Inside Dentistry
Jul/Aug 2008
Volume 4, Issue 7

Dental Patient Awareness of Smoking Effects on Oral Health: Comparison of Smokers and Non-Smokers

Howard E. Strassler, DMD

Al-Shammari KF, Moussa MA, Al-Ansari JM, et al. J Dent. 2006;34(3):173-178.


OBJECTIVES: The negative effects of cigarette smoking on oral health are well established, yet few studies assessed patient awareness of such effects. The aim of this study was to examine differences in dental patient knowledge and awareness of the effects of smoking on oral health between smokers and non-smokers. METHODS: Adult patients from 12 dental centers in Kuwait were asked to complete a 14-point self-administered structured questionnaire on the effects of smoking on oral health in this cross-sectional survey. Significant associations between oral health knowledge, smoking status, and sociodemographic variables were examined with univariate analysis and logistic regression. RESULTS: A total of 1,012 subjects participated (response rate = 84.3%). The prevalence of smoking was 29.3%. Fewer smokers than non-smokers thought that oral health and smoking are related (92.2% vs 95.8%; P = .020), and that smoking affected oral cancer (52.4% vs 66.8%; P < .001), periodontal health (72% vs 78%; P = .040), or tooth staining (86.1% vs 90.9%; P = .018). Logistic regression analysis showed smokers to be significantly less aware of the oral health effects of smoking than non-smoking patients (OR = 1.51; 95% CI: 1.05?2.16; P = .025). CONCLUSION: Smoking dental patients are significantly less aware of the oral health effects of smoking than non-smokers. Comparative studies in other populations may be warranted to ascertain the validity of these results.


Smoking is bad for you. Who doesn’t know this incontrovertible fact? What is interesting is that our patients many times relate to the negative effects of smoking as they relate to general health. Smoking is a major risk factor for systemic diseases, but what many of our smoking patients may not be aware of is that smoking plays a harmful role in dental disease. The negative effects of smoking on dental health range from cosmetic changes such as tooth staining to life-threatening conditions such as oral cancer. Smoking increases susceptibility to periodontal diseases, reduced response to both surgical and non-surgical periodontal therapies, increased risk of implant failure, and a higher risk for oral cancer and pre-cancerous lesions.

This survey of smokers and non-smokers presents us with important information as to whether our patients are aware of the negative oral effects of smoking. While the survey gathered information in Kuwait, the implication of our patients’ knowledge base cuts across all countries and oceans. Do our patients have an awareness? According to the survey results there is significant gap in knowledge of oral health effects of smoking between smokers and non-smokers. The survey also leveled the playing field by assessing other variables that might be associated with patient awareness. The association of smokers’ lack of awareness of the risks of smokers compared to non-smokers was independent of age, gender, martial status, or education level.

The dental profession’s knowledge of the harmful effects of smoking both systemically and intraorally is obvious with the increase in smoking cessation programs in dental offices. We as dental professionals need to provide patient education brochures, posters, and counseling in our offices to increase this awareness.

About the Author

Howard E. Strassler, DMD
Professor and Director of Operative Dentistry
Department of Endodontics, Prosthodontics and Operative Dentistry
University of Maryland Dental School, Baltimore, Maryland

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