Tobacco-use patterns and self-reported oral health outcomes: A cross-sectional assessment of the Population Assessment of Tobacco and Health study, 2013-2014.

Background: Few studies consider simultaneously the oral health implications of nontraditional tobacco products and tobacco-use patterns. The authors aimed to evaluate self-reported gingival disease among cigarette smokers and users of other types of tobacco products.

Methods: The authors used survey-weighted multivariable logistic regression to assess associations between different tobacco products, use patterns (for example, dual or multiple tobacco product use or product switching); and lifetime history of gingival disease diagnosis and treatment. They used the nationally representative (US) Population Assessment of Tobacco and Health study's Wave 1 (2013-2014) adult data (N = 32,320).

Results: Overall, 12.1% of participants self-reported gingival disease diagnosis, and 19.1% reported receiving treatment. Groups with the highest adjusted relative odds for diagnosis (reference, lifetime tobacco never users) were pipe users (2.7; 95% confidence interval [CI], 1.3 to 5.3), e-cigarette users (2.9; 95% CI, 1.9 to 4.5), multiple tobacco product users (2.8; 95% CI, 2.4 to 3.4), and recent (< 12 months) quitters (2.8; 95% CI, 2.0 to 3.8). Similarly, odds of treatment report were highest among pipe users (2.3; 95% CI, 1.3 to 4.1), e-cigarette users (2.3; 95% CI, 1.3 to 4.1), multiple tobacco product users (1.6; 95% CI, 1.4 to 1.9), and recent quitters (1.7; 95% CI, 1.3 to 2.2).

Conclusions: Numerous tobacco-use patterns were associated with worse periodontal health compared with tobacco never users. These findings are consistent with previous biological and epidemiologic evidence linking tobacco use to poor periodontal health.

Practical Implications: Dental clinicians should anticipate various tobacco-use patterns among their patients, all of which may impact oral health. Oral health care professionals should remain informed of, screen for, and address the use of all tobacco products in practice.