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

Yuko Goto,Fumi Mizuta,Jun Ueyama,Takaaki Kondo,Chisato Nagata,Kie Konishi,Keiko Wada,Michiyo Yamakawa,Kaori Watanabe,Takahiro Uji,Sachi Koda,Kyoko Ando

doi:10.1186/s12199-019-0764-1

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.

Highlights

We aimed to examine the association of exposure to environmental tobacco smoke with dental caries among preschool children
It has been suggested that exposure of children to environmental tobacco smoke is associated with an increased risk of dental caries
Cotinine is a direct metabolite of nicotine that has a high specificity for environmental tobacco smoke exposure

Summary

Introduction

We 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. It has been suggested that exposure of children to environmental tobacco smoke is associated with an increased risk of dental caries. Blood, or urine can be an effective measure to assess a dose-dependent association of exposure to environmental tobacco smoke with dental caries [18]. The present study assessed the association of environmental tobacco smoke with dental caries among preschool children in terms of urinary cotinine concentrations and pack-years of exposure to smoking by parents and other family members at home

Objectives

Methods

Results