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国民健康・栄養調査（NHANES）2009年～2012年における元喫煙者の禁煙期間と歯周炎との関連
Association between time since quitting smoking and periodontitis in former smokers in the National Health and Nutrition Examination Surveys (NHANES) 2009 to 2012.
PMID: 30102767 DOI: 10.1002/JPER.18-0183.
抄録
背景:
本研究の目的は、2009年から2012年の間に取得された2つの国民健康・栄養調査（NHANES）において、非喫煙者、元喫煙者、現喫煙者の歯周状態を分析し、禁煙後の時間と歯周状態との関連を明らかにすることであった。
BACKGROUND: The aims of this study were to analyze the periodontal conditions among non-smokers, former smokers and current smokers in the two National Health and Nutrition Examination Surveys (NHANES) acquired between 2009 to 2012 and determine the association between time since quitting smoking and periodontal status.
方法:
NHANES 2009～2010 年および 2011～2012 年の喫煙状況および歯周検査データを分析した。解析対象者は18歳以上で、歯周病分類アルゴリズムに必要なすべての測定値を記録したNHANES口腔保健-歯周検査を完全に受けており、NHANES喫煙-タバコ使用質問票のデータを完全に持っていた。ロジスティック回帰は、禁煙開始からの時間を暴露、歯周炎の有無をアウトカムとし、交絡因子の調整を含めて実施した。
METHODS: Smoking status and periodontal examination data from NHANES 2009 to 2010 and 2011 to 2012 were analyzed. Respondents included in the analysis were aged ≥18 years, had undergone a complete NHANES Oral Health - Periodontal Exam with all measurements recorded as required for the periodontal classification algorithm, and had complete data from the NHANES Smoking - Cigarette Use questionnaire. Logistic regression was conducted with time since quitting as the exposure and presence of periodontitis as the outcome, and included adjustment for confounders.
結果:
喫煙状態は歯周状態と有意に関連していた（カイ二乗；P＜0.0001）。歯周炎の発生率は喫煙者（35％）で最も高く、元喫煙者（19％）および非喫煙者（13％）と比較した。元喫煙者では、交絡因子を調整した後、禁煙後1年を増すごとに歯周炎のオッズ比（OR）が3.9％有意に減少した（各年のOR 0.961、95％信頼区間0.948～0.975）。
RESULTS: Smoking status was significantly associated with periodontal status (Chi-square; P < 0.0001). The rate of periodontitis was highest among smokers (35%), compared with former smokers (19%) and never smokers (13%). Among former smokers, after adjusting for confounders, each additional year since quitting smoking was associated with a significant reduction in the odds ratio (OR) for periodontitis by 3.9% (OR for each year 0.961, 95% confidence interval 0.948 to 0.975).
結論:
元喫煙者の間では、禁煙後の期間が長いほど歯周炎になる可能性が低くなります。したがって、歯科医師は患者の禁煙を支援することを公衆衛生上義務づけられています。今後の研究では、歯科患者の禁煙を促進するための最良の戦略を決定する必要があります。
CONCLUSIONS: Among former smokers, a longer time since quitting smoking was associated with a lower likelihood of periodontitis. Consequently, dental practitioners have a public health mandate to help their patients quit smoking. Future research should determine the best strategies for facilitating smoking cessation in dental patients.
© 2018 American Academy of Periodontology.