Non-Cochrane · aetiology · PM41772555
Environmental tobacco smoke exposure and periodontitis in non-smokers: a systematic review and meta-analysis.
Ye Fangfei, Jiang Qingkun, Zhang Siying · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-08025-y
Findings
Population Non-smoking adults (18 years or older)
18 findings
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Region: US | OR 1.41 [1.17, 1.70] GRADE not reported 6 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Sample size >= 1000 | OR 1.46 [1.19, 1.79] GRADE not reported 8 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis ETS diagnosis: self-reported | OR 1.19 [1.04, 1.37] GRADE not reported 5 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Gender: women | OR 0.92 [0.59, 1.43] GRADE not reported 2 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Adjusted for diabetes: no | OR 1.49 [1.22, 1.83] GRADE not reported 7 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Region: Japan | OR 1.32 [0.93, 1.87] GRADE not reported 4 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis | OR 1.47 [1.22, 1.76] GRADE not reported 11 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Adjusted for oral hygiene management: yes | OR 1.36 [1.04, 1.80] GRADE not reported 5 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Sample size < 1000 | OR 1.70 [0.92, 3.13] GRADE not reported 3 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Study quality: moderate | OR 1.54 [0.77, 3.07] GRADE not reported 2 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Gender: both sexes | OR 1.60 [1.29, 1.97] GRADE not reported 9 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Tooth loss | OR 1.03 [0.80, 1.31] GRADE not reported 3 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Adjusted for oral hygiene management: no | OR 1.60 [1.22, 2.10] GRADE not reported 6 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Adjusted for diabetes: yes | OR 1.37 [0.96, 1.94] GRADE not reported 4 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis ETS diagnosis: biological marker | OR 1.85 [1.42, 2.39] GRADE not reported 6 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Publication year >= 2015 | OR 1.31 [0.96, 1.78] GRADE not reported 4 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Study quality: high | OR 1.47 [1.20, 1.81] GRADE not reported 9 studies |
| Exposure to environmental tobacco smoke (secondhand smoke) | No exposure to environmental tobacco smoke | Periodontitis Publication year < 2015 | OR 1.59 [1.28, 1.97] GRADE not reported 7 studies |
Included primary studies 14
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Akinkugbe 2016 Environmental tobacco smoke exposure and periodontitis prevalence among nonsmokers in the hispanic community Health Study/Study of Latinos. PMID:27978596 | 2017 | this review only | Periodontitis | not extracted yet |
| Arbes 2001 Environmental tobacco smoke and periodontal disease in the United States. PMID:11211634 | 2001 | this review only | Periodontitis | not extracted yet |
| Arora 2010 Cigarette smoking and tooth loss in a cohort of older Australians: the 45 and up study. PMID:20884927 | 2010 | this review only | Tooth loss | not extracted yet |
| Liu 2024 Interaction Between Tobacco Smoke Exposure and Zinc Intake and Its Effect on Periodontitis: Evidence From NHANES. PMID:38688800 | 2024 | this review only | Periodontitis | not extracted yet |
| Nishida 2008 Association between involuntary smoking and salivary markers related to periodontitis: a 2-year longitudinal study. PMID:19053911 | 2008 | this review only | Periodontitis | not extracted yet |
| Sanders 2011 Secondhand smoke and periodontal disease: atherosclerosis risk in communities study. PMID:21551377 | 2011 | this review only | Periodontitis | not extracted yet |
| Sanders 2013 State cigarette excise tax, secondhand smoke exposure, and periodontitis in US nonsmokers. PMID:22994169 | 2013 | this review only | Periodontitis | not extracted yet |
| Sutton 2012 Environmental tobacco smoke and periodontitis in U.S. non-smokers. PMID:22947841 | 2012 | this review only | Periodontitis | not extracted yet |
| Sutton 2017 Environmental Tobacco Smoke and Periodontitis in United States Non-Smokers, 2009 to 2012. PMID:28168902 | 2017 | this review only | Periodontitis | not extracted yet |
| Tanaka 2005 Active and passive smoking and tooth loss in Japanese women: baseline data from the osaka maternal and child health study. PMID:15840549 | 2005 | this review only | Tooth loss | not extracted yet |
| Tanaka 2013 Active and passive smoking and prevalence of periodontal disease in young Japanese women. PMID:23317345 | 2013 | this review only | Periodontitis | not extracted yet |
| Ueno 2015 The association of active and secondhand smoking with oral health in adults: Japan public health center-based study. PMID:26225132 | 2015 | this review only | Periodontitis | not extracted yet |
| Umemori 2020 Does second-hand smoke associate with tooth loss among older Japanese? JAGES cross-sectional study. PMID:32585047 | 2020 | this review only | Tooth loss | not extracted yet |
| Yamamoto 2005 Association between passive and active smoking evaluated by salivary cotinine and periodontitis. PMID:16174266 | 2005 | this review only | Periodontitis | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Non-smoking adults aged 18 years or older | Non-smoking adults (n=115,925 participants across 14 studies) |
| Intervention | Exposure to environmental tobacco smoke (indoor or ambient air) | ETS exposure (self-reported n=8 studies; serum cotinine n=4; salivary cotinine n=2) |
| Comparison | Unexposed adults | Unexposed non-smokers |
| Outcomes | Diagnosis of periodontitis or occurrence of tooth loss | Periodontitis (n=11 studies); tooth loss (n=3 studies) |
| Study designs | Observational studies reporting OR or RR with 95% CI; English language | 13 cross-sectional studies and 1 cohort study |
| Timing | Not specified | Not specified |