Article

Dental caries in 3-year-old children and smoking status of parents

Authors:
  • Takarazuka University of Medical and Health Care
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Abstract

An association has been suggested between environmental tobacco smoke and oral disease. The present study examined the relationship between early childhood caries (ECC) and parental smoking, particularly paternal smoking, using records of 711 36-month-old children. The smoking status of parents as an independent variable was entered in the multivariable logistic regression model for caries experience as the dependent variable with confounders: sex, residential location, and possible risks of ECC such as order of birth, type of main drink, frequency of daily intake of sugar-containing snacks, daily toothbrushing by parents and use of fluoridated toothpaste. About 65% of children were caries free. Children whose parents did not smoke (CN), those in whom only the father smoked (CF), and those whose mother smoked regardless of the smoking status of the father (CM) comprised 33%, 33% and 34% respectively. The adjusted mean number [95% CI] of decayed teeth and caries experience prevalence for CN, CF and CM were 1.2 [0.8, 1.6], 1.6 [1.2, 2.0] and 2.1 [1.7, 2.5], and 25.6%, 35.3% and 45.7% respectively. The relationship between caries experience and parental smoking was significant on multivariable analysis. The adjusted OR [95% CI] of CF and CM relative to CN was 1.52 [1.01, 2.30] and 2.25 [1.51, 3.37] respectively. These results indicate the association of ECC with parental smoking, although the association with paternal smoking was weaker than with maternal smoking.

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... 18 Several studies have found a dose-response effect related to TSE and caries, which indicates that higher home TSE levels are associated with increased risk of developing caries. 7,[19][20][21] These studies have not specified whether children were exposed to both SHS and THS or to THS only, which would occur if children lived with smokers who had indoor smoking bans. Because these studies did not provide this information, it is likely that child participants in these studies were exposed to both SHS and THS. ...
... Then, we conducted a series of weighted logistic regression analyses to assess the relations between child TSE status and current teeth condition, oral health problems, oral health care visits, and preventive oral health care services, adjusting for the child age, child sex, child race or ethnicity, child premature birth, caregiver education level, family structure, and federal poverty threshold. We selected these sociodemographic covariates a priori on the basis of prior work, [6][7][8][9][10]29,[31][32][33][34] and all covariates with the exception of child sex were associated significantly with TSE status and included in the multivariable logistic regression models. We excluded all missing cases before analyses, and we used a 2-sided P value, with P less than .05 ...
... Caries were the most prevalent dental issues. Our study builds on prior research that indicated children who live with caregivers who smoke and are thus exposed to SHS and THS are at increased risk of developing caries 6,7,12,13,15,[19][20][21]36,37 by also assessing home THS exposure only. There are several mechanisms that can explain how TSE potentially could increase a child's risk of developing caries. ...
Article
Background: The objective of the authors was to assess the relationships between tobacco smoke exposure (TSE) and dental health and dental care visits among US children. Methods: The authors examined 2018-2019 National Survey of Children's Health data on TSE, dental health, and oral health care visits. Children aged 1 through 11 years (N = 32,214) were categorized into TSE groups: no home TSE (did not live with a smoker), thirdhand smoke (THS) exposure (lived with a smoker who did not smoke inside the home), or secondhand smoke (SHS) and THS exposure (lived with a smoker who smoked inside the home). The authors conducted multivariable logistic regression analyses, adjusting for child age, sex, race or ethnicity, prematurity, caregiver education level, family structure, and federal poverty threshold. Results: Children with home SHS and THS exposure were at increased odds of having frequent or chronic difficulty with 1 or more oral health problem (adjusted odds ratio [AOR], 1.59; 95% CI, 1.07 to 2.35; P = .022) and carious teeth or caries (AOR, 1.74; 95% CI 1.14 to 2.65; P = .010) than those with no TSE. Compared with children aged 1 through 11 years with no TSE, children with SHS and THS exposure were 2.22 times (95% CI, 1.01 to 4.87; P = .048) more likely to have not received needed oral health care but at decreased odds of having had any kind of oral health care visit (AOR, 0.55; 95% CI, 0.32 to 0.95; P = .032), including a preventive oral health care visit (AOR, 0.60; 95% CI, 0.36 to 0.99; P = .047). Conclusions: TSE in children is associated with caries and inadequate oral health care visits. Practical implications: The pediatric dental visit is an opportune time to educate caregivers who smoke about dental health to improve their children's teeth condition and increase oral health care visits.
... A multifactorial disease development model is assumed for ECC [6]. Increasing importance is attributed to psychosocial risk factors such as maternal psychopathologies [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], educational deficits and poverty [15]. However, the still fragmentary knowledge about the influence of psychopathologies and their widely neglected interactions with socioeconomic factors complicates the integration in a multifactorial bio-psycho-social model. ...
