High prevalence of apical periodontitis amongst smokers in a sample of Spanish adults


Dr Juan J. Segura-Egea; Cueva de Menga nº 1, portal 3, piso 6º-C, 41020-Seville, Spain (e-mail: segurajj@us.es).


Aim  To study the prevalence of apical periodontitis in smoker and nonsmoker patients.

Methodology  In a cross-sectional study, the records of 180 subjects, 109 smokers and 71 nonsmokers, were examined. All participants underwent a full-mouth radiographic survey incorporating 14 periapical radiographs. The periapical region of all teeth, excluding third molars, was examined. Periapical status was assessed using the Periapical Index score. Statistical analyses were conducted using the Cohen’s Kappa test, analysis of variance and logistic regression.

Results  Apical periodontitis in at least one tooth was found in 74% of smokers and in 41% of nonsmokers (P < 0.01; odds ratio = 4.2; 95% C. I. = 2.2–7.9). Amongst smoker patients 5% of the teeth had apical periodontitis, whereas in nonsmoker subjects 3% of teeth were affected (P = 0.008; odds ratio = 1.5; 95% C. I. = 1.1–2.1). The percentage of root filled teeth in smoker and nonsmoker patients was 2.5% and 1.5%, respectively (P < 0.05; odds ratio = 1.7; C. I. 95% = 1.0–2.6).

Conclusions  In this study population, smoking was significantly associated with a greater frequency of root canal treatment and with an increased prevalence of apical periodontitis.