CHICAGO - More than half of the cases of severe gum disease in U.S. adults may be linked to cigarette smoking, according to government researchers who suggest that a main cause of tooth loss could be prevented.

It has long been known that smoking can help cause gum disease, but this is the first national study to show how widespread the problem is, said Dr. Scott Tomar, a researcher with the federal Centers for Disease Control and Prevention. Current smokers were about four times more likely than people who never smoked to have periodontitis, but ex-smokers who had abstained for 11 years faced no increased risk, according to Tomar, whose findings were published in the May issue of the Journal of Periodontology. Overall, 52.8 percent of periodontitis in the study was attributed to current and former smoking. Jack Caton, president of the American Academy of Periodontology, called the numbers "staggering" and said the study should "compel even more dental care providers to get involved in tobacco cessation efforts." Periodontitis, advanced gum disease that destroys the tissue and bone surrounding the teeth, is generally caused by bacteria contained in plaque buildup. Researchers believe smoking causes damage that makes the gums more vulnerable to bacterial infection. Tobacco can suppress the body's immune system, impeding its ability to fight infection. It also reduces blood flow to the gums, depriving them of oxygen and nutrients that allow gums to stay healthy, Tomar said. "One of the functions of gums is to prevent underlying bone from being destroyed. If you reduce the ability of cells to repair, you will over time lose support for the tooth" and tooth loss may result, said Tomar, who studied government health data on 12,329 people. Fifty-five percent of the study subjects with periodontitis were current smokers and 21.8 percent were former smokers. Current smokers of more than 1½ packs of cigarettes a day were nearly six times more likely than nonsmokers to have periodontitis. Those who smoked less than half a pack daily were almost three times more likely to have the disease. Smoking and periodontitis were both more common in black men and low-income adults – findings in line with U.S. Surgeon General David Satcher's report last week on a "silent epidemic" of oral disease in minorities and low-income Americans. Tobacco use was one of the factors blamed for the problem in the report. Deborah Winn, a specialist in dental disease and oral cancer at the National Cancer Institute, called Tomar's findings "complementary" with Satcher's report. She said the study does a good job of outlining yet another reason to quit smoking. "Tobacco prevention and cessation will be critical in reducing periodontal disease," she said.

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