Independent and combined effects of smoking, drinking and depression on periodontal disease

Abstract

Abstract Background Periodontitis is a complex chronic inflammatory disease that is particularly associated with health-related behaviors such as smoking, excessive drinking and depression. This research aimed to investigate the interaction between these lifestyles factors on periodontitis risk. Methods This study included participants from the National Health and Nutrition Examination Survey (2009–2014) having completed oral health-periodontal examination, Smoking-Cigarette Use Questionnaire, Alcohol Use Questionnaire, and Patient Health Questionnaire. Participants were then divided into three different subgroups: smoking-depression group, drinking-depression group, and smoking-drinking group. The logistic regression combined with interaction models were used to analyze the independent and combined effects of smoking, drinking and depression on periodontitis risk. Results Results showed that participants with both smoking behavior and depression had 58% higher risk of developing periodontitis than those without, particularly in elderly men. A dose-dependent J-shape relationship was first identified in the association between drinking-depression interaction and periodontitis risk. When living with depression, heavy drinkers (> 56 g/d) had an increased risk for developing periodontitis, whereas low drinkers (< 14 g/d) had a decreased risk. Conclusion These results supported the fact that there were interactive effects between smoking, drinking and depression on periodontitis risk and policies aimed at healthy behaviours and mental health may be beneficial for our oral health.