... In most previous studies only one or few disorders were considered, making it difficult to compare the effects of the influencing factors. A few of these determinants are quite well verified (e.g., parental smoking [17][18][19][20]25], dental anxiety [7-10,21-24]), others have hardly (e.g., alcohol [11]) or not at all been investigated (e.g., childhood trauma, eating disorders), or study results are contradictory (e.g., depressiveness: positive studies [10,[12][13][14], negative studies [15,16]). ...
... Studies have shown that both, mental disorders [33,34] as well as ECC [5,[35][36][37][38][39][40][41], are associated with low SES, which implicates SES could be a linking factor. Such a mediating influence of the SES is suspected [19] as an explanation for the observed association between household smoking and ECC [17][18][19][20]25]. However, since studies focusing on the influence of PSB on ECC often record the SES insufficiently or not at all, little is known about the triangular relationships of these factors. ...
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Article
Objectives Various maternal mental disorders and socioeconomic status [SES] are discussed as risk factors for early childhood caries [ECC]. In our study, we examined a wide range of symptoms of mental disorders with the aim to identify those maternal psychopathological symptom burdens [PSBs] which show relevant associations with ECC. Our second objective was to investigate how SES affects the associations between PSB and ECC. Methods In this study, sixty children with ECC (caries group [CG]) and sixty caries-free children [NON-CG] with their mothers were recruited at two sites in Germany. Children aged three or four years were included in the study. Children’s dental status [dmf-t] and plaque index were recorded, and mothers answered a multidimensional SES index (including education, profession and income) as well as screening questionnaires capturing dental anxiety, depressive disorders, generalized anxiety, somatic symptom burden, eating disorders, traumatic childhood experiences, nicotine dependency and alcohol dependency. Results Mothers of the CG reported significantly higher dental anxiety (dCohen = 0.66), childhood trauma (dCohen = 0.53) and nicotine dependency (dCohen = 0.64) than the NON-CG. However, mediator analyses showed that these effects were partly mediated by the SES. Mothers of the CG had a significantly lower SES (dCohen = 0.93); with education as strongest predictor of dental status. The groups did not differ significantly in symptoms of depressiveness, subjective somatic symptom burden, alcohol dependency, eating disorders, and generalized anxiety. Conclusions Several PSBs are associated with ECC, however the SES as the strongest influencing factor mediates this association. Difficult socioeconomic conditions might predispose for both, ECC and mental illness. Targeted strategies are needed to facilitate the use of preventive measures and dental health services especially in families of lower status. For this purpose, psychosocial risk constellations must be identified. More integrative, multifactorial oriented research is necessary to gain a bio-psycho-social understanding of ECC.
... A review of the literature by Hanioka et al. in 2011 identified 11 studies on parental or household smoking and dental caries in early childhood [1]. Significant association was reported in ten of them [2][3][4][5][6][7][8][9][10][11]. After this review, to our knowledge, six studies, including four cohort studies, have been published, and all of them showed a positive association between environmental tobacco smoke and early childhood caries [12][13][14][15][16][17]. ...
... The association of dental caries with smoking by the father or other family members appeared to be weaker than that with maternal smoking, and the dose-relationship for pack-years of exposure to smoking by them was not statistically significant. In Japan, as younger children at preschool age generally spend a lot of time with their mothers at home, exposure to smoking by the mother assessed in terms of pack-years may have more effect than exposure to smoking by the father or other family members [4,13]. In our study, the association for total pack-years of exposure to smoking by all family members should mainly reflect that for exposure to maternal smoking. ...
... Most previous studies assessed only the status of maternal smoking or household smoking as a whole in relation to dental caries. Even for the status of paternal smoking, only a few studies included this variable [4,7,13]. One study observed that paternal smoking status was significantly associated with the presence of dental caries [4], but the other two studies did not [7,13]. ...
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Article
Background 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. Methods This 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. Results Overall, 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. Conclusions These data suggest that exposure to tobacco smoke may have a dose-dependent influence on the development of caries.
... Only 5 articles investigated prenatal exposure (in the womb) [21,28,30,40,41] in the remaining 23 the exposure was postnatal (in infancy). Most of the studies examined caries in primary dentition [14,15,[20][21][22][23][24][25][26][27][28]30,32,35,36,[38][39][40][41], while the rest examined the permanent dentition. Different indices were used, such as DMFT or DS for permanent dentition and dft, ds or dt for primary dentition. ...
... Delpisheh [48] confirmed that passive exposure to tobacco use in children is significantly associated with low socio-economic level. Hanioka et al. [20] and Nakayama et al. [24] observed that the children of parents who smoked had poorer hygiene habits, brushed their teeth less frequently and consumed more sugar, favouring the appearance of caries. Leroy et al. [22] detected that children growing up with smoker parents brushed their teeth less and ate more between meals, so had poorer oral hygiene. ...
