Data visualization of the relationship between smoking and periodontal site‐specific effects across the lifespan in the US adult population

Data visualization techniques were used to ascertain (1) site‐specific effects of cigarette smoking on the periodontium compared to never‐smokers; (2) patterns of site‐specific effects by age among current and never‐smokers using contour maps. Data from 10,713 dentate participants aged ≥30 years in NHANES 2009‐2014 were used. Pocket depth (PD) and clinical attachment level (CAL) for six sites/tooth were ascertained by smoking status and plotted using contour maps to identify new patterns. In the overall sample, 19% (n= 2015) were current smokers and 56% (n= 6013) were never‐smokers. Contour maps of the overall sample showed teeth/sites most affected with mean PD > 2.1 mm were molars (2,3,15,18,19,30,31) in mesio‐lingual (ML) and disto‐lingual (DL) sites. Most affected sites for current smokers were interproximal sites of most posterior teeth. Among never‐smokers, fewer teeth/sites were affected with PD > 2.1 mm, whereas among smokers, number of affected teeth/sites increased with age. Overall, teeth/sites most affected with mean CAL≥2.1 mm were noted in 2,3(ML), 3(DL), 14(DF, DL), 15(MF, ML), 18(ML), 19(DL, ML), and 30‐31(ML, DL) with upper anterior teeth least affected. Among current smokers, several teeth/sites were affected (CAL≥2.1 mm): 2,3(all six sites), 4(ML, DL), 9(ML), 11‐21(DL), 13‐18(DF, ML, MIL, DL), 19‐20(DF, ML, MIL), 14‐18(MIF), 21(MIF, ML, DL), 22(MF), 23‐27(MIL), 24‐26(MIL, MF, DF in 26), 27(MF), 28(MF, ML, DL), 29‐31(all 6 sites except MIF 30,31). As age increased, more teeth/sites were affected among smokers and by the 5th decade nearly all teeth/sites had CAL≥2.0 mm. Contour mapping identifies patterns and dramatically visualizes the substantial periodontal site‐specific differences. Current smokers had more affected teeth and/or periodontal sites with a different contour pattern than never‐smokers.