Impact of smoking on gingival inflammation in representative samples of three South American cities

Abstract The aim of this study was to investigate the impact of smoking on gingival inflammation in a representative sample of 1,650 adults from Santiago (Chile), Porto Alegre (Brazil), and Tucumán (Argentina). A questionnaire was administered to participants to gather demographic and behavioral characteristics, including smoking habits. The participants were clinically examined to obtain gingival index (GI), gingival bleeding index (GBI), visible plaque index (VPI), and calculus presence values. Gingival inflammation was defined as a mean GI > 0.5. Heavy smokers presented significantly lower levels of gingival inflammation, as reflected by both GI and GBI, than both light and moderate smokers, despite their having increased amounts of plaque and calculus. Being 50 years old or older [odds ratio (OR), 1.93], a VPI ≥ 30% (OR, 28.1), and self-reported diabetes (OR, 2.79) were positively associated with detection of gingival inflammation. In conclusion, the occurrence of clinically detectable gingival inflammation was lower in heavy smokers than light and moderate smokers. Older age, diabetes, and visible plaque emerged as risk indicators of gingivitis. Plaque and gingival indices are significantly associated regardless of the smoking status.

摘要 本研究旨在探究吸烟对牙龈炎症的影响，研究对象为来自智利圣地亚哥、巴西阿雷格里港以及阿根廷图库曼的1650名成年人群代表性样本。研究人员向所有参与者发放问卷，以收集人口统计学特征与行为学特征信息，其中涵盖吸烟习惯相关内容。随后对参与者开展临床检查，获取牙龈指数（gingival index, GI）、牙龈出血指数（gingival bleeding index, GBI）、可见菌斑指数（visible plaque index, VPI）以及牙结石检出情况相关指标。本研究将平均牙龈指数＞0.5作为牙龈炎症的判定标准。尽管重度吸烟者的菌斑与牙结石堆积量更高，但相较于轻度及中度吸烟者，其牙龈炎症水平显著更低，该结果可通过牙龈指数与牙龈出血指数得到验证。年龄≥50岁[比值比（odds ratio, OR）=1.93]、可见菌斑指数≥30%（OR=28.1）以及自我报告的糖尿病史（OR=2.79）均与牙龈炎症的检出呈正相关。综上，临床可检测的牙龈炎症发生率在重度吸烟者中低于轻度与中度吸烟者。高龄、糖尿病以及可见菌斑均为牙龈炎的危险因素。无论吸烟状态如何，菌斑指数与牙龈指数均存在显著相关性。