Association Between Tobacco Smoking and Gum Bleeding in Indonesian Population: Results of a National Study in 2018

Abstract

Smoking is a risk factor for pathologic diseases both locally in the oral cavity and systemic diseases. Smoking tobacco has been associated with an increased risk of periodontitis. The National Basic Health Research, RISKESDAS 2018 conducted by the Ministry of Health of the Republic of Indonesia, shows a high prevalence (74.1%) of periodontitis in Indonesia. This study aimed to analyze the Indonesian population's association between tobacco smoking and gum bleeding. This is a cross-sectional data analysis using secondary data collected from RISKESDAS 2018. The study population included 34326 Indonesians from 26 provinces aged 15 years and older who underwent dental examinations and dental support tissues. The Community Periodontal Index (CPI) was used to measure periodontal status as the dependent variable. The independent variables were smoking status and level of exposure to cigarettes based on the Brinkman index. Multivariate logistic regression analysis was performed to determine the relationship between smoking status and smoking rate with gum bleeding. The results showed that 70.7% of the population experienced gum bleeding, with a slightly higher rate in women (71.4%) than in men (69.6%). Smoking behavior is 24.0% of current smokers and 5.2% of former smokers. The level of smoking consumption >=400 is 27.6%. Multivariate results showed that current smoking status affected gum bleeding in general respondents (aOR = 1.173; 95%CI = 1.084-1.269; p < 0.001), especially in the male group (aOR = 1.230; 95%CI = 1.127-1.342); p < 0.001). Heavy smoking affected gum bleeding in men (aOR = 1.143; 95%CI = 1.049-1.247; p = 0.002) and women (aOR = 0.795; 95%CI = 0.668-0.947; p = 0.010). This study shows that smoking is associated with gum bleeding in the Indonesian population.