Work-Family Conflict Modifies the Association of Smoking and Periodontal Disease.

PURPOSE: The aims of the study were to assess the association of periodontal loss of attachment with smoking and work-family conflict and assess whether work-family conflict modifies the association of smoking and periodontal disease. METHOD: A random sample of 45-54 year olds from metropolitan Adelaide, South Australia, was surveyed by mailed self-complete questionnaire during 2004-2005. Oral examinations were performed on persons who responded to the questionnaire, providing an assessment of periodontal status. RESULTS: A total of 879 responded (participation rate = 43.8 %), with n = 709 oral examinations (completion rate = 80.7 %). Prevalence of periodontal loss of attachment (LOA) of 6+ mm was higher (p < 0.05) for smokers (23.8 %) compared to non-smokers (7.8 %) among employed adults. The adjusted prevalence ratio for LOA 6+ mm was prevalence ratio (PR) = 4.9 (95 % CI 2.2-8.8) for smokers, and there was a significant interaction (p < 0.05) between smoking status and work-family conflict. CONCLUSION: Work-family conflict modified the association of smoking with periodontal disease. Higher levels of work interfering with family were associated with higher levels of periodontal LOA for smokers compared with non-smokers.

Development and evaluation of the Stages of Change in Oral Health instrument.

OBJECTIVES: Oral health personnel are limited in their ability to assess the readiness of patients to make changes to improve oral health. We aimed to develop and test the Stages of Change in Oral Health (SOCOH) model, a scaled index of the stages of change - pre-contemplative, contemplative or active - with particular emphasis on pregnancy. MATERIALS AND METHODS: Items were collected in a self-report questionnaire conducted among a convenience sample of 446 mothers (age range: 14-43 years) pregnant with Aboriginal children in South Australia, Australia. Scales representing openness (four items; Cronbach's alpha = 0.73), value (four items; Cronbach's alpha = 0.71), inconvenience (six items; Cronbach's alpha = 0.79) and permissiveness (four items; Cronbach's alpha = 0.66) were developed. Participants were categorised according to the Stages of Change model and were evaluated against key self-reported oral health outcomes. RESULTS: Some 11.9% of participants were classified as pre-contemplators, 46.4% as contemplators and 41.7% as active. A higher proportion of active participants had a higher education, last visited a dentist less than a year previously, had no dental fear, owned a toothbrush, brushed the previous day, used toothpaste, had no difficulties paying a $100 dental bill, self-reported their dental health as 'excellent' and in the previous 12 months did not experience dental pain, embarrassment related to their dental appearance or difficulties eating food. CONCLUSIONS: The SOCOH model offers an internally consistent and valid instrument for detailed assessment of the readiness for change in regarding oral health behaviours in pregnancy and has potential benefits for clinical decision making and research.

Substance use and periodontal disease among Australian Aboriginal young adults.

AIM: To investigate the effects of tobacco, marijuana, alcohol and petrol sniffing on periodontal disease among Australian Aboriginal young adults. DESIGN: Cross-sectional nested within a long-standing prospective longitudinal study. Setting Aboriginal communities in Australia's Northern Territory. PARTICIPANTS: Members of the Aboriginal Birth Cohort study who were recruited from birth between January 1987 and March 1990 at the Royal Darwin Hospital, Northern Territory, Australia. Data were from wave III, when the mean age of participants was 18 years. MEASUREMENTS: Clinical dental examination and self-report questionnaire. FINDINGS: Of 425 participants with complete data, 26.6% had moderate/severe periodontal disease. There was elevated risk of periodontal disease associated with tobacco [prevalence ratio (PR) = 1.59, 95% CI = 1.06-2.40], marijuana (PR = 1.44, 95% CI = 1.05-1.97) and petrol sniffing (PR = 1.83, 95% CI = 1.08-3.11), but not alcohol (PR = 0.92, 95% CI = 0.67-1.27). Stratified analysis showed that the effect of marijuana persisted among tobacco users (PR = 1.47, 95% CI 1.03-2.11). It was not possible to isolate an independent effect of petrol sniffing because all petrol sniffers used both marijuana and tobacco, although among smokers of both substances, petrol sniffing was associated with an 11.8% increased prevalence of periodontal disease. CONCLUSIONS: This is the first time that substance use has been linked with periodontal disease in a young Australian Aboriginal adult population, and the first time that petrol sniffing has been linked with periodontal disease in any population. The role of substance use in periodontal disease among this, and other, marginalized groups warrants further investigation.

Smoking-attributable periodontal disease in the Australian adult population.

BACKGROUND: The extent to which periodontitis is attributable to smoking in Australia has not been examined. OBJECTIVES: To investigate the smoking-periodontitis relationship and to estimate the public health impact of smoking on periodontitis in Australia. MATERIAL AND METHODS: The National Survey of Adult Oral Health 2004-2006 collected nationally representative oral epidemiologic data for the Australian adult population. Examiners measured probing pocket depth (PPD) and gingival recession at three sites per tooth to compute clinical attachment level (CAL). Moderate-severe cases were defined as having: >/=2 interproximal sites (not on same tooth) with >/=4 mm CAL or with >/=5 mm PPD. Smoking status was defined as never-, former- or current-smoker. Current-smokers were further classified into light-, moderate- or heavy-smoker using calculated pack-years. Age, sex and socioeconomic position were examined as potential confounders. RESULTS: Twenty-three per cent were former-smokers and 15% were current-smokers. Prevalence of periodontitis was 23%. In unadjusted analyses, former- and current-smokers had significantly higher periodontitis prevalence than never-smokers. Relative to non-smokers, adjusted prevalence ratios (95% confidence interval) for periodontitis were as follows: former-smokers: 1.22 (1.03-1.46), moderate-smokers: 1.63 (1.16-2.30); and heavy-smokers: 1.64 (1.27-2.12). The population attributable fraction of smoking for moderate-severe periodontitis was 32% (equivalent to 700,000 adults). CONCLUSION: Smoking has a significant impact on periodontal health of the Australian adults.