Long-term effects of smoking on tooth loss after cessation among middle-aged Finnish adults: the Northern Finland Birth Cohort 1966 Study

Abstract Background Despite smoking cessation efforts, cigarette smoking remains a serious general and oral health problem. We aimed to investigate the putative benefits of smoking cessation on dentition and to analyse whether the time elapsed since smoking cessation associated positively with the remaining number of teeth. Methods This cross-sectional study analyses data from the 46-year follow-up of the Northern Finland Birth Cohort Study 1966 (NFBC1966). A total of 5 540 subjects participated in this cross-sectional study, which utilises both clinical dental examinations and mailed questionnaires. We used the following information on smoking: status (current, former, never), years of smoking (current, former) and years elapsed since smoking cessation (former). Self-reported and clinically measured number of teeth (including third molars) served as alternative outcomes. We used binary logistic regression models to analyse the dichotomised number of teeth (‘0–27’, ’28–32’) and then calculated unadjusted and adjusted odds ratios (OR) with 95 % confidence intervals (CI) for the smoking variables (never smoker as the reference). Gender, education, tooth brushing frequency, diabetes and alcohol use served as confounders for the adjusted models. Results Ten years or more of smoking associated with tooth loss; this effect was the strongest among men who reported having an ongoing smoking habit (self-reported outcome: adjusted OR = 1.74, CI = 1.40–2.16) and the weakest among women classified as former smokers (self-reported outcome: adjusted OR = 1.27, CI = 1.00–1.62). Conclusions This study shows that smoking has long-term effects on tooth loss even after cessation. The findings support smoking cessation efforts to reduce oral health risks

Validity of self-reported number of teeth in middle-aged Finnish adults: the Northern Finland Birth Cohort Study 1966

BackgroundWe examined the validity of self-reported number of teeth in middle-aged adults by using representative cohort data to compare corresponding self-reported and clinical values.MethodsThis validity study is part of the representative 46-year-old follow-up of the Northern Finland Birth Cohort 1966 (NFBC1966) Study. Mailed questionnaires (n=5950) requested information on self-reported number of teeth and background variables (education, tooth brushing and smoking), while clinical oral health examinations (n=1891) assessed the number of teeth (the gold standard'). The main analyses compared the self-reported and clinical values for the number of teeth in 1669 participants. Scatterplot and Bland-Altman plot served for visual analyses, and alternative correlation coefficients (Pearson, Spearman, intraclass) for numerical comparisons separately for men and women, with stratification according to background variables.ResultsThe clinical assessment revealed that the mean value for the number of teeth was 27.46 (SD=2.38), while the corresponding value based on self-reported information was 27.48 (SD=2.78). According to the Bland-Altman plot, the mean difference between the clinical and self-reported values was -0.02 (95% limits of agreement, LoA: -3.37 to 3.32). The observed ranges of intraclass correlation coefficients (ICC) among men and women were 0.72 to 0.95 and 0.72 to 0.85, respectively, depending on the background variables.ConclusionsSelf-reported number of teeth in middle-aged Finnish adults agreed closely with the corresponding clinical measure.</div

Tooth loss among middle-aged adults in the Northern Finland Birth Cohort 1966:associations with tobacco smoking and diabetes

