Second-hand Smoke Exposure and Gingival Health among Dentate South Africans

Objectives: To determine the association between exposure to second-hand tobacco smoke and gingival health among dentate South Africans. Method: This cross-sectional study involved a nationally representative sample of dentate South Africans >15-years-old (n=2,621) who participated in the 2007 South African Social Attitude Survey (SASAS), conducted by the South African Human Sciences Research Council. This household survey used an interviewer-administered questionnaire to collect data on participants' socio-demographic characteristics, active and passive smoking, oral hygiene practices, any dental visit in the past year, medical history and current dental status. Main outcome measure: ‘poor gingival health' defined as reported experience of frequent bleeding gums while brushing during the past month. Data obtained was weighted to produce representative sample of South African adults. Taking account of the multi-stage sampling used in the SASAS, data analysis included descriptive statistics, chi-square and multi-variable adjusted logistic regression. Result: Of the dentate respondents, 20.5% (95% CI; 18.3%-22.8%) reported having experienced frequent bleeding gums in the past month. Compared to those who reported brushing, but not every day, those who reported brushing at least once daily were less likely to report poor gingival health (OR=0.53; 95% CI: 0.38-0.75). Compared to whites, black/Africans were significantly more likely to report poor gingival health (OR= 5.62; 95% CI; 2.55-12.37). Compared to those not exposed to second-hand smoke for at least 6 days in a month, those exposed for this long and for longer periods only outside the home had a non-significant, but higher odds of reporting poor gingival health (OR=1.48; 0.97-2.26), while those exposed both in the home and outside the home had a significantly higher odds of reporting poor gingival health (OR=1.74; 1.26-2.40). Conclusion: The study findings suggest that independent of socioeconomic status and oral hygiene care, cumulative exposure to second-hand tobacco smoke is a risk indicator for poor gingival health.