Do circumstances in early life contribute to tooth retention in middle age?

Self-reported smoking status and exhaled carbon monoxide: results from two population-based epidemiologic studies in the North of England

STUDY OBJECTIVES

To investigate the validity of self-reported responses to questions on current smoking in two cohorts based in Northern England.

DESIGN

A cross-sectional population-based study (the Newcastle Heart Project [NHP]) and a follow-up of the Newcastle Thousand Families birth cohort established in 1947.

PATIENTS OR PARTICIPANTS

Participants included 1,189 members of the NHP and 410 members of the Newcastle Thousand Families cohort who completed a health and lifestyle questionnaire, including questions on current smoking, and attended a clinical examination, including testing for exhaled carbon monoxide between April 1993 and December 1998.

RESULTS

The number of self-reporting smokers for whom very low (ie, < 6 ppm) exhaled carbon monoxide levels were recorded varied between 9% in the Newcastle Thousand Families Study and 26% among the members of the NHP who were of South Asian origin. Using a cutoff of 8 ppm, 80% of self-reported smokers were identified in both the Newcastle Thousand Families study and in the NHP European population, but only 60% were identified in the NHP South Asian population. In each population, < 7% of nonsmokers had exhaled carbon monoxide measurements of > 6 ppm, with nonsmoking men more likely to have higher levels than nonsmoking women. Among the nonsmokers, the levels of exhaled carbon monoxide did not vary with respect to the smoking status of a partner or socioeconomic status.

CONCLUSIONS

Using a cutoff value of 6 ppm would potentially miss a large number of smokers, although this may vary with ethnicity. Epidemiologic studies should continue to use biochemical markers to validate responses to smoking surveys. However, the use of exhaled carbon monoxide measurements as a method of assessing the validity of self-reported smoking status may require additional analyses of whether the cutoff level should vary for different populations.

Childhood circumstances, psychosocial factors and the social impact of adult oral health

OBJECTIVES

The aim of this study was to determine whether childhood familial conditions are associated with the social impact of adult oral health and to investigate the role of psychosocial attributes as potential mechanisms by which risk might be conveyed from childhood to adulthood.

METHODS

Using a cross-sectional design, self-report data were obtained from a representative sample of adults in Australia with a telephonic interview and a self-completed questionnaire. The dependent variable was the sum of impacts on the short-form Oral Health Impact Profile (OHIP-14). Childhood familial conditions included socioeconomic position assessed by paternal occupation group, family structure and quality of rearing. Current adult sense of control, perceived stress and satisfaction with life were assessed with standard scales and social support was evaluated with four items.

RESULTS

Data were obtained for 3678 dentate adults aged 18-91 years. In bivariate analysis controlling for sex, age and household income in adulthood, parenting style was significantly associated with OHIP-14 scores (anova, P < 0.001). Adults who were reared supportively had more favourable scores on all four current psychosocial attributes (anova, P < 0.001). All four psychosocial attributes were associated with summed OHIP scores in the expected directions (anova, P < 0.001). In the multiple regression, parental rearing style was significantly associated with social impact after adjusting for sex, age and household income in adulthood, but was no longer significant in the presence of the psychosocial factors.

CONCLUSION

The importance of parental rearing to adult oral health may be mediated through the quality and nature of psychosocial attributes.

Tooth loss and Helicobacter pylori seropositivity: the Newcastle Thousand Families Cohort Study at age 49-51 years

BACKGROUND

Helicobacter pylori, one of the commonest chronic bacterial infections of humankind, is an important risk factor for gastric carcinoma. It has also been suggested to be present in dental plaque. This study investigated the potential link between the number of teeth lost and H. pylori seropositivity at age 50 years.

METHODS

H. pylori seropositivity at age 50 years was investigated among 334 individuals born in Newcastle upon Tyne, United Kingdom, in May and June 1947 and related to the number of teeth lost, after adjusting for socioeconomic status.

RESULTS

The unadjusted risk of being seropositive for H. pylori increased with increasing number of teeth lost (odds ratio per tooth 1.03, 95% confidence interval 1.01-1.06, p = .019). However, after adjustment for socioeconomic status at birth and at age 50 years, the relationship was no longer significant (p = .36).

CONCLUSIONS

Our results, obtained using prospectively collected data, suggest that any relationship between poor oral health and seropositivity to H. pylori may be due to both tooth loss and H. pylori colonization being associated with socioeconomic status and related factors.