Risk variables in the association between frequency of alcohol consumption and periodontitis Lages EJP, Costa FO, Lages EMB, Cota LOM, Cortelli SC, Nobre-Franco GC, Cyrino RM, Cortelli JR. Risk variables in the association between frequency of alcohol consumption and periodontitis. J Clin Periodontol 2012; 39: 115–122. doi: 10.1111/j.1600-051X.2011.01809.x. Abstract Objective: Investigate the association between the frequency of alcohol consump- tion and periodontitis. Moreover, evaluate the influence of biological, behaviour- al, and social risk variables in this association. Methods: Sample was comprised by 542 subjects of both genders, 35–55 years of age, who underwent a complete periodontal examination, and was divided into four groups according to the frequency of alcohol use, based on alcohol use dis- orders identification test (AUDIT) and Cut-down, Annoyed, Guilty, Eye-opener (CAGE) instruments: (1) no or occasional alcohol use (NA), (2) moderate alcohol use (MA), (3) intense alcohol use (IA) and (4) alcohol dependence (DA). Associa- tions between the occurrence of periodontitis and potential risk variables were analysed by univariate and multivariate logistic regression stratified by smoking status when appropriate. Results: The prevalence of periodontitis in NA, MA, IA and DA groups were 17.2%, 24.0%, 29.6% and 53%, respectively. Alcohol odds ratio (OR) estimates significantly increased with an increase in consumption frequency (DA>IA>- MA>NA) and were approximately two times higher in smokers (OR = 3.43 to 7.91) compared to non-smokers (OR = 1.22 to 3.02). Conclusion: Occurrence of periodontitis among alcohol users were high and the frequency of alcohol consumption increased the odds of periodontitis incremen- tally mainly in smokers. Euge ˆnio J. P. Lages 1 , Fernando O. Costa 1 , Elizabeth M. B. Lages 1 , Luı ´s O. M. Cota 1 , Sheila C. Cortelli 2 , Gilson C. Nobre-Franco 2 , Renata M. Cyrino 1 and Jose ´ R. Cortelli 2 1 Department of Periodontology, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Brazil; 2 Department of Dentistry, Periodontics Research Division, University of Taubate ´, Taubate ´, Sa ˜o Paulo, Brazil Key words: alcohol; periodontitis; prevalence; risk factors Accepted for publication 12 September 2011 It is well known that the complex interaction between the microflora of the oral cavity and the host organ- ism is an important issue in the understanding of causal associa- tions between systemic conditions and periodontal diseases suscepti- bility. Classically, diabetes, smok- ing, immunosuppression, hormonal changes, stress, medication and alco- holism are recognized factors that can alter the pathogenesis, the expression and the clinical manage- ment of periodontal diseases (Alban- dar 2002, Costa et al. 2009, Sarfati et al. 2010). According to Tezal et al. (2001), the consumption of alcoholic bever- ages was associated with the severity of periodontal disease independently of oral hygiene levels. By contrast, other studies suggested that the sever- ity of periodontitis was associated with behavioural risk factors, although a poor oral hygiene level was a common finding among alcohol users (Nova- cek et al. 1995, Amaral et al. 2009). The abusive alcohol use is consid- ered a serious global problem that favours a life style that can bring social, economic and health prob- lems (Casswell 2011). A study com- prising 8,589 subjects in Brazil reported that 68.7% of the sample was composed by alcohol users and 11.2% were considered alcohol dependents (Amaral et al. 2008). Conflict of interest and source of funding statement The authors declare that they have no conflict of interest. This study was supported by grants from the Research Support Foundation of Min- as Gerais (FAPEMIG-00207-11) and National Research Council (CNPq/ Brazil – 474235/2010-6) © 2011 John Wiley & Sons A/S 115 J Clin Periodontol 2012; 39: 115–122 doi: 10.1111/j.1600-051X.2011.01809.x