Since current evidences support a negative influence of tobacco smoking on the periodontal bone, an increased prevalence or severity of periapical lesions would be expected among smokers. The aim of this study was to investigate the difference in the periapical status of endodontically treated and untreated teeth in current smokers and never-smokers.
The cross-sectional study included 259 subjects, 108 current smokers and 151 never-smokers, presenting as new patients at the Dental Clinic of the Clinical Hospital Centre Rijeka, Croatia. The periapical index (PAI) was used to assess the periapical status of all teeth, excluding third molars.
Results and conclusions
Current smokers had higher fraction of teeth with apical periodontitis (AP) than never-smokers (0.13 vs. 0.10; P = 0.025), while fractions of endodontically treated teeth and endodontically treated teeth with AP did not differ significantly. When overall number of teeth was controlled for, smokers were 16.4 times more likely to have AP than a non-smokers (95% CI: 5.7–47.7; P < 0.001) and if a person was male, he was 3.1 times more likely to have AP than if the person was female (95% CI: 1.1–8.9; P = 0.039). The probability of AP increases with increase of age. Smokers will on average have two teeth with AP more than non-smokers, while controlling for gender, age and overall number of teeth.