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May JADA examines impact of all tobacco products on oral health

April 24, 2019

By Mary Beth Versaci


All tobacco products, not just cigarettes, could be harmful to periodontal health, according to research published in the May issue of The Journal of the American Dental Association.

The cover article, “Tobacco-Use Patterns and Self-Reported Oral Health Outcomes: A Cross-sectional Assessment of the Population Assessment of Tobacco and Health Study, 2013-2014,” found gingival disease diagnosis was more likely to be reported among nearly all tobacco product users compared with those who had never used tobacco. Similarly, the odds of gingival disease treatment also were higher among all users, except for current experimenters, users of smokeless tobacco products and hookah users.

“Dental professionals need to understand how tobacco use affects oral health, dental treatment and overall health and well-being,” said corresponding author Dr. Benjamin W. Chaffee, who is an assistant professor at the University of California, San Francisco School of Dentistry. “Our results suggest that all forms of tobacco, not just cigarettes, are associated with worse oral health. Dentists asking only about cigarette smoking may be missing a substantial portion of patients who are using tobacco and suffering poor health outcomes because of it.”

The researchers used data from the Population Assessment of Tobacco and Health study, which includes the self-reported tobacco use and health outcomes of 32,320 U.S. adults.

The highest prevalence of diagnosis was reported by current users of pipes, e-cigarettes and cigarettes, according to the article. Treatment was most common among current pipe and e-cigarette users, long-term quitters, product switchers and recent quitters.

“Regarding e-cigarettes specifically, one must remember that this study was based on cross-sectional data and self-reported outcomes,” Chaffee said. “Therefore, it should not be taken as proof that e-cigarettes cause oral disease. However, the association deserves further study, especially given recent increases in e-cigarette use.”

To read the article, visit

Other articles in the May issue of JADA examine the ethical considerations when prescribing opioids to patients for acute dental pain and the potential for new fluoride- and calcium-containing toothpastes to remineralize caries lesions.

Every month, JADA articles are published online at in advance of the print publication.