Tobacco and Dental Caries
The National Institute of Dental and Craniofacial Research
The results of
the study summarized here indicate that the use of chewing tobacco may cause
dental caries. If you think a 'chaw' of tobacco won't hurt you, chew on this:
Chewing tobacco users are more likely to develop dental caries, particularly on
the root surfaces of their teeth, than those who don't use tobacco, say
scientists at the National Institutes of Health (NIH) and the Centers for
Disease Control and Prevention (CDC).
results of this study give tobacco chewers yet one more reason to quit,"
said lead author Scott Tomar, D.M.D., Dr.P.H., National Center for Chronic
Disease Prevention and Health Promotion, CDC. "We already know that
chewing tobacco use is a risk factor for gingival (gum) recession and oral
cancer," he said. "The damage that it can do to teeth is another item
we can add to the list of health consequences."
study of dental caries and chewing tobacco use in the United States is the
first large-scale, detailed analysis of the relationship between dental decay
and the leafy form of tobacco. The study results appear in the November, 1999
issue of the Journal of the American Dental Association. The researchers
analyzed dental caries and tobacco use data from more than 14,000 adults aged
18 and over. The data were collected by the National Center for Health
Statistics between 1988-1994 as part of the Third National Health and Nutrition
distinguished between the two types of spit tobacco, also called smokeless
tobacco, and other types of tobacco such as cigarettes, pipes, and cigars. Spit
tobacco comes in two forms, chew and snuff. Chewing tobacco is a bulky, leafy
form of tobacco that is packaged as loose leaf, plugs, or twists, and snuff is
a finely ground or shredded tobacco. The survey data revealed that 6 percent of
men aged 18 and older use some form of spit tobacco, a figure that is
consistent with other recent studies on tobacco use. (The researchers limited
their data analysis to men since the vast majority of spit tobacco users are
men.) Of the men who use spit tobacco, 59 percent use the chewing tobacco form.
Almost half of those who use chewing tobacco also use one or more other types
showed that men who use chewing tobacco exclusively were four times more likely
than those who had never used tobacco to have one or more decayed or filled
root surface. Men who currently use only chewing tobacco also were more likely
than former tobacco users or those who currently used only snuff to have root
caries. On average, the men who used chewing tobacco exclusively had 3.84
decayed or filled root surfaces (out of 112 possible surfaces), more than any
other tobacco-use group and those who had never used tobacco.
also found a dose-dependent relationship between chewing tobacco use and the
likelihood of having root caries. The more packages of chew a man used each
week, the more likely he was to have a decayed or filled root surface.
Additionally, the more years a man had used chewing tobacco, the more likely he
was to have a decayed or filled root surface.
speculate that the high sugar content in chewing tobacco is one reason the
product is associated with an increased risk of dental caries on tooth roots
and crowns. Additionally, the way chewing tobacco is used might also help
promote tooth decay, the scientists say. A typical user holds a wad of chew in
his cheek for 30 minutes at a time and uses the product in this manner
throughout the day, exposing the teeth to the tobacco for several hours.
Moreover, both chew and snuff can contribute to gingival (gum) recession and
therefore make tooth roots more vulnerable to decay.
Chewing Tobacco Use and Dental Caries Among U.S. Men. Tomar S.L., Winn D.M.
JADA The Journal of the American Dental Association, November 1999, vol. 130,
no. 11,pp. 1601-1610