Oral disease burden at 40: substance use and behaviors using data from 1982 Pelotas Cohort

To investigate whether behavioral factors and substance use influence the oral disease burden at 40 years of age in a population-based birth cohort. This longitudinal study drew data from the 1982 Pelotas Birth Cohort, Brazil. At age 40, 453 participants were examined. Oral disease burden was modeled as a latent construct including decayed teeth, periodontal probing depth ≥4 mm, clinical attachment level ≥3 mm, and bleeding on probing. Exposures included prior sugar intake, alcohol, tobacco, and cannabis use. Models were adjusted for sex, family income at birth, common mental disorders, dental visits, and dental flossing. Associations were estimated using structural equation modeling. Higher sugar intake (SC = 0.269, 95% CI: 0.168–0.370) and tobacco use (SC = 0.432, 95% CI: 0.336–0.527) were associated with an increased oral disease burden at age 40. Dental flossing (SC = -0.450, 95% CI: -0.605 to -0.294) and regular dental visits (SC = -0.311, 95% CI: -0.426 to -0.197) were protective. Cannabis use showed an apparent protective effect (SC = -0.259, 95% CI: -0.389 to -0.129), likely due to correlation with tobacco. Alcohol use was not associated with the outcome. Behavioral factors and substance use at age 30 significantly influenced oral disease burden at age 40. The long-term impact of behavioral trajectories on oral health is underscored by these findings. Clinical and policy interventions prioritizing the stabilization of healthy habits during early adulthood are essential to mitigate the cumulative burden of chronic oral diseases later in life.