Cigarette and e-cigarette smoking as associated factors of gingivitis in 15-year-olds: a cross-sectional study in Poland

Periodontal disease can affect subjects in every age including childhood and adolescence. In adolescents its prevalence, extent and severity can be modified by smoking habit. To assess the association of cigarette/e-cigarette smoking and gingival health in Polish 15-year-olds a cross-sectional study including clinical assessment of periodontal health (gingival bleeding, depth of periodontal pockets, loss of attachment) and self-administered questionnaire (sociodemographic factors, oral health-related knowledge and behaviors) was carried out. Appropriate statistical tests were performed, with significance set at p < 0.05, and 95% confidence intervals (CI) were calculated. Gingival bleeding occurred in 25.1% of 992 participants, PPD = 4-5 mm in 0.7%, CAL in 1.1%. Gingival bleeding was reported in the area of 3.18 (standard deviation - SD = 7.15) teeth on average with the mean number of teeth affected higher in boys than in girls (3.92 vs. 2.52; p = 0.002) and similar in rural and urban residents (3.09 vs. 3.28; p = 0.675). The mean number of teeth with dental calculus was 2.40 (SD = 5.66). 7.2% respondents smoked cigarettes, 11.7% e-cigarettes, both were associated with presence of gingival bleeding (OR = 2.5; p < 0.001 and OR = 1.92; p = 0.002, respectively). The association remained strong after adjusting for sociodemographic factors and oral behaviors (aOR = 2.54; p < 0.001 and aOR = 1.85; p = 0.004). As cigarette or e-cigarette smoking was correlated with gingivitis in Polish 15-year-olds anti-smoking recommendations should be part of oral health education in teenagers. Regarding cigarette smoking association with gingivitis in 15-year-olds in Poland, nationwide anti-smoking recommendations should be incorporated into youth education programs on general and oral health. Dentists, when examining adolescents, should pay attention to unhealthy habits, including smoking, in the context of periodontal health and provide individualized education.