Table 1 Characteristics of the cross-sectional studies included in this review (n = 14 studies)

Author (Country)

Subjects characteristics

Smoking status assessment

Outcome assessment

Main findings

Albandar et al. 2010 (EUA)

705 patients (age range of 21 to 91 years; mean 56.9 ± 16.4 years) from the Baltimore Longitudinal Study

Structured interview

Infrequent / non-smokers: quit smoking cigarettes after smoking less than 10 years / no history of smoking

Current cigarettes smokers: smoke daily

Former heavy smokers: smoked cigarettes daily for 10+ years and quit

Clinical examination.

Outcome: Number of missing teeth

Mean (S.E.) number of missing teeth:

Non-smokers (n =  475): 2.8 (0.28)

Current smokers (n = 36): 5.1 (0.78)

Former heavy smokers (n = 167): 3.9 (0.43)

Arora et al. 2010 (Australia)

99,663 (45 years and older) participants from the 45 and Older Study who responded the question about tooth loss

Self-reported questionnaire

Never smokers: not defined by the authors

Current smokers: heavy smokers (> 20 cigarettes per day) and those who smoke < 20 cigarettes per day.

Former smokers: subjects were divided in categories of years since smoking cessation (<  10, 10–19, 20–29, 30 or more)

Self-reported questionnaire.

Outcome: Number (%) of edentulous subjects

Number (%) of edentulous subjects

Never smokers (n = 56,203): 4898 (8.7%)

Current smokers (n = 7230): 939 (13%)

Former smokers (n = 32,368): 3706 (11,4%)

Cunningham et al. 2016 (EUA)

439,637 respondents (18 to 98 years) from the 2021 Behavioral Risk Factor Surveillance System

Telephone interview

Never smokers: smoked < 100 cigarettes during their lifetime

Current cigarette smokers: smoked > 100 cigarettes during their life-time and reported smoking “every day” or “some days” at the time of the interview.

Former smokes: reported ever smoking > 100 cigarettes but reported smoking “not at all” at the interview.

Telephone interview

Question: “How many of your permanent teeth have been removed because of tooth decay or gum disease?”

Outcome: number of teeth lost (in categories: none; 1 to 5; >  6 but not all; all)

Number (%) of edentulous subjects (all teeth lost)

Never smokers (n = 239,920): 67,418 (28.1%)

Current smokers (n = 72,210): 23,107 (32.0%)

Former smokers (n = 127,507): 50,875 (39.9%)

Hanioka et al. 2007 (Japan)

3999 (> 40 years) from Survey of Dental Disease (SDD) and National Nutrition Survey (NSS)

Dietitian-applied questionnaire

Non-smoker: never smoked or smoked no more than 100 cigarettes

Current smoker: smokes currently and has smoked more than 100 cigarettes

Former smoker: has previously smoked more than 100, but does not currently smoke

Clinical examination

Outcome: number of subjects with less than 19 teeth

Number (%) of subjects having less than 19 teeth

Non-smoker (n = 2502): 928 (37.1%)

Current smoker (n = 922): 344 (37.3%)

Former smoker (n = 575): 219 (38.1%)

Mai et al. 2013 (EUA)

1106 postmenopausal (mean 66.9 ± 7.1 years) women enrolled in the Buffalo Osteoporosis and Oral Bone Loss (OsteoPerio) Study

Self-administered questionnaire

Never smokers: not defined by the authors

Current smokers: light smokers (first tertile,< eight pack-years); Moderate smokers (second tertile, eight to 25 pack-years); Heavy smokers (third tertile, ≥ 26 pack-years).

Former smokers: not defined by the authors

Clinical examination

Outcome: number of subjects with any tooth loss

Number (%) of subjects with any tooth loss

Never smokers (n = 593): 476 (80,2%)

Current smokers (n = 40): 32 (80%)

Former smokers (n = 473): 392 (82,8%)

Mundt et al. 2007 (Germany)

4310 individuals

(20 to 79 years) from the Study of Health in Pomerania (SHIP-0)

Interview

Always nonsmoker: not defined by the authors

Current smoker: maximum quantity of cigarettes smoked per day over a year was classified as < 10 cigarettes/ day, 10 to 19 cigarettes/day, and > 20 cigarettes/day.

