Objective: Little is known of the association between secondhand smoke (SHS) and periodontal disease in adolescents. This prospective study examined the influence of SHS on the development of gingivitis among a population of South African adolescents. Methods: Data were obtained from adolescents (12- to 19-year-olds) participating in a cluster-randomized tobacco use prevention trial. Only participants in the control group were included in the current study. Questionnaires were administered at baseline during 2005 and 12-months later. At follow-up, 835 of the original group of 1,025 could be reached. The questionnaire inquired about the usual smoking habit of the household member (HHM) that smokes, namely; smokes usually outdoors or usually indoors. The questionnaire also included questions related to socio-economic status, depressive mood, the frequency of toothbrushing and history of past dental visits. Main outcome measure - gingivitis, was defined as self-report of past-month frequent bleeding gums (BG) after toothbrushing. Taking into account the complex sample design used, data was analyzed using chi-square statistics and multiple logistic regression. Results: At baseline, 27.7% of the respondents reported that a HHM smokes, but usually smokes outdoors; and 10.5% reported that a HHM smokes and usually smokes indoors. At baseline, 38.1% (n=318) of adolescents reported frequent BG. Of those who did not report frequent BG at baseline (n=517), 42.2% reported frequent BG at follow-up. Compared to those who reported that no HHM smokes or that smoking HHM smoked mainly outdoors, those who reported that HHM mainly smoked indoors at baseline were more likely to report frequent BG at follow-up (48.9% vs. 40.1%; p=0.04). Even after adjusting for potential confounders, living in a home where a HHM usually smoked indoors was significantly associated with reporting symptom of gingivitis (OR=1.57; 95% CI=1.06-2.30). Conclusion: The study findings suggest that SHS is a risk factor for gingivitis in adolescents.

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