Methods: The subjects were male military personnel, 25 to 60-year-old, who sought a routine dental care during 2005 in Zrifin Dental Clinic. Ischemic heart disease and/or diabetic patients were excluded. The periodontal health of the subjects was evaluated, according to a 4-point scale: 0- no observed attachment-loss, 1- mild, 2- moderate and 3- advanced attachment-loss, using a pair of standardized posterior bite-wing photographs. Using the Χ2-test, associations were evaluated between the periodontal score and the participants' parents birth place as well as life-style habits, which were obtained from the self-reported questionnaire of the IDF-Staff Periodical Examination Centre.
Results: 621 personnel met the inclusive criteria of the study. The mean age was 38.1±7.0 years. The individuals' self-estimations of their periodontal health were usually correct (p<0.01). Associations were found between the individuals' attachment-loss and age and smoking. Smoking of more than 20 cigarettes/day or smoking for 5 years or more were strongly related to attachment-loss (p=0.02 and p<0.01, respectively). Among the currently non-smokers, attachment-loss was associated to a past smoking habit (p=0.03). No significant association was found between attachment-loss and physical activities (p=0.79), alcohol consumption (p=0.61), dental visits regularity (p=0.36) and teeth brushing frequency (p=0.86). Strong association was found between advanced attachment-loss and Yemenite origin, whereas individuals from Israeli or European descent were found to have healthier periodontium (p<0.01).
Conclusions: This large-scale study confirms the destructive influence of smoking on the periodontal health in Israeli population. Moreover, due to the irreversible nature of periodontal disease, it seems that smoking cessation has no complete gaining effect on the periodontium. The dental practitioner has to bear this in mind when treating a smoker or a past-smoker periodontal patient.