludwick W, Massler M Relation of dental caries experience and gingivitis to cigarette smoking in males 17 to 21 years old (at the great lakes naval training center). J Dent Res 1952;31:319-22.
Aguilar-Zinser V, Irigoyen ME, Rivera G, Maupomé G, Sánchez-Pérez L, Velázquez C Cigarette smoking and dental caries among professional truck drivers in Mexico. Caries Res 2008;42:255-62.
Badel T, Pavicin IS, Carek AJ, Segović S Dental caries experience and tobacco use in 19-year-old Croatian army recruits. Coll Antropol 2014;38:671-5.
Rooban T, Vidya K, Joshua E, Rao A, Ranganathan S, Rao UK, et al
. Tooth decay in alcohol and tobacco abusers. J Oral Maxillofac Pathol 2011;15:14-21.
] [Full text]
Shalini P, Niramathi K, Ranjith K, Chaly PE, Priyadarashini VI, Nijesh JE Dental Caries Experience Among Tobacco Consuming Truck Drivers In North Chennai, India. IJDRD 2017;7:1-8.
Hart GT, Brown DM, Mincer HH Tobacco use and dental disease. J Tenn Dent Assoc 1995;75:25-7.
Campus G, Cagetti MG, Senna A, Blasi G, Mascolo A, Demarchi P, et al
. Does smoking increase risk for caries? A cross-sectional study in an Italian military academy. Caries Res 2011;45:40-6.
[Table 1], [Table 2], [Table 3]