Background
Data visualization techniques were used to ascertain (1) site‐specific effects of cigarette smoking on the periodontium compared to never‐smokers; (2) patterns of site‐specific effects by age among current and never‐smokers using contour maps.
Methods
Data from 10,713 dentate participants aged ≥30 years in NHANES 2009‐2014 were used. Pocket depth (PD) and clinical attachment level (CAL) for six sites/tooth were ascertained by smoking status and plotted using contour maps to identify new patterns.
Results
In the overall sample, 19% (n = 2015) were current smokers and 56% (n = 6013) were never‐smokers. Contour maps of the overall sample showed teeth/sites most affected with mean PD > 2.1 mm were molars (2,3,15,18,19,30,31) in mesio‐lingual (ML) and disto‐lingual (DL) sites. Most affected sites for current smokers were interproximal sites of most posterior teeth. Among never‐smokers, fewer teeth/sites were affected with PD > 2.1 mm, whereas among smokers, number of affected teeth/sites increased with age. Overall, teeth/sites most affected with mean CAL≥2.1 mm were noted in 2,3(ML), 3(DL), 14(DF, DL), 15(MF, ML), 18(ML), 19(DL, ML), and 30‐31(ML, DL) with upper anterior teeth least affected. Among current smokers, several teeth/sites were affected (CAL≥2.1 mm): 2,3(all six sites), 4(ML, DL), 9(ML), 11‐21(DL), 13‐18(DF, ML, MIL, DL), 19‐20(DF, ML, MIL), 14‐18(MIF), 21(MIF, ML, DL), 22(MF), 23‐27(MIL), 24‐26(MIL, MF, DF in 26), 27(MF), 28(MF, ML, DL), 29‐31(all 6 sites except MIF 30,31). As age increased, more teeth/sites were affected among smokers and by the 5th decade nearly all teeth/sites had CAL≥2.0 mm.
Conclusions
Contour mapping identifies patterns and dramatically visualizes the substantial periodontal site‐specific differences. Current smokers had more affected teeth and/or periodontal sites with a different contour pattern than never‐smokers.