Methods: Subjects were 563 VA Dental Longitudinal Study participants with triennial clinical examinations between 1985 and 1998. Subjects are not VA patients, but receive medical and dental care in the private sector. At each examination, a calibrated examiner evaluated all teeth for calculus, probing pocket depth, clinical attachment loss, caries and restorations. Root caries increment was computed as the cumulative number of root surfaces with new or recurrent clinical decay or restorations per decade of follow-up. Gingival recession was defined as attachment loss minus pocket depth. Mean recession and calculus were computed for each subject. Smoking status, diet and use of floss were obtained by self-report. In 1985, 456 men had not smoked within the past five years, 72 smoked cigarettes, and 35 smoked cigars or pipes. Differences in the mean root caries increment among smoking status groups were assessed with analysis of covariance. Means were adjusted for age, number of teeth, ever use floss, mean recession level, mean calculus score, and sugar intake.
Results: In the multivariable model, smoking status was associated with root caries increment (F=5.5, df=2, p<0.01). Adjusted mean (± se) root caries increments per decade were similar in cigar/pipe smokers and cigarette smokers (3.4±0.6 and 3.0±0.4 new surfaces, respectively), but were 70 to 90% higher than in nonsmokers (1.8±0.2 new surfaces).
Conclusions: These results suggest that use of cigarettes, cigars or pipes increases the risk of root caries in older men independently of gingival recession, oral hygiene and sugar intake.
Supported by US Dept. of Veterans Affairs and NIH grant K24DE00419