Snuff Use, Smoking, Periodontal Health and Premature Death: 30-year Study

University of Helsinki1,676 enrolled

Overview

Snuff use and smoking associated with poor periodontal health, especially if used together.

Aim: The investigators investigated how snuff use and smoking affect periodontal health parameters and mortality in a Swedish cohort, hypothesizing that snuff use increases the risks. Material and methods: Study cohort of 1 532 subjects aged 30 to 40 (758 men and 774 women) from Stockholm area was clinically examined and followed up from 1985 to 2015. Associations were analysed between periodontal health parameters, snuff use, smoking and age of death. For analyses, all subjects were classified into four groups: "dual-users" (current and ex-snuffers, current and ex-smokers); "pure snuffers" (current and ex-snuffers); "pure smokers" (non-snuffers, current and ex-smokers) and "non-users" (non-snuffers and non-smokers). Cross-tabulation, chi-square and Fisher's exact tests were used.

Study Type

OBSERVATIONAL

Enrollment

1,676

Conditions

Tobacco Use Periodontitis

Interventions

Epidemiological studyOTHER

Eligibility

Sex: ALLMin age: 30 YearsMax age: 40 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * In 1985-1986 a sample was selected from the registry file of all inhabitants of the Stockholm area, of people born on the 20th of any month from 1945 to 1954.The sample comprised 3200 people. They were informed about the purpose of the study and called for clinical investigation. 1681 (52.5%) individuals, 840 men and 841 women, participated in the study. From the remaining 1519 non-respondents to the initial call, 100 randomly selected subjects, 45 men and 55 women, were reinformed and persuaded and finally agreed to participate in this investigation. They were used as a drop-out control sample. Exclusion Criteria: * Other people

Outcomes

Primary Outcomes

Periodontal Pockets

Dual users, pure snuffers and pure smokers had more ≥5mm deep periodontal pockets than non-users. Periodontal pockets were measured from all teeth and from six surfaces with a Hu-Friedy (PCPUNC 15) periodontal probe (Hu-friedy, Chicago, Ill., USA).

Time frame: 1985

Missing teeth

Pure smokers had more likely missing teeth than subjects in other groups. Missing teeth were calculated my dentist in clinical examination.

Time frame: 1985

Gingival Index (GI)

Dual-users, pure snuffers and pure smokers had higher GI scores than non-users. GI was scored from 0 (no gum bleeding) to 3 (abundant gum bleeding)

Time frame: 1985

Premature death

Snuff users or smokers did not die earlier than non-users of the cohort in 30 years. The Swedish National Death Register listing the cumulated causes of all deaths was used in the analyses.

Time frame: From year 1985 to year 2015

Plaque Index (PI)

Dual-users, pure snuffers and pure smokers had higher PI scores than non-users. PI was scored from 0 (no plaque) to 3 (abundant plaque)

Time frame: 1985

Calculus Index (CI)

Dual-users, pure snuffers and pure smokers had higher CI scores than non-users. CI was scored from 0 (no calculus) to 3 (abundant calculus) according to Greene \& Vermillion

Time frame: 1985

Data from ClinicalTrials.gov

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