Document Type : Research articles


1 Research Center for Caries Prevention, Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran

2 Dental Carries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran


Background: Smoking among adolescents is a universal matter. Several findings suggest that smoking can lead to impaired oral health.
Objectives: The current study was undertaken to evaluate the normative and subjective oral health status of 13-year-old smokers and nonsmokers in Qazvin, Iran.
Methods: This cross-sectional study was carried out on a multistage cluster sample of 519 adolescents in Qazvin, Iran, in 2015. A self-administered questionnaire comprising three parts pertaining to oral health behavior (frequency of tooth brushing and dental visits, snacking, and the use of fluoride toothpaste) was administered. The socio-demographic and subjective characteristics of the study participants, including self-reported smoking, gum bleeding, and halitosis, were determined. The simplified oral hygiene index (OHI-S) was used to evaluate their clinical condition. Binary logistic regression analysis was performed separately for the smokers and nonsmokers. Correlation, kappa agreement, sensitivity, and specificity between the subjective and normative measurements were calculated.
Results: 26% of the male adolescents and 15% of the female adolescents claimed that they smoked cigarettes or used water pipe. Infrequent dental visits (≥ 2 years) [odds ratio (OR) = 3.0, 95% confidence interval (CI): 1.1–7.8, P = 0.030), frequent snacking (≥ 3 times between meals) (OR = 3.5, 95% CI: 1.5 - 8.4, P = 0.001), and halitosis were significantly associated with poor self-perceived oral health. Poor oral hygiene index, which represents normative measurement, was similar among smokers and nonsmokers in this age group. Sensitivity and specificity were reported to be 81% and 85% for smokers and 30% and 21% for nonsmokers, respectively.
Conclusions: Normative and subjective oral health evaluations were not in the same line among smoking and nonsmoking adolescents. Professional screening is necessary to evaluate oral health in this age group, especially in countries with developing oral health care systems.