Abstract Oral and general health are linked to each other, and both are contributed by many sociodemographic and behavioral factors. Information on tooth loss, as a simple indicator of oral health of an individual, can easily be collected through self-report for research purposes in population studies. This cross-sectional study was conducted among the 46-year-old members of the Northern Finland Birth Cohort 1966 (N = 10,321), providing a comprehensive and representative sample of middle-aged Finns. First, it was explored if smoking (history), as a harmful health behavior, associated with tooth loss. In addition, the duration of smoking history and the presumed benefits of cessation on tooth loss were investigated. The validity of self-report as a substitute for clinically determined number of teeth was also evaluated. Finally, the usefulness of number of teeth as an indicator of impaired glucose metabolism (prediabetes and diabetes) was tested. Tooth loss, as the outcome, was assessed by clinically measured (N = 1,946) and/or self-reported (N = 5,950) number of teeth. Questionnaires inquired about socioeconomic and behavioral factors, with smoking as the exposure of interest. Impaired glucose metabolism was determined through different sources, with oral glucose tolerance test as the primary screening tool. Negative binomial and logistic regression models served to statistically explore the associations while controlling for relevant confounders. Intraclass correlation coefficient and Bland-Altman plot were the primary tools for validation analysis. Smoking had an exposure-dependent association with tooth loss, mainly among males. It also seemed that those males who had stopped smoking started to gradually reclaim the aptitude for tooth retention. Self-reported number of teeth was in good agreement with the corresponding clinical measure in this study population. A reduced number of teeth associated with impaired glucose metabolism, mainly among females. The findings of this study advocate the importance of recognizing smoking as a harmful oral health behavior. Additionally, this study demonstrated self-reported number of teeth as a reasonably valid option for tooth loss measure in population studies. Furthermore, according to the obtained results, noticeably increased tooth loss can be considered as a possible initial indicator of underlying diabetes.Tiivistelmä Suun terveys ja yleisterveys ovat yhteydessä toisiinsa, ja monet sosiodemografiset ja käyttäytymistekijät vaikuttavat niihin. Hampaiden menetystä voidaan pitää yksinkertaistettuna yksilön suun terveyden indikaattorina ja tieto siitä voidaan helposti kerätä itseraportoinnin avulla väestötutkimuksissa. Tämä poikittaistutkimus perustui tietoihin 46-vuotiaista Pohjois-Suomen vuoden 1966 syntymäkohortin jäsenistä (N = 10 321), joka muodostaa edustavan otoksen keski-ikäisistä suomalaisista. Ensiksi tarkasteltiin tupakointia haitallisena terveyskäyttäytymisenä suhteessa hampaiden menetykseen, ja lisäksi tutkittiin tupakointihistorian pituuden ja lopettamisen oletettujen hyötyjen vaikutusta tähän liittyen. Myös itseraportoidun hampaiden lukumäärän validiteettia arvioitiin suhteessa vastaaviin kliinisessä tutkimuksessa saatuihin arvoihin. Hampaiden lukumäärän toimivuutta sokeriaineenvaihdunnan häiriöiden indikaattorina testattiin. Hampaiden menetys määritettiin kliinisesti mitatun (N = 1 946) ja/tai itseraportoidun (N = 5 950) hampaiden lukumäärän perusteella. Kyselylomakkeilla tiedusteltiin sosioekonomisia ja käyttäytymistekijöitä, joista tupakointi oli tutkimuksen keskeinen muuttuja. Sokeriaineenvaihdunnan häiriöt määritettiin eri tietolähteistä ja sokerirasituskoetta käytettiin seulontamenetelmänä. Negatiiviseen binomijakaumaan perustuvaa regressiomallia ja vastaavia logistisia malleja hyödynnettiin tilastoanalyyseissä, kun tutkittiin olennaisten sekoittavien tekijöiden suhteen vakioituja yhteyksiä. Sisäkorrelaatio (ICC) ja Bland-Altman -kuvaaja olivat ensisijaiset työkalut validointianalyysissä. Tupakoinnilla havaittiin altistustasosta riippuva yhteys hampaiden menetykseen, joskin yhteys esiintyi lähinnä miehillä, joilla myös tupakoinnin lopettamisesta näytti olevan hyötyä suhteessa oman hampaiston pysyvyyteen. Itseraportoidut hampaiden lukumäärät olivat tässä tutkimuksessa pääsääntöisesti yhtäpitäviä kliiniseen tarkastukseen perustuvien lukujen kanssa. Vähentynyt hampaiden lukumäärä oli yhteydessä sokeriaineenvaihdunnan häiriöihin naisilla. Tupakoinnilla on merkittävä rooli haitallisena suun terveyteen liittyvänä käyttäytymistekijänä. Itseraportoitu hampaiden lukumäärä osoittautui kohtuullisen luotettavaksi hampaiden menetyksen mittariksi väestötutkimuksiin. Vähentynyttä hampaiden lukumäärää voidaan pitää yhtenä mahdollisena merkkinä piilevästä diabeteksesta

Association between smoking intensity and duration and tooth loss among Finnish middle-aged adults:the Northern Finland Birth Cohort 1966 Project

Abstract Background: Smoking is a risk factor for oral diseases and tooth loss. Our aim was to analyze the association between smoking intensity and duration and tooth loss among middle-aged Finnish adults who have enjoyed access to subsidized dental care since childhood. Methods: This study was based on the Northern Finland Birth Cohort 1966 (NFBC1966) Project, a representative sample of Finnish 46-year-olds. Altogether 1946 46-year-olds participated in a survey and comprehensive clinical oral examinations. We measured smoking exposure in pack-years (intensity) and years of smoking (duration) combined with recent smoking status (current, former, occasional or never). We used negative binomial regression models to estimate the unadjusted and adjusted relative risks (RR) with corresponding 95 % confidence intervals (CI) for tooth loss as an outcome. Gender, education, tooth brushing frequency, dental plaque, diabetes and alcohol use served as explanatory variables for the adjusted models. Results: Smoking intensity associated with tooth loss in an exposure-dependent manner: those with a high number of pack-years had a significantly greater probability of tooth loss than never smokers: 11–20 pack-years (RR = 1.55, 95 % CI = 1.15–2.08) and 21 or more pack-years (RR = 1.78, 95 % CI = 1.36–2.33). Smoking duration also associated with tooth loss: those who had smoked for several years had a significantly higher probability of tooth loss than never smokers: 21–30 years of smoking (RR = 1.66, 95 % CI = 1.29–2.12) and 31 or more years of smoking (RR = 1.72, 95 % CI = 1.20–2.45). Conclusions: We found a clear intensity- and duration-dependent relation between smoking and tooth loss among adults with access to subsidized dental care and in good oral health

