Relationship between smoking and oral health: results of the 6th German Oral Health Study (DMS • 6)

Objectives: Smoking is the most significant individual health risk and the leading cause of premature mortality in industrialized nations. International studies demonstrate that smoking also affects oral health adversely. This study aimed to investigate the association between smoking and oral health using population-representative data for Germany.
Method and materials: The data source was the 6th German Oral Health Study (DMS • 6), conducted between 2021 and 2023. Data from a total of 2,135 individuals were included in the analyses. The distribution of sociodemographic characteristics (gender, age, education status), oral health behaviors (frequency of toothbrushing, interdental cleaning, and dental visits), and oral health-related parameters (self-assessed oral health, oral health-related quality of life, root caries, periodontitis, oral mucosal changes, and the number of teeth present) were reported separately for smoking status (daily smokers, former smokers, and never smoked). To estimate the associations between smoking status and oral health outcomes, mixed-effects regression models were employed.
Results: Daily smokers exhibited worse outcomes in both self-assessed oral health parameters and clinical oral health measures compared to individuals who had never smoked. These associations persisted even after adjusting for sociodemographic factors and oral health behaviors. Similar trends were observed for former smokers compared to never smokers.
Conclusion: Smoking is a well-established risk factor for poorer oral health. The findings of DMS • 6 confirm this association and are consistent with those of other national and international studies. Given the strong impact of smoking on oral health, comprehensive measures to curb smoking are essential. Evidence-based behavioral and structural preventive interventions exist to reduce tobacco consumption and promote smoking cessation. Dental offices can also contribute to tobacco prevention and cessation by providing brief counseling on the risks of smoking for both oral and general health.