Lower use of dental services among long term cigarette smokers.

STUDY OBJECTIVE Given the advanced stage of most oral cancer cases at diagnosis, it is hypothesised that a significant proportion of higher risk adults do not visit a dentist annually. The study objectives were to assess whether long term smokers were less likely to visit the dentist. DESIGN Data from the 1998 Massachusetts Behavioral Risk Factor Surveillance System, a population-based, random digit dial telephone health survey, were used to evaluate whether adults at higher risk of oral cancer attributable to long term cigarette smoking were less likely to go to the dentist, controlling for socioeconomic, demographic, and health related characteristics. PATIENTS A representative sample of 2119 Massachusetts adults aged 35 and older. MAIN RESULTS Adults who were long term smokers were less likely than never smokers to have visited the dentist in the previous year (adjusted OR = 0.69, 95% confidence intervals (CI) = 0.48, 0.99). Moreover, adults who were at higher risk from both long term smoking and low fruit and vegetable consumption were even less likely to visit the dentist than adults with neither risk factor (adjusted OR = 0.39, 95% CI = 0.22, 0.68). Among long term smokers, the likelihood of a yearly examination decreased with increasing smoking duration and amount smoked per day. CONCLUSIONS These findings support the hypothesis that adults at higher risk of oral cancer attributable to long term cigarette smoking are less likely to have routine dental examinations, even controlling for socioeconomic and health related differences.