DOI QR코드

DOI QR Code

Effects of Smoking on Oral Health : Preliminary Evaluation for a Long-Term Study of a Group with Good Oral Hygiene

흡연이 구강 건강에 미치는 영향 : 구강 위생이 양호한 집단의 장기적 연구를 위한 예비 평가

  • Lee, Hyun-Suk (Department of Oral Medicine and Institute of Dental Science, School of Dentistry Dankook University) ;
  • Kim, Mee-Eun (Department of Oral Medicine and Institute of Dental Science, School of Dentistry Dankook University)
  • 이현석 (단국대학교 치과대학 구강내과학교실.치의학연구소) ;
  • 김미은 (단국대학교 치과대학 구강내과학교실.치의학연구소)
  • Received : 2011.10.10
  • Accepted : 2011.11.21
  • Published : 2011.12.30

Abstract

Tobacco smoking is a major risk factor of systemic health and also impairs oral health, which is related to development of oral cancers, periodontitis, delayed wound healing, tooth loss, failure of implant, etc. Aside from smoking, many other risk factors can be related to oral health and long-term effects of smoking on salivary flow and taste threshold are still in controversy. Authors considered dental students to be an appropriate group with good oral hygiene for a long-term study to reveal effects of smoking on oral health. This study was performed to compare smoking patterns and current oral health conditions between smokers and nonsmokers in dental students prior to long-term evaluation. 192 volunteers (85.7%) of 224 male dental students in Dankook University were evaluated through questionnaires and clinical examination in 2010. Questionnaires included smoking pattern, alcohol use, nicotine dependence, preventive care, psychological profile and clinical examinations comprised assessment of teeth or periodontal status, nicotine pigmentation, salivary flow, electrical taste thresholds and halitosis. From the study, (current) smokers were older, and drank more frequently with more alcohol intake compared to former smokers and nonsmokers(p<0.05). There was no significant difference among them in salivary flow rate, halitosis and electrical taste threshold. However, there was significant difference in DMFT rate, periodontal treatment need, nicotinic pigmentation between smokers and nonsmokers(p<0.05), irrespective of their levels of preventive care. The smokers in this study, who are young dental students with relatively shorter duration of smoking, less use of cigarettes and low level of nicotine dependence, did not reveal significant impairment of oral health. However, their oral health was found to be relatively impaired compared to nonsmokers', which suggests negative effect of smoking on the oral health and a need of smoking cessation.

흡연은 전신건강 뿐 아니라 구강건강에도 유해하여 구강암과 치주염의 발생, 창상치유 지연, 치아상실 등과 관련성을 가지는 것으로 알려져 있다. 이미 흡연과 구강건강의 관련성에 대한 연구가 많이 있지만, 구강건강에 대한 인식도나 위생관리 등 흡연 외의 다양한 요소가 구강건강에 영향을 줄 수 있으며 타액 분비나 구취처럼 흡연과의 관련성이 확실히 밝혀지지 않은 부분도 존재한다. 그러므로 구강위생에 대한 인식 수준이 상대적으로 높고 추적조사가 용이한 치과대학생이라는 집단에서 흡연자와 비흡연자의 구강건강을 상태를 장기적, 포괄적으로 비교한다면 흡연이 구강건강에 미치는 영향을 보다 명확하게 확인할 수 있을 것이다. 본 연구는 장기적 연구에 앞서 치과대학생 중 흡연자들의 흡연 특성을 파악하고, 흡연자들과 비흡연자들의 전반적인 구강건강상태를 비교하여 보고하고자 하였다. 2010년 4월 21일부터 2011년 4월 20일까지 단국대학교 치과대학 치의학과에 재학 중인 1학년부터 4학년까지의 남학생 224명 중 지원자 192명(85.7%)을 대상으로 하여 설문지 조사와 임상검사를 시행하였다. 설문지조사에는 흡연 양태, 음주, 니코틴의존도, 구강위생관리, 간이심리검사가 포함되었고 임상검사에는 치아 및 치주 상태, 니코틴 착색, 타액분비량, 전기 미각역치, 구취에 대한 평가가 시행되었다. 본 연구에서, 흡연자군은 금연자군, 비흡연자군에 비해 연령이 약간 높고, 음주를 하는 경우가 많았으며 알코올섭취량도 많았다(p<0.05). 세 군은 타액분비율, 구취, 전기미각역치 등의 임상조사에서는 유의한 차이를 보이지 않았으나, 양치질 횟수나 치과방문 횟수에 차이가 없음에도 불구하고 우식경험영구치율(DMFT rate), 치주가료필요 정도 및 니코틴 착색 정도에 있어서 흡연자군과 비흡연자군 사이에는 차이가 관찰되었다(p<0.05). 본 연구의 피검자들이 평균 25세로서 흡연자군이라 해도 흡연기간이 길지 않고 흡연량이나 니코틴의존도가 낮은 수준임에도 불구하고 치주조직에는 이미 유해한 효과를 주고 있다고 판단된다. 기초 자료 분석이지만 흡연은 치주조직에 신속히 영향을 미치므로 금연 치료를 조기에 시행할 필요가 있다.

