Considering the harmful effects of smoking on oral and dental health, our aim was to investigate the oral and dental health status of people in the city of Bandare-Kong, Iran, and its relationship to smoking. This cross-sectional population-based study used baseline data from the Bandare-Kong Cohort Study. A total of 4063 participants aged 35-70 years were included in this study. Using Stata17 software, negative binomial regression was employed to identify factors related to the decayed, missing, and filled teeth (DMFT) index. The association between smoking status and DMFT was assessed by the adjusted incidence rate ratio (IRR). Of the 4063 participants, 987 (24.29%) used cigarettes, hookahs, or both. The mean +/- standard error (SE) DMFT index in all subjects was 11.08 +/- 0.15; it was 14.17 +/- 0.53 for cigarette smokers and 12.39 +/- 0.37 for hookah users (p < 0.001). After adjusting for other variables, the rate of DMFT for cigarette smokers was 0.33 (IRR: 1.33; 95% confidence interval [CI]: 1.22, 1.44), which was higher than for those who did not use cigarettes. The rate of DMFT for those who used cigarettes, hookahs, or both was 0.11 (IRR: 1.11; 95% CI: 1.05, 1.18), which was also higher than for those who did not smoke. Cigarette smoking is a risk factor for oral health complaints. Although the rate of DMFT was increased in hookah smokers, it was not a predictor of dental problems. However, we suggest that hookah use be included in educational policies to control oral and dental diseases.
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