Correlation Between Maternal Smoking During Pregnancy and Dental Caries in Children: A Systematic Review and Meta-Analysis

Abstract

Background: Dental caries is a long-standing oral health problem for children all over the world. The available evidence shows that the association between maternal smoking during pregnancy and childhood caries is still controversial. Therefore, the aim of this systematic review and meta-analysis was to determine whether there was a correlation of prenatal smoking and dental caries in children.Methods: PubMed, EMBASE, Cochrane, Web of Science, and Scopus databases were searched for observational studies assessing the relationship between maternal smoking during the pregnancy and childhood caries. According to the predesigned eligibility criteria and items, studies selection, and data extraction were conducted, respectively. The effect estimates were pooled using a fixed-effect model or a random-effect model. Newcastle-Ottawa Scale (NOS) was adopted to evaluate the methodological quality of the included studies. All analyses were carried out through Stata 12.0 software.Results: Our systematic review included a total of 11 studies, of which 6 cross-sectional studies and 3 longitudinal studies were included in the final meta-analysis. The pooled estimates indicated maternal smoking during pregnancy was significantly associated with dental caries in children both in cross-sectional studies (OR = 1.57, 95% CI = 1.47–1.67) and longitudinal studies (RR = 1.26, 95% CI = 1.07–1.48). Sensitivity analyses confirmed the overall effect estimates were robust.Conclusions: There is a significant correlation of maternal smoking during pregnancy and childhood caries. However, the causal relationship between them cannot be determined. More prospective and extensive studies on this theme is needed for verification. Even so, it is necessary for pregnant women and women of reproductive age to quit smoking. Strategies must be developed to raise public awareness about the impact of prenatal smoking on children's oral health.

Revisiting Prenatal Dental Care Practices- A Comprehensive Review

“…Moreover, Williams, et al (2000) [44] explored parental smoking practices and their connection to caries experience in pre-school children, providing insights into the broader environmental context influencing oral health outcomes in early childhood [44]. A recent systematic review and meta-analysis by Zhong, et al (2021) [45] further corroborated the correlation between maternal smoking during pregnancy and dental caries in children, adding to the growing body of evidence supporting the need for comprehensive preventive measures targeting maternal smoking in the context of oral health promotion [45].…”

Protocol for CARES–HAPIN: an ambidirectional cohort study on exposure to environmental tobacco smoke and risk of early childhood caries

“…Mounting evidence evinces fetal and early-life exposure to ETS, even at low levels, increases the susceptibility of dental caries in children and adult life. [6][7][8][9] A recent meta-analysis has demonstrated that children residing with a smoker had significantly higher odds (prenatal-OR: 1.57 (1.47-1.67); postnatal-OR: 1.72 (1.45-2.05)) of presenting with dental caries. 7 ETS, an ubiquitous pollutant, also known as 'passive smoke' or 'secondhand smoke' refers to the mixture of smoke emitted from a burning tobacco product and exhaled by an active smoker.…”

“…Emerging evidence indicates that exposure to environmental toxicants such as environmental tobacco smoke (ETS) and metal(loid)s can modify oral health. [6][7][8][9][10]…”

Perceptions of the Oral Health Risks of Passive Smoking from cigarettes, Electronic Cigarettes, and Heated Tobacco Products.

“…Approximately 40% of children are exposed to passive smoking globally, with particularly high percentages found in Europe (77.8%) and the Western Pacific (50.6%) 2 . Children exposed to passive smoking show a greater incidence of dental caries, with a significantly higher Decay, Missing, Filled Teeth (DMFT) index compared to control groups not exposed to passive smoking 3 , 4 . The dose-response relationship between the level of passive smoking exposure and DMFT scores provides further supporting evidence.…”