Keywords

References

  1. Yoo SL, Kim KH, Kim KK, Kim JH. Trends of smoking attributable mortality in Korea. Korean Assoc Health Med Soc 2005;17:133-148.
  2. 이은하, 박수경, 고광필 외. 한국인의 흡연과 사망위험에 관한 코호트 연구. Journal of Preventive Medicine and Public Health 2010;43:151-158. https://doi.org/10.3961/jpmph.2010.43.2.151
  3. Blot WJ, McLaughlin JK, Winn DM et al. Smoking and drinking in relation to oral and oral and pharyngeal cancer. Cancer Res 1988;48:3282-3287.
  4. Tonetti MS. Cigarette smoking and periodontal disease: Etiology and management of disease. Ann Periodontol 1988;3:88-101.
  5. American Academy of Periodontology. Tobacco use and the periodontal patient (position paper). J Periodontol 1999;70:1419-1427. https://doi.org/10.1902/jop.1999.70.11.1419
  6. Hayes RB, Bravo-Otero E, Kleinman DV et al. Tobacco and alcohol use and oral cancer in Puetro Rico. Cancer Causes Control 1999;10:27-33. https://doi.org/10.1023/A:1008876115797
  7. Marshall JR, Graham S, Haughey BP et al. Smoking, alcohol, dentition and diet in the epidemiology of oral cancer. Eur J Cancer Oral Oncol 1992;28B:9-15.
  8. Mashberg A, Boffetta P, Winkelman R, Garfinkel L. Tobacco smoking, alcohol drinking, and cancer of the oral cavity and oropharynx among U.S. veterans. Cancer 1993;72:1369-1375. https://doi.org/10.1002/1097-0142(19930815)72:4<1369::AID-CNCR2820720436>3.0.CO;2-L
  9. Bartsch H, Nair U, Risch A et al. Genetic polymorphism of CYP genes, alone or in combination, as a risk modifier of tobacco-related cancers. Cancer Epidemiol Biomarkers Prev 2000;9:3-28.
  10. Papapanou PN. Periodontal diseases: Epidemiology. Ann Periodontol 1996;1:1-36. https://doi.org/10.1902/annals.1996.1.1.1
  11. Bergstrom J. Cigarette smoking as a risk factor in chronic periodontal disease. Community Dent Oral Epidemiol 1989;17:245-247. https://doi.org/10.1111/j.1600-0528.1989.tb00626.x
  12. Calsina G, Ramon JM, Echeverria J-J. Effects of smoking on periodontal tissues. J Periodontol 2002;29:771-776. https://doi.org/10.1034/j.1600-051X.2002.290815.x
  13. Haffajee AD and Socransky SS. Relationship of cigarette smoking to attachment level profiles. J Clin Periodontol 2001;28:283-295. https://doi.org/10.1034/j.1600-051x.2001.028004283.x
  14. Bergstrom J, Elisson S. Cigarette smoking and alveolar bone height in subjects with a high standard of oral hygiene. J Clin Periodontol 1987;14:466-469. https://doi.org/10.1111/j.1600-051X.1987.tb02253.x
  15. Bergstrom J, Eliasson S, Preber H. Cigarette smoking and periodontal bone loss. J Peiodontol 1991;62:242-246. https://doi.org/10.1902/jop.1991.62.4.242
  16. Johnson GK and Hill M. Cigarette smoking and the periodontal patient. J Periodontol 2004;75:196-209. https://doi.org/10.1902/jop.2004.75.2.196
