Smoking status and oral health-related quality of life among adults in the United Kingdom

Objective: The primary objective of this study was to examine the association between smoking and oral health-related quality of life (OHRQoL) among dentate people aged 16 years and above in England.
Methods: Cross-sectional study, based on the Adult Dental Health Survey (ADHS) 2009. ADHS 2009 involved data collection from 11,380 face-to-face interviews and 6,469 dental examinations from England, Wales and Northern Ireland. This study focuses on the dentate sample from England, consisting of 5,622 individuals who underwent dental examination. OHRQoL was measured by two indices; Oral Health Impact Profile-14 (OHIP-14) and Oral Impacts on Daily Performance (OIDP). Unadjusted and adjusted zero-inflated regression models were used. Adjustment was sequentially done for socio-demographics, clinical oral conditions and self-reported general health.
Results: Prevalence of those who had never smoked, past smokers and current smokers were 45.6%, 35.3% and 19.2% respectively. Current smokers had considerably higher mean OHIP-14 and OIDP scores than non-smokers. There was a statistically significant association between smoking and OHRQoL (both OHIP-14 and OIDP) even in the fully adjusted models. Current smokers were more likely to report worse OHRQoL compared to those who had never smoked in both OHIP-14 and OIDP score. There was no statistically significant difference between past smokers with those who had never smoked in reporting OHIP-14 and OIDP. Among those reporting OHRQoL, there was a stepwise gradient risk of reporting no oral impact, where the probability was higher among those who had never smoked, followed by past smokers and current smokers both in OHIP-14 and OIDP.
Conclusion: Smoking was independently associated with worse OHRQoL, even after adjusting for a range of socio-demographic factors, clinical oral conditions and self-reported general health.