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Contemporary impact of tobacco use on periodontal disease in the USA
  1. Emily Vogtmann1,2,
  2. Barry Graubard1,
  3. Erikka Loftfield1,
  4. Anil Chaturvedi1,
  5. Bruce A Dye3,
  6. Christian C Abnet1,
  7. Neal D Freedman1
  1. 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
  2. 2Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland, USA
  3. 3National Institute of Dental and Craniofacial Research, Bethesda, Maryland, USA
  1. Correspondence to Dr Emily Vogtmann, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI 9609 Medical Center Dr MSC 9768, Bethesda, MD 20892, USA; emily.vogtmann{at}

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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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  • Contributors AC, CCA and NDF designed the study; EV, BG, EL, BAD, CCA and NDF analysed and interpreted the data; EV and NDF drafted the manuscript; BG, EL, AC, BAD and CCA critically reviewed the manuscript; all authors gave final approval on the manuscript.

  • Funding This study was supported by funds from the Intramural Research Program of the NCI and the Tobacco Regulatory Science Program through the NIH and FDA.

  • Competing interests None declared.

  • Ethics approval Research Ethics Review Board of the National Center for Health Statistics, Centers for Disease Control and Prevention.

  • Provenance and peer review Not commissioned; externally peer reviewed.