  17. Lambert PM, Morris HF, Ochi S. The influence of smoking on 3-year clinical success of osseointegrated dental implants. Ann Periodontol 2000;5:79-89. https://doi.org/10.1902/annals.2000.5.1.79
  18. Wallace RH. The relationship between cigarette smoking and dental implant failure. Eur J Prosthdont Restor Dent 2000;8:103-106.
  19. Millar WJ and Locker D. Smoking and oral health status. JCDA 2007;73:155-155g
  20. Vellappally S, Fiala Z, Smejkalova J et al. smoking related systemic and oral diseases. Acta Medica 2007;50:161-166.
  21. Reibel J. Tobacco and oral disease. Med Princ Pract 2003;12(suppl 1):22-32.
  22. 서홍관, 정유석, 명승권, 김열, 이원경: 한국 성인 흡연자들의 흡연관련 특성- 2005년 국제담배규제정책평가조사 결과. 가정의학학회지. 2008;29:844-853.
  23. 송제일, 이기호, 김미은, 김기석. 국내 치과대학병원에서 시행한 단기 금연 진료에 대한 조사. 대한구강내과학회지 2010;35:245-257.
  24. Bobo JK and Husten C. Sociocultural influences on smoking and drinking. Alcohol Research & health 2000;24:225-232.
  25. 보건복지부 국가건강정보포털-알코올중독의 진단: http://health.mw.go.kr/HealthInfoArea /HealthInfo.aspx?Mode=View&IDX=3700&CIC=70418214F2
  26. Lacchetti C, Cohen J, Ashley MJ et al. Is nicotine dependence related to smokers' support for restrictions on smoking? Nicotine Tob Res 2001;3:257-260.
  27. Tomar SL and Asma S. Smoking-attributable periodontitis in the United States: findings from HNANES III. National Health and Nutrition Examination Survey. J Periodontol 2000;71;743-751. https://doi.org/10.1902/jop.2000.71.5.743
  28. 김영구 외. 구취: 입냄새의 원인과 치료방법. 2008 신흥인터내셔날 pp.16-53.
  29. Nalcaci T, Baran I. Factors associated with self-reported halitosis (SRH) and perceived taste disturbance (PTD) in elderly. Arch Gerontol Geriatr 2008;46:307-316. https://doi.org/10.1016/j.archger.2007.05.004
  30. Miyazaki H, Sakao S, Katho Y, Takehara T. Correlation between volatile sulphur compounds and certain oral health measurement in the general population. J Periodontol 1995;66:679-684. https://doi.org/10.1902/jop.1995.66.8.679
  31. Bornstein MM, Kislig K, Hoti BB, Seemann R, Lussi A. Prevlence of halitosis in the population of the city Bern, Switzerland: A study comparing self-reported and clinical data. Eur J Oral Sci 2009;117:261-267. https://doi.org/10.1111/j.1600-0722.2009.00630.x
  32. Konstantinidis I, Chatziavramidis A, Printza A, Metaxas S, Constantinidis J. Effects of smoking on taste: Assessment with contact endoscopy and taste strips. Laryngoscope 2010;120:1958-1963. https://doi.org/10.1002/lary.21098
  33. Lie MA, Loos BG, Henskens YM et al. Salivary cystatin activity and cystatin C in natural and experimental gingivitis in smokers and non-smokers. J Clin Periodontol 2001;28:979-984. https://doi.org/10.1034/j.1600-051x.2001.028010979.x

Cited by

  1. 구강관리용품의 사용에 따른 흡연자의 구강 환경 변화 vol.18, pp.2, 2011, https://doi.org/10.5392/jkca.2018.18.02.361