Former smoker: not defined by the authors

Clinical examination

Outcome: few teeth in relation to their age. The 15% of participants with

the highest number of missing teeth in each 5-year age group were considered as cases.

Percentage of the case group (n = 355):

Never smokers: 19.7%

Current smokers (n = 196):

< 10: 11.3%

10–19: 22.3%

> 20: 21.7%

Former smokers (n = 89):

< 10 (n = 34): 9.6%

10–19 (n = 20): 5.6%

> 20 (n = 35): 9.9%

Mussachio et al. 2007 (Italy)

3054 subjects > 65 years (mean age: 76.8 ± 8.7) from Porgetoo Veneto Anziani (Pro.V.A.) Study

Home interview

Never smoker: not defined by the authors

Current smoker: not defined by the authors

Former smoker: not defined by the authors

Former and current were subdivided by number of cigarettes/day in light, mild, and heavy smokers (< 10; 10–20; >  20 cigarettes/day)

Clinical examination

Outcome: Prevalence of edentulism and number of remaining teeth, applied as dichotomous (none versus at least 1) or categorical (0; 1–7; 8–19; >  20).

Number (%) of edentulous subjects

Never (n = 1900): 1144 (60.2%)

Current (n = 260): 24 (9.4%)

Former (n = 895): 273 (30.5%)

Ojima et al. 2007 (Japan)

1314 (20 to 39 years) subjects from the Nation Nutrition Survey (NNS) and the Survey of Dental Diseases (SDD)

Questionnaire (interview)

Nonsmoker: experimental smoker or has never smoked cigarettes

Current smoker: currently smokes cigarettes daily or occasionally

Former smoker: has smoked cigarettes at some point in life, but currently does not smoke.

Clinical examination

Outcome: Prevalence of participants with1+ tooth loss

Number (%) of subjects with 1+ tooth loss

Overall

Nonsmoker (n = 847): 236 (27.9%)

Current smoker (n = 389): 158 (40.6%)

Former smoker (n = 78): 18 (23.1%)

Randolph et al. 2001 (EUA)

3050 noninstitutionalized Mexican Americans age 65 to 99 from the Hispanic Established Population for the Epidemioligical Study of the Eldery survey.

Interview

Nonsmokers: never smoked or reported having smoked fewer than 100 cigarettes in their lifetime

Current smokers: currently smoking

Former smokers: had smoked more than 100 cigarettes in their lifetime but were not currently smoking

Questionnaire (self-reported)

Question “How many of your own teeth do you still have?”

Categories: all, about three-quarters, about half, about one-quarter, none

Outcome: Prevalence of tooth loss.

Number (%) of edentulous subjects (0 teeth)

Nonsmoker (n = 1707): 397 (23,2%)

Current smoker (n = 369): 131 (35,5%%)

Former smoker (n = 826): 267 (32,3%)

Number (%) of subjects with tooth loss (1+)

Nonsmokers (n = 1707): 1311 (76,8%)

Current (n = 369): 240 (65%)

Former (n = 868): 598 (68,9%)

Simila et al. 2016 (Filand)

5540 subjects from Northern Finland Birth Cohort Study 1996. The study used data from the 46-year follow-up (carried out in 2012–2014).

Mailed questionnaire

Never smokers: had smoked daily for less than one year in their lifetime and were not smokers at the time of the follow-up

Current smokers: reported smoking at least occasionally.

Former smokers: had smoked daily

for at least one year, but had quit smoking and were not smokers at the time of the study

Self-reported Questionnaire

Number (%) of subjects in the following categories of number of teeth: 0–27 or 28–32

Number (%) of subjects in each category of number of teeth:

Never smoker (n = 3062)

0–27: 933 (35%)

28–32: 1763 (65%)

Current smoker (n = 1757)

0–27: 742 (49%)

28–32: 758 (51%)

Former smoker (n = 1525)

0–27: 559 (42%)

28–32: 785 (58%)

Torrungruang et al. 2012 (Thailand)

1463 individuals (50–73 years old) from the cross-sectional data of senior employess and retired personnel of the Electricity Generating Authority of Thailand.