Validity of self-reported number of teeth in middle-aged Finnish adults:the Northern Finland Birth Cohort Study 1966

Abstract Background: We examined the validity of self-reported number of teeth in middle-aged adults by using representative cohort data to compare corresponding self-reported and clinical values. Methods: This validity study is part of the representative 46-year-old follow-up of the Northern Finland Birth Cohort 1966 (NFBC1966) Study. Mailed questionnaires (n= 5950) requested information on self-reported number of teeth and background variables (education, tooth brushing and smoking), while clinical oral health examinations (n= 1891) assessed the number of teeth (the ‘gold standard’). The main analyses compared the self-reported and clinical values for the number of teeth in 1669 participants. Scatterplot and Bland-Altman plot served for visual analyses, and alternative correlation coefficients (Pearson, Spearman, intraclass) for numerical comparisons separately for men and women, with stratification according to background variables. Results: The clinical assessment revealed that the mean value for the number of teeth was 27.46 (SD = 2.38), while the corresponding value based on self-reported information was 27.48 (SD = 2.78). According to the Bland-Altman plot, the mean difference between the clinical and self-reported values was − 0.02 (95% limits of agreement, LoA: − 3.37 to 3.32). The observed ranges of intraclass correlation coefficients (ICC) among men and women were 0.72 to 0.95 and 0.72 to 0.85, respectively, depending on the background variables. Conclusions: Self-reported number of teeth in middle-aged Finnish adults agreed closely with the corresponding clinical measure

School Achievement and Oral Health Behaviour Among Adolescents in Finland: A National Survey

PURPOSE: We examined oral health behaviour and its association with school achievement among Finnish adolescents.MATERIALS AND METHODS: This study is part of the Finnish national School Health Promotion study (SHP). The study population comprised a representative sample of Finnish 15-year-olds (N = 45,877). A questionnaire inquired about the respondents' school achievements and health habits (toothbrushing, smoking), background factors (age, gender, school type, family structure), and their parents' background factors (education, smoking). Chi-square tests and logistic regression models were used in the statistical analyses.RESULTS: Better school achievements were associated with better oral health behaviour: 73.1% of students with the highest mean grades (9-10) brushed their teeth twice daily, compared to 33.8% of those with the lowest mean grade (6.9 or less). The lowest mean grade was associated with brushing less than twice daily, especially among boys (odds ratios (OR) = 4.1; 95% CI 3.6-4.7) when compared to those with the highest mean grade, but also among girls (OR = 2.3; 95% CI 2.1-2.7). Smoking among boys was associated with poor oral hygiene (OR = 1.3; 95% CI 1.2-1.4).CONCLUSION: School success is strongly associated with oral health behaviour among adolescents. Preventive treatment should be targeted especially at boys with poor school achievement and smoking behaviour.</div

Long-term effects of smoking on tooth loss after cessation among middle-aged Finnish adults:the Northern Finland Birth Cohort 1966 study

Abstract Background: Despite smoking cessation efforts, cigarette smoking remains a serious general and oral health problem. We aimed to investigate the putative benefits of smoking cessation on dentition and to analyse whether the time elapsed since smoking cessation associated positively with the remaining number of teeth. Methods: This cross-sectional study analyses data from the 46-year follow-up of the Northern Finland Birth Cohort Study 1966 (NFBC1966). A total of 5 540 subjects participated in this cross-sectional study, which utilises both clinical dental examinations and mailed questionnaires. We used the following information on smoking: status (current, former, never), years of smoking (current, former) and years elapsed since smoking cessation (former). Self-reported and clinically measured number of teeth (including third molars) served as alternative outcomes. We used binary logistic regression models to analyse the dichotomised number of teeth (‘0–27’, ’28–32’) and then calculated unadjusted and adjusted odds ratios (OR) with 95 % confidence intervals (CI) for the smoking variables (never smoker as the reference). Gender, education, tooth brushing frequency, diabetes and alcohol use served as confounders for the adjusted models. Results: Ten years or more of smoking associated with tooth loss; this effect was the strongest among men who reported having an ongoing smoking habit (self-reported outcome: adjusted OR = 1.74, CI = 1.40–2.16) and the weakest among women classified as former smokers (self-reported outcome: adjusted OR = 1.27, CI = 1.00–1.62). Conclusions: This study shows that smoking has long-term effects on tooth loss even after cessation. The findings support smoking cessation efforts to reduce oral health risks