Normative and Subjective Oral Health Evaluation among Smoker and non-Smoker Adolescents of Qazvin, Iran, in 2015

Abstract

Background: Smoking among adolescents is a universal matter. Several findings suggest that smoking can lead to impaired oral health. Objectives: The current study was undertaken to evaluate the normative and subjective oral health status of 13-year-old smokers and nonsmokers in Qazvin, Iran. Methods: This cross-sectional study was carried out on a multistage cluster sample of 519 adolescents in Qazvin, Iran, in 2015. A self-administered questionnaire comprising three parts pertaining to oral health behavior (frequency of tooth brushing and dental visits, snacking, and the use of fluoride toothpaste) was administered. The socio-demographic and subjective characteristics of the study participants, including self-reported smoking, gum bleeding, and halitosis, were determined. The simplified oral hygiene index (OHI-S) was used to evaluate their clinical condition. Binary logistic regression analysis was performed separately for the smokers and nonsmokers. Correlation, kappa agreement, sensitivity, and specificity between the subjective and normative measurements were calculated. Results: 26% of the male adolescents and 15% of the female adolescents claimed that they smoked cigarettes or used water pipe. Infrequent dental visits (≥ 2 years) [odds ratio (OR) = 3.0, 95% confidence interval (CI): 1.1-7.8, P = 0.030), frequent snacking (≥ 3 times between meals) (OR = 3.5, 95% CI: 1.5 -8.4, P = 0.001), and halitosis were significantly associated with poor self-perceived oral health. Poor oral hygiene index, which represents normative measurement, was similar among smokers and nonsmokers in this age group. Sensitivity and specificity were reported to be 81% and 85% for smokers and 30% and 21% for nonsmokers, respectively. Conclusions: Normative and subjective oral health evaluations were not in the same line among smoking and nonsmoking adolescents. Professional screening is necessary to evaluate oral health in this age group, especially in countries with developing oral health care systems.

Influence of tobacco smoking on the development of halitosis

“… Reference Country Study design Study participants Smoking definition Diagnosis of halitosis Subgroup (halitosis, YES/NO) Smokers Nonsmokers OR Patient group (n) (n) (95% CI) Al Ansari et al [31] Kuwait Cross-sectional 1551 Kuwaiti adult subjects Smoking history Self-reported All 107/182 249/976 2.30 (1.75–3.04) Alqatahni et al [32] Saudi Arabia Cross-sectional 100 male participants with peri-implantitis Current smoking Self-reported All 20/15 11/21 2.55 (0.95–6.85) AlSadhan [7] Saudi Arabia Cross-sectional Male and female students Smoking history Self-reported All 66/173 468/1636 1.33 (0.99–1.80) Al-Zahrani et al [33] Saudi Arabia Cross-sectional 38 consecutive type 2 diabetic patients were recruited from among patients who presented for treatment at a University hospital Smoking history Self-reported All 3/7 13/15 0.49 (0.11–2.31) Ayo-Yusuf et al [34] South Africa Cross-sectional 896 patients examined between January and October 2004 were retrospectively analyzed. Current smoking Halimeter: No halitosis considered in subjects with halitosis measurement of 0–1 All 119/133 206/431 1.87 (1.39–2.52) Babazadeh et al [35] Iran ...…”

“…The sensitivity analysis shown in Fig. 4 includes six studies [32] , [34] , [35] , [41] , [42] , as the studies by Rech et al [38] , Jiun et al [37] , and Romano et al [39] accounted for 20% of all interstudy heterogeneity. The results of this analysis also showed an increased risk of halitosis among current smokers in both fixed and random effects models (ORs = 1.43 [95% CI, 1.26–1.63] and OR = 1.49 [95% CI, 1.15–1.92], respectively; I 2 = 65%).…”