RESULTS

Table 1 presents the general characteristics of the study population. Included is the presence or absence of periodontal disease according to sex. Among the participants (5,715 men and 7,836 women), 2,206 men (38.6%) and 2,054 women (26.2%) exhibited periodontal disease. The relationship between vaping or smoking each cigarette and periodontal disease was statistically significant. Additionally, differences in demographic, socioeconomic, and health‐related characteristics were also generally significant.

Table 2 shows the association of cigarette smoking and electronic cigarette vaping with periodontal disease. Compared to people who never used cigarettes, people who use electronic or conventional cigarettes demonstrated a higher risk of periodontal diseases. These results were especially evident in men (men, electronic cigarette: OR = 2.41, 95% CI = 1.57 to 3.72, conventional cigarette: OR = 2.22, 95% CI = 1.80 to 2.73). As age increased, both men and women demonstrated an increased risk of periodontal disease. This was generally significant, but not statistically significant from the age of 50 and older. People living in urban areas were less likely to suffer periodontal disease than people living in rural areas. Dental related variables were also related to periodontal disease. In self‐reported oral health status, people who reported high levels of oral health demonstrated a lower risk of periodontal disease. Furthermore, when individuals reported dental caries or toothache, more periodontal disease was noted for both sexes. These results were significant for both men and women. Finally, while individuals who reported dental damage also exhibited more instances of periodontal disease, the difference did not reach statistical significance.

Table 3 shows results of subgroup analyses between cigarette usage and periodontal disease, focusing on self‐reported oral health status, education level, region, dental caries, toothache within the past year, and the experience of dental damage. For self‐reported oral health status, electronic cigarette vapers or conventional cigarettes smokers demonstrated a higher likelihood of having periodontal disease than those who never used. Furthermore, the risk of periodontal disease in cigarette users increased even in individuals who self‐reported high levels of oral health. In other words, self‐reported oral health status did not have a large effect in predicting periodontal disease. Other dental diseases, such as dental caries, toothache, and dental damage, were associated with an increased likelihood of periodontal disease in electronic cigarette vapers or conventional cigarette smoker. However, the risk was also high for those who vaping or smoking cigarette who did not report dental caries, toothache, and/or dental damage. Vapers and smokers were also more likely to have periodontal disease, regardless of whether they lived in an urban or rural area, when compared to individuals who never use cigarettes. Finally, vaping or smoking individuals were more likely to suffer from periodontal disease, regardless of education level, when compared to non‐users.