Association between exposure to household smoking and dental caries in preschool children: a cross-sectional study

Abstract

BackgroundWe aimed to examine the association of exposure to environmental tobacco smoke with dental caries among preschool children. Exposure to environmental tobacco smoke was assessed in terms of urinary cotinine concentrations and pack-years of exposure to smoking by parents and other family members at home.MethodsThis cross-sectional study included 405 preschool children aged 3–6 years from two preschools in Japan in 2006. Information on the smoking habits of family members living with the child was obtained from parent-administered questionnaires. Dental examination was conducted to assess dental caries, that is, decayed and/or filled teeth. Urinary cotinine levels were measured using first-void morning urine samples.ResultsOverall, 31.1% of the children had dental caries, and 29.5% had decayed teeth. Exposure to current maternal and paternal smoking was positively associated with the presence of dental caries after controlling for covariates. More than three pack-years of exposure to maternal smoking and more than five pack-years of exposure to smoking by all family members were significantly associated with the presence of dental caries as compared with no exposure (odds ratio [OR] = 5.55, 95% confidence interval [CI] = 2.17–14.22, P for trend < 0.001 and OR = 2.00, 95% CI = 1.12–3.58, P for trend = 0.004, respectively). These exposure variables were similarly associated with the presence of decayed teeth (OR = 2.92, 95% CI = 1.23–6.96, P for trend = 0.01 and OR = 1.75, 95% CI = 0.96–3.20, P for trend = 0.03, respectively). As compared with lowest tertile of the urinary cotinine level, the highest tertile of the urinary cotinine level was significantly associated with the presence of dental caries as well as decayed teeth; the ORs for the highest vs. lowest tertile of urinary cotinine levels were 3.10 (95% CI = 1.71–5.63, P for trend = 0.012) and 2.02 (95% CI = 1.10–3.70, P for trend = 0.10), respectively.ConclusionsThese data suggest that exposure to tobacco smoke may have a dose-dependent influence on the development of caries.

Early childhood caries and related risk factors: A cross‐sectional study of children in Zhejiang Province, China

“…Province is much higher than that in Japanese (31.1%) 9 and English children (31.7%). 10 Compared with more developed countries such as Japan and England, Zhejiang is slower in terms of oral health promotion and treatment, which falls behind its economic development, 13 analysis showed that the prevalence of ECC increased significantly with age.…”

“…Among a total of 2700 children enrolled in this study, 1909 children experienced tooth decay or secondary caries after filling (dmft > 0). The prevalence of ECC in children aged 3‐5 years in Zhejiang Province is much higher than that in Japanese (31.1%) 9 and English children (31.7%) 10 . Compared with more developed countries such as Japan and England, Zhejiang is slower in terms of oral health promotion and treatment, which falls behind its economic development, 13 thus leading to a higher incidence of caries.…”

“…ECC is influenced by many factors, including genetic, dietary and environmental ones. Some studies showed that children's sugar intake and frequency, 3 breast‐feeding time, 4,5 brushing frequency, 6 fluoride use, 7 children's body mass index 8 and even parents' smoking history 9 are all possible risk factors for ECC.…”

“…Compared this survey with the third (66% ECC incidence rate among 5‐year‐old children in 2005) and the second (77% ECC incidence rate among 5‐year‐old children in 1995), a decline in the ECC prevalence rate was observed. However, there is still a large gap with developed countries (such as Japan at 31.1% 9 and Britain at 31.7% 10 ).…”

The impact of a school-based tooth-brushing program on dental caries: a cross-sectional study

“…In addition, this study revealed the relationship between lifestyle behaviors, such as skipping of breakfast, and the status of caries in children, although no significant association was shown in the regression analysis. As a severe status of caries and lifestyles at home often reflect other social aspects or family environment [41, 42], further studies considering the overall lifestyles of children and attitudes of caretakers [11] are required.…”