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Ylöstalo P, Sakki T et al. Eur J Oral Sci 2004; 112: 121–126

Smoking is associated with dental caries (probably for behavioural reasons unfavourable to health and common to both) and with periodontal diseases (because smoking interferes with the immune response). However, periodontitis is unlikely to account for much tooth loss in subjects as young as 30 yrs old.

This study investigated tooth loss in relation to smoking in a cohort of subjects born in 1966, when 11,541 remaining members were sent a questionnaire at the age of 31–32 yrs and 8,690 responded. Five subjects had lost all teeth, 29 had lost more than 10 teeth, 2% had 6–10 missing teeth, 41% had 1–5 missing, and 57% had lost none.

In a multivariate analysis including demographic factors, healthy lifestyle and dentally related behaviour, smoking exposure had a dose-related association with tooth loss: the significant odds ratios were for 6-10 pack-years (1.24), 11–15 pack-years (3.47) and 16 or more pack-years (5.3). The authors suggest that both smoking and the tendency for smokers to indulge in other unhealthy behaviour are likely to be reasons for their findings.