Self-perception of Dental Appearance and Prophylactic Habits in Smoking Patients

Methods: A cross-sectional sample of 540 randomly selected patients, addressing seven different dental offices from north-western Romania, has been interrogated using a multiple-choice questionnaire accompanied by a set of standardized pictures for self-assessment of tooth color. Differences between smokers and non-smokers, regarding their motivation to consult a dentist, self-perception of tooth color, dental appearance and oral hygiene have been analyzed using Pearson's chi-square and Fisher's exact tests. Likelihood of a response in smokers versus non-smokers has been quantified using odds ratio.

Results: The sample included 139 smokers (25.74%) and 401 non-smokers (74.26%). Smokers in our sample were more likely than non-smokers (p=0.001; OR=2.05, CI95%=1.33-3.16), to consider dental color as the most noticeable esthetic defect of their teeth, rather than shape, dimensions, crowding, spacing, or unaesthetic restorations. None of the latter esthetic defects exhibited statistically significant differences in smokers versus non-smokers. Smokers were also more likely to self-assess their tooth color to a darker shade-group than non-smokers (p=0.005; OR=1.74, CI95%=1.17-2.57). A significantly higher 22.3% of smokers, as opposed to 14% of non-smokers, admitted brushing their teeth only once a day, (p=0.02), while no significant differences between the number of smokers and non-smokers who brushed at least twice a day were found. This was also associated with a significantly higher number of smokers than non-smokers being motivated for their dental appointment by dental pain (p=0.008; OR=1.75, CI95%=1.16-2.66) or esthetic reasons (p=0.01; OR=1.84, CI95%=1.15-2.94), rather than regular check-ups (p=0.001; OR=0.5, CI95%=0.33-0.76) or functional reasons (p=0.58 for mastication; p=0.97 for speech).

Conclusion: Our study indicates higher degrees of self-assessed tooth discoloration and poorer oral hygiene habits in smokers compared to non-smokers.

Funding: CEEX research-grant no.152, “DentColor”