Oral health and smoking in pregnant women

Purpose: A smoking habit is maintained by psychological and physical dependence. We have already developed a health check questionnaire, “Oral Healthiness Score (OHiS)” and the “The Kano Test for Social Nicotine Dependence (KTSND)”, which contains psychological nicotine dependence. The OHiS and KTSND have ten questions with a total score of 20 and 30, respectively. In order to investigate the validity of the OHiS and KTSND, we applied them to pregnant women. Methods: We delivered the OHiS and KTSND and received the 95 answers from subjects, aged 21 to 40 years (30.7 ± 3.8 years). After anti-smoking education, the KTSND was reevaluated. Results: The present teeth and OHiS were 27.3 ± 3.6, 13.5 ± 3.6, and OHiS in 19 women were less than 10. Fifty nine women had signs of gingival bleeding and/or swelling. They consisted of one smoker (1.1%), 15 ex-smokers (15.8%), and 79 non-smokers (83.1%), and 39 of them inhaled second-hand smoke at home. The total KTSND score of 9.5 ± 4.6 decreased significantly to 4.6 ± 4.2 after the education (P < 0.01). According to smoking status, the KTSND score changed from 9 to 5 in smoker, 13.5 ± 4.5 to 6.5 ± 5.4 in ex-smokers, and 8.8 ± 4.2 to 4.2 ± 3.8 in non-smokers (P < 0.01). The KTSND scores in smokers and ex-smokers were significantly higher than those in non-smokers (P < 0.01), but there is no difference after education. Conclusions: About sixty percent of women had periodontal signs. Smokers quitted smoking immediately after knowing they were pregnant, except one smoker. However, most pregnant women inhaled second-hand smoke. This study demonstrated that the KTSND well reflected the smoking status of the pregnant women and the positive effect of education. It is important to continue this type of education.