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Smoking, tooth loss linked

Postmenopausal women who have smoked are at much higher risk of losing their teeth than women who never smoked, according to a new study published and featured on the cover of the Journal of the American Dental Association by researchers at the University at Buffalo.

The study involved 1,106 women who participated in the Buffalo OsteoPerio Study, an offshoot of the Women’s Health Initiative, which is the largest clinical trial and observational study ever undertaken in the U.S. and involved more than 162,000 women, including nearly 4,000 in the Buffalo Niagara region.

The UB study is the first to examine comprehensive smoking histories for participants who allowed the researchers to unravel some of the causes behind tooth loss in postmenopausal women who smoked.

Smoking long has been associated with tooth loss, but postmenopausal women, in particular, experience more tooth loss than their male counterparts.

“Regardless of having better oral health practices, such as brushing and flossing, and visiting the dentist more frequently, postmenopausal women in general tend to experience more tooth loss than men of the same age,” Xiaodan Mai, a doctoral student in epidemiology in the UB Department of Social and Preventive Medicine in the School of Public Health and Health Professions, said in a news release. “We were interested in smoking as a variable that might be important.”

Fewer adults lose their teeth now than in past decades, but tooth loss is associated with poor health outcomes, including stroke, cancer, rheumatoid arthritis and diabetes.

In the UB study, heavy smokers – defined as those who had at least 26 pack-years of smoking, or the equivalent of having smoked a pack a day for 26 years – were nearly twice as likely to report having experienced tooth loss overall and more than six times as likely to have experienced tooth loss due to periodontal disease, compared with those who never smoked. On the other hand, they found that smoking was a less important factor in tooth loss due to tooth decay. That’s an important distinction, Mai said.

“Periodontal disease is a chronic, inflammatory condition that may be related to the development of cancer,” she added. The paper notes that cigarette smoke may accelerate periodontal disease and that other studies suggest that chemicals found in smoke may favor plaque-forming bacteria that could reduce the ability of saliva to be anti-oxidative. Nicotine also has been shown to reduce bone density and bone mineral factors, while estrogen hormones have been found to be lower among women who smoke. Several UB professors and researches co-authored the study.