Variation in tobacco use profiles obtained from periodontal maintenance patients

Picard, J.P.; Singer, D.L.; Kells, L.; Fisher, S.; Lix, L.; Scott, D.A.

doi:10.1016/j.jdent.2007.09.007

« Previous Next »Journal of Dentistry
Volume 35, Issue 12 , Pages 934-938, December 2007

Variation in tobacco use profiles obtained from periodontal maintenance patients

J.P. Picard
- Departments of Dental Diagnostics and Surgical Sciences, University of Manitoba, Winnipeg, Man., Canada
D.L. Singer
- Departments of Dental Diagnostics and Surgical Sciences, University of Manitoba, Winnipeg, Man., Canada
L. Kells
- Departments of Dental Diagnostics and Surgical Sciences, University of Manitoba, Winnipeg, Man., Canada
S. Fisher
- Departments of Dental Diagnostics and Surgical Sciences, University of Manitoba, Winnipeg, Man., Canada
L. Lix
- Community Health Sciences, University of Manitoba, Winnipeg, Man., Canada
D.A. Scott
- Oral Health and Systemic Disease Research Group, University of Louisville School of Dentistry, Louisville, KY, USA
- Corresponding author. Tel.: +1 502 852 8905; fax: +1 502 852 4052.

Received 17 July 2007; received in revised form 4 September 2007; accepted 7 September 2007.

Abstract

Objectives

To compare methods of tobacco use profiling in patients undergoing maintenance treatment for periodontitis.

Methods

The smoking status of 108 subjects attending a university-based specialist periodontics clinic was assessed by examination of referring records, patient-completed questionnaires, clinician-administered interviews and by salivary cotinine and expired-air carbon monoxide (ECO) measurement.

Results

Ten percent of the detected smokers (salivary cotinine>14.2ngml⁻¹) reported to be non-smokers in the clinician-administered interview. 4.2% of the smokers detected by ECO analysis (ECO>8ppm) reported to be non-smokers in the clinician-administered interview. Systematic under reporting of tobacco use was also apparent in patient-completed questionnaires from the periodontics clinic and, to a larger degree, in the referring clinic records when compared to the clinician-administered interview.

Conclusions

By biochemically analyzing recent cigarette smoke exposure, our data show that clinician assessment is the most accurate means by which to obtain anamnestic data concerning tobacco use. ECO analysis using portable CO monitors is inexpensive and simple with no requirement for laboratory support. The combination of ECO measurement and clinician-administered tobacco use interview represents a clinically applicable method to improve the detection of an important, periodontally susceptible population—regular smokers who deny smoking.

Keywords: Carbon monoxide, Cotinine, Periodontal disease, Tobacco smoking, Treatment