Self-reported questionnaire

Non-smokers: had never smoked or had smoked fewer than 100 cigarettes in their lifetime.

Current smokers: currently smoked at the time of examination (smoked at least 100 cigarettes in their lifetime)

Former smokers: had quit smoking prior to the time of examination (smoked at least 100 cigarettes in their lifetime)

Clinical examination

Outcome: number of remaining teeth

Number of remaining teeth:

Non-smoker (n = 477)

Maxillary anterior teeth: 2.8 ± 0.03

Maxillary posterior teeth: 3.2 ± 0.05

Mandibular anterior teeth: 2.9 ± 0.02

Mandibular posterior teeth: 2.9 ± 0.05

Current smoker (n = 272)

Maxillary anterior teeth: 2.6 ± 0.05

Maxillary posterior teeth: 2.9 ± 0.07

Mandibular anterior teeth: 2.8 ± 0.03

Mandibular posterior teeth: 2.8 ± 0.07

Former smoker (n = 714)

Maxillary anterior teeth: 2.7 ± 0.03

Maxillary posterior teeth: 2.9 ± 0.04

Mandibular anterior teeth: 2.9 ± 0.02

Mandibular posterior teeth: 2.8 ± 0.04

Yanagisawa et al. 2009 (Japan)

547 men (55–75 years) from JPHC Study Cohort I

Self-reported questionnaire administered in 1990, 1995, 2000, and 2005

Never smokers: answered “Not smoking” in both 1990 and 2005 and answered “Not smoking” in 1995 and 2000 or had a missing value in 1995 and 2000.

Current smokers: answered “Currently smoking” in 2005, regardless of answers in 1990, 1995 and 2000.

Former smokers: answered “Quit smoking” in 2005 or those who answered “Not smoking” in 2005 but “Currently smoking” or “Quit smoking” in 1990.

clinical examination

Outcome: having more than 8 missing teeth, mean number of teeth present

% of subjects having more than 8 missing teeth

Never smokers (n = 161): 28.6% (n = 46)

Current smokers (n = 135): 39.3% (n = 53)

Former smokers (n = 251): 39,0% (n = 98)

Mean number of teeth present (SE):

Never smokers: 22.1 (0.6)

Current smokers: 19.0 (0.7)

Former smokers: 18.8 (0.5)

Yanagisawa et al. 2010 (Japan)

1088 men (40–75 years of age) resident in Yokote city, Akita prefecture

Self-reported questionnaire

Never smoker: not defined by the authors

Current smokers: not defined by the authors

Former smokers: not defined by the authors

The number of cigarettes per day was calculated for current smokers and former smokers, and the smoking-cessation years were calculated for former smokers

clinical examination

Outcome: having more than 8 missing teeth, mean number of teeth present

% of subjects having more than 8 missing teeth:

Never smoked (n = 350): 29.4% (n = 87)

Current smokers (n = 317): 26.2% (n = 83)

Former smokers (n = 421): 26.8% (n = 113)

Mean number of teeth present (SE):

Never smoked: 22.0 (0.5)

Current smokers: 21.4 (0.5)

Former smokers: 21.4 (0.4)

Yoshida et al. 2001 (Japan)

2015 employees (males, 20–59 years) of a large petroleum chemical plant located in Osaka Prefecture

Self-reported questionnaire

Non-smoking: not defined by the authors

Quit-smoking: not defined by the authors

Smoking: not defined by the authors

Tooth loss: clinical examination

OR (95% CI) for tooth loss

Non-smoking: 1 (reference)

Quit-smoking: 1.27 (0.89–1.81)

Smoking: 1.54 (1.20–1.96)

* The number of subjects in each group was not informed