Periodontal attachment loss attributable to cigarette smoking in an urban Brazilian population

Cristiano Susin, Rui V. Oppermann, Ola Haugejorden, Jasim M. Albandar

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Aims: The present study estimated the percentages of cases with severe periodontal attachment loss (PAL) attributable to cigarette smoking in a representative adult urban population in southern Brazil. Methods: A representative sample comprising 853 dentate individuals (age: 30-103 years) was selected by a multistage, probability sampling method. A full-mouth clinical examination of six sites per tooth was performed and an interview using a structured written questionnaire was undertaken. Cases were defined as individuals with ≥ 30% teeth with PAL ≥ 5 mm. A multivariate logistic regression analysis for complex surveys was performed, and adjusted for age, gender, race, socioeconomic status and dental calculus. Results: The prevalence of cases in this population was 49.7%, or 739,000 subjects. Overall, 50.9% of this adult population, or approximately 757,000 subjects have had a lifetime exposure to cigarette smoking. Multivariate analysis showed that heavy and moderate smokers had a significantly higher risk for PAL ≥ 5 mm than non-smokers (odds ratio = 3.6, 2.0, respectively) after adjusting for the above covariates. We estimated that the number of moderate and heavy smokers with ≥ 30% teeth with PAL ≥ 5 mm might be reduced by approximately 28% and 48%, respectively, had they not smoked cigarettes. We project that a smoking cessation program could result in a reduction in the number of cases by up to 12% in this population, or approximately 90,000 potential cases. Conclusion: Cigarette smoking was strongly associated with severe attachment loss in this population. A significant percentage of cases may have been prevented if smoking cessation interventions had been implemented. The results support the implementation of population-based smoking cessation programs to reduce the prevalence of severe attachment loss in populations with high level of smoking exposure.

Original languageEnglish (US)
Pages (from-to)951-958
Number of pages8
JournalJournal of Clinical Periodontology
Issue number11
StatePublished - Nov 2004
Externally publishedYes


  • Attributable fraction
  • Attributable risk
  • Periodontal attachment loss
  • Periodontal disease/epidemiology
  • Risk factors
  • Smoking

ASJC Scopus subject areas

  • Periodontics


Dive into the research topics of 'Periodontal attachment loss attributable to cigarette smoking in an urban Brazilian population'. Together they form a unique fingerprint.

Cite this