The relationship between smoking history, periodontal screening and recording (PSR) codes and overweight/obesity in a Mississippi dental school population

Oral Health Prev Dent. 2008;6(1):67-74.


Purpose: To examine the risks for being overweight (Ow) or obese (Ob) in subjects with elevated Periodontal Screening and Recording (PSRTM) Codes (> or =1) (with smoking as a modifier) in a population of dental school patients located within a region with a high incidence of Ow, Ob, diabetes mellitus (Db), and cardiovascular disease (CVD).

Materials and methods: 1098 patient files were studied and data were grouped by average PSR Codes, smoking history, and body mass index (BMI). Data were compared by factorial ANOVA, the Mann-Whitney U test, and chi-square analysis using PSRTM Code as an exposure for BMI, Db, or CVD, with smoking as the effect modifier. Data were then analysed by adjusted multivariate logistic regression to determine the risks for being Ow or Ob.

Results: Subjects with an average PSRTM Code > or =1 and a smoking history did not have a significantly increased risk for either Db or CVD. Non-smoking subjects with an average PSR Code =3 had a significantly higher risk for being Ow; those with an average PSR Code of 2-4 had a significantly higher risk for being Ob (p < 0.05). In contrast, only smokers with an average PSR Code =4 had a significant risk for being either Ow or Ob.

Conclusion: Our data suggest that smoking may not directly increase the risk factors for Db or CVD in subjects with an average PSRTM Code > 1 (confirming the 'Smoker's Paradox'), but could be an indirect risk factor for these diseases as a consequence of its effect on body weight.

MeSH terms

  • Analysis of Variance
  • Body Mass Index
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / epidemiology
  • Diabetes Complications / epidemiology
  • Diabetes Mellitus / epidemiology
  • Humans
  • Logistic Models
  • Mississippi / epidemiology
  • Overweight / complications*
  • Overweight / epidemiology
  • Periodontal Diseases / complications*
  • Periodontal Diseases / epidemiology
  • Periodontal Index
  • Risk Factors
  • Smoking* / epidemiology