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Periodontal disease (PD) is a common chronic disease that can be expensive to treat, and when untreated, can inflict significant morbidity and tooth loss. Growing evidence also links PD to higher risks of cancer, cardiovascular and other chronic diseases.
Cigarette smoking has been estimated to cause 8 million cases of PD in the USA or more than half of the 15 million cases of PD.1 However, these estimates are based on data from the third National Health and Nutrition Examination Survey (NHANES), conducted from 1988 to 1994. The prevalence of PD was underestimated in this survey because a partial mouth examination was utilised that included many fewer sites per tooth than currently recommended.2 Current prevalence estimates of PD in the USA are substantially higher, as they incorporate new population-based PD case definitions and full-mouth assessments.3 Equally important, previous estimates of the tobacco-induced PD burden failed to include the effects of non-cigarette tobacco products and environmental tobacco smoke (ETS). There have also …
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