Masticatory Changes as a Result of Oral Disorders in
                    Smokers

The aim of this study is to verify the presence of oral changes in smokers and the impact of the changes on masticatory function compared with individuals who never smoked.

Methods

Forty-eight subjects were evaluated, split into two study groups (24 subjects each) of current tobacco users and individuals who have never smoked. The variables halitosis, presence of lesions suggestive of caries and periodontal problems, number of teeth, classification of malocclusions according to angle, standard grinding food, chewing pattern, and speed of chewing were evaluated.

Results

There was no statistically significant difference in tooth loss between the groups, but the smokers had more losses manifesting malocclusion. Most smokers had halitosis and lesions suggestive of caries and periodontal problems; the halitosis was associated with the latter variable. Masticatory speed was also reduced significantly in these individuals compared with the control group when associated with occlusal alterations, in addition to grinding food with the tongue. No difference was observed regarding the chewing pattern. The presence of halitosis and periodontal problems were more common in those who smoke more than 20 years.

Conclusion

There is an association between smoking and dental changes, which cause increased masticatory changes.

mastication; malocclusion; halitosis; smoking; stomatognathic system

Variable	Category	Group				p
		Nonsmokers		Smokers
		n	%	n	%
Halitosis	No	23	95.8	16	66.7	0.023^a a Significant at p ≤ 0.05.
Halitosis	Yes	1	4.2	8	33.3
Lesions suggestive of cavities	No	23	95.8	17	70.8	0.048^a a Significant at p ≤ 0.05.
Lesions suggestive of cavities	Yes	1	4.2	7	29.2
Periodontal problems	No	20	83.3	11	45.8	0.015^a a Significant at p ≤ 0.05.
Periodontal problems	Yes	4	16.7	13	54.2
Class left	Class I	19	79.2	16	66.7	0.039^a a Significant at p ≤ 0.05.
	Class III	-	-	4	16.7
	Class II/I	5	20.8	2	8.3
	Class II/II	-	-	2	8.3
Class right	Class I	17	70.8	12	50.0	0.006^a a Significant at p ≤ 0.05.
	Class III	-	-	5	20.8
	Class II/I	7	29.2	3	12.5
	Class II/II	-	-	4	16.7
Crushing food	Posterior teeth	22	91.7	13	54.2	0.011^a a Significant at p ≤ 0.05.
	Anterior teeth	2	8.3	7	29.2
	With tongue	-	-	4	16.7
Chewing speed	Adequate	16	66.7	13	54.2	0.048^a a Significant at p ≤ 0.05.
	Increased	5	20.8	1	4.2
	Decreased	3	12.5	10	41.7
Chewing pattern	Bilateral alternating	15	62.5	9	37.5	0.287 (NS)
	Unilateral right	5	20.8	6	25.0
	Unilateral left	1	4.2	4	16.7
	Simultaneous bilateral	3	12.5	5	20.8

		Halitosis
		No		Yes
Variable	Category	n	%	n	%	p
Presence of cavities	No	11	68.8	6	75.0	>0.999 (NS)
Presence of cavities	Yes	5	31.3	2	25.0
Periodontal problems	No	10	62.5	1	12.5	0.033^a a Significant at p ≤ 0.05.
Periodontal problems	Yes	6	37.5	7	87.5

		Total number of teeth
Crushing food	n	Average	Standard deviation	p
Posterior teeth	13	28.2	0.6	<0.001^a a Significant at p ≤ 0.01.
Anterior teeth	7	26.0	1.6
With tongue	4	17.3	2.9

		Time smoking					Cigarettes per day
		<20		≥29			<20		≥20
Variable	Category	n	%	n	%	p	n	%	n	%	p
Halitosis	No	11	100.0	5	38.5	0.002^a a Significant at p ≤ 0.01.	10	62.5	6	75	0.667 (NS)
Halitosis	Yes	-	-	8	61.5	0.002^a a Significant at p ≤ 0.01.	6	37.5	2	25	0.667 (NS)
Presence of caries	No	8	72.7	9	69.2	>0.999 (NS)	12	75	5	62.5	0.647 (NS)
Presence of caries	Yes	3	27.3	4	30.8	>0.999 (NS)	4	25	3	37.5	0.647 (NS)
Periodontal problems	No	8	72.7	3	23.1	0.03^b a Significant at p ≤ 0.01.	6	37.5	5	62.5	0.390 (NS)
Periodontal problems	Yes	3	27.3	10	76.9	0.03^b a Significant at p ≤ 0.01.	10	62.5	3	37.5	0.390 (NS)

		Class of right side
		Class I		Class III		Class II/I		Class II/II
Variable	Category	n	%	n	%	n	%	n	%	p
Chewing speed	Adequate	10	83.3	-	-	1	33.3	2	50.0	0.002^a a Significant at p ≤ 0.01 significant.
	Increased	-	-	-	-	1	33.3	-	-
	Decreased	2	16.7	5	100.0	1	33.3	2	50.0
Chewing pattern	Bilateral alternating	6	50.0	1	20.0	1	33.3	1	25.0	0.121 (NS)
	Unilateral right	2	16.7	1	20.0	1	33.3	2	50.0
	Unilateral left	4	33.3	-	-	-	-	-	-
	Simultaneous bilateral	-	-	3	60.0	1	33.3	1	25.0

		Class of left side
		Class I		Class III		Class II/I		Class II/II
Variable	Category	n	%	n	%	n	%	n	%	p
Chewing speed	Adequate	12	75.0	-	-	-	-	1	50	0.001^a a Significant at p ≤ 0.01.
	Increased	-	-	-	-	1	50	-	-
	Decreased	4	25.0	4	100.0	1	50	1	50
Chewing pattern	Bilateral alternating	6	37.5	1	25.0	1	50	1	50	0.011 ^b b Significant at p ≤ 0.05.
	Unilateral right	6	37.5	-	-	-	-	-	-
	Unilateral left	4	25.0	-	-	-	-	-	-
	Simultaneous bilateral	-	-	3	75.0	1	50	1	50

Fundação Otorrinolaringologia R. Teodoro Sampaio, 483, 05405-000 São Paulo/SP Brasil, Tel.: (55 11) 3068-9855, Fax: (55 11) 3079-6769 - São Paulo - SP - Brazil
E-mail: iaorl@iaorl.org

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[1] Address for correspondence Rafaela Soares Rech, Student, Department of Fonoaudiologia, Universidade Federal de Ciências da Saúde Porto Alegre, Rua Dinazaíde Ferreira de Andrade, 129, Caxias do Sul, 95057-340, Brazil (e-mail: rafasoaresrech@hotmail.com).