Table 6.21Case-control studies on the association between smoking and periodontitis

StudyNumber of cases/controlsCase definitionSources of cases/controlsFindings
Smoking statusOdds ratio95% confidence interval
Preber and Bergström1986260/1,769Moderate to severe periodontitis; advanced periodontitis (mean PPD* >4.5 mm)Dental school periodontal clinic/population- based sampleCurrent smokers
 Moderate to severe periodontitis2.11.7–2.7
 Advanced periodontitis2.41.7–3.5
Bergström and Eliasson 1987b134PPD ≥4 mm on ≥1 sitePeriodontal patients/population- based sampleCurrent smokers
Haber and Kent 1992196/209Moderate periodontitis(20–50% bone loss on≥1 surface); advanced periodontitis(>50% bone loss on ≥1 surface)Periodontal offices/general dental practicesNever smoked1.0
Ever smoked(moderate or advanced disease)2.61.6–3.9
Current smokers(moderate or advanced disease)3.31.8–5.8
 ≤10 cigarettes/day1.00.4–2.5
 >10 cigarettes/day5.42.8–10.6
 ≤10 years’ duration1.00.2–6.5
 >10 years’ duration4.31.6–12.1
 Moderate disease1.80.9–3.7
 Advanced disease6.12.9–12.8
MacFarlane et al. 199231/12Refractory periodontitis: persistent failure of conventional treatment including root planing, surgery, and antibioticsPrivate periodontal practices and dental school graduate periodontal clinics/laboratory personnelCurrent smokers(odds ratio estimate calculated from reported raw data by adding 0.5 to each cell; 0 smokers in the control group)203.69.8–4, 242.4
Gelskey et al. 1998205/205≥1 tooth with alveolar bone loss >3 mm, or≥1 tooth with PPD* ≥7 mmDental school ClinicNever smoked1.0NR
Ever smoked1.81.1–2.9
 Aged 35–87 years
 Aged 35–54 years
 Aged 55–87 years
Quinn et al. 1998270/193≥2 mm loss of periodontal attachment on ≥1 toothClinical Research Center for Periodontal Diseases, VirginiaBlacks
Former smokers1.0ΔNR
Current smokers2.1Δ0.9–5.1
Former smokers1.0ΔNR
Current smokers4.0Δ2.1–7.6

PPD = Probing pocket depth.

Odds ratio estimates in this study were based on comparisons with smoking prevalence in a general population survey in Stockholm, Sweden. However, periodontal health was not examined in this “control” group.

NR = Data were not reported.


Cigarette-years = Number of years of smoking multiplied by the number of cigarettes smoked per day.


Crude odds ratio estimates were calculated from data reported in the paper.

From: 6, Other Effects

Cover of The Health Consequences of Smoking
The Health Consequences of Smoking: A Report of the Surgeon General.
Office of the Surgeon General (US); Office on Smoking and Health (US).

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