... The strong relationship between caries and socio-economic and behavioural factors does not help to clarify the relationship between passive exposure to tobacco use and caries in children. However, the estimate of this association in the present results is mostly derived from studies with OR values adjusted through logistic regression using variables such as toothbrushing frequency, age, gender, educational level, application of fluoride, visits to the dentist, socioeconomic level, place of residence, etc. [14,15,17,[19][20][21][22][23]25,26,29,39]. Few studies that presented only the raw OR were included in the meta-analysis [16,35]. ...
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Article
To examine the available evidence on the association between exposure to tobacco use in the womb and in infancy and the presence of caries in primary and permanent dentition in children and adolescents. A systematic review was conducted through searches in 4 data bases (Pubmed, Scopus, Embase and Web of Science), complemented by hand-searching. Of the 559 articles identified, 400 were duplicates. Finally, 28 articles were included in the qualitative review and 21 in the meta-analysis. Their quality was assessed using the Newcastle-Ottawa scale. The quality was medium in 44% of the articles included and high in 56%. The overall meta-analysis gave a significant odds ratio (OR = 1.53, 95% confidence interval 1.39–1.68, Z test p-value = 0.000) and high heterogeneity (Q = 200.3, p = 0.000; I² = 86.52%). Separate meta-analyses were also performed for three subgroups: exposure in the womb (prenatal) and caries in primary dentition, which resulted in a significant OR = 1.46 with a 95% CI of 1.41–1.52 (Z test p = 0.000), without heterogeneity (Q = 0.91, p = 0.824; I² = 0%); exposure in infancy (postnatal) and caries in primary dentition, with OR = 1.72 (95% CI 1.45–2.05) and high heterogeneity (Q = 76.59, p = 0.00; I² = 83.01%); and postnatal exposure and caries in permanent dentition, with OR = 1.30 (95% CI 1.25–1.34) and no heterogeneity (Q = 4.48, p = 0.880; I² = 0%). In children and adolescents, a significant though moderate association was found between passive tobacco exposure and caries.
... Instead we provide a summary of a broad set of results. The 55 studies included in this review were spread across North Europe, 8,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Asia, [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] South America, 7,44-49 North America, [50][51][52][53][54][55] Africa, [56][57][58] Australia, 59-61 Canada 10,62 and the middle east. 63,64 Forty-seven studies were cross-sectional in design, 7,10,[15][16][17][18][19][20][21][22][24][25][26][27][28][29][30][31][32][33][34][35][37][38][39][40][41]43,44,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] 7 were longitudinal 13,14,23,36,42,45,51 and one was case-control. ...
... The 55 studies included in this review were spread across North Europe, 8,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Asia, [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] South America, 7,44-49 North America, [50][51][52][53][54][55] Africa, [56][57][58] Australia, 59-61 Canada 10,62 and the middle east. 63,64 Forty-seven studies were cross-sectional in design, 7,10,[15][16][17][18][19][20][21][22][24][25][26][27][28][29][30][31][32][33][34][35][37][38][39][40][41]43,44,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] 7 were longitudinal 13,14,23,36,42,45,51 and one was case-control. 61 The distribution of age across studies approximated a normal distribution, with preschool children aged 3 years the most heavily studied group, included in 42 studies. ...
... For example being of higher birth order is associated with lower level of medical surveillance, 69 immunisation, 70 and medical consultation, 71 smaller stature 72 and eating more 'junk food' 73 compared to lower-level siblings. In this review higher birth order is also associated with higher caries rates, 30,32,36,39,62 as is having a larger family size, 27,33,40,46 although this association was not universal. 24,28,59,64 ...
Article
A well established body of research documents the role of individual factors, such as biology and diet, in the aetiology of early childhood caries (ECC). Recently empirical attention has shifted to the relationships between broader ecological influences (e.g., education, ethnicity and income) and ECC; however, how such determinants interplay in the aetiology of ECC remains unclear. An intermediary mechanism that warrants greater empirical attention is parental influences. This oversight is interesting given the primacy of the parent in governing the child's proximate environment and the likelihood of the child endorsing adaptive or maladaptive health attitudes, beliefs and behaviours. The objective of this paper was to conduct a systematic review of the evidence for parental influences on the development of caries in children aged 0-6 years. All studies testing associations between dental caries and socio-demographic factors, feeding practices, parent attributes, behaviours, oral health, attitudes, knowledge and beliefs in children aged 0-6 years, published between 2006 and 2011. Medline, ISI, Cochrane, Scopus, Global Health and CINAHL databases. Fifty-five studies were included from an initial identification of 1805 studies. To date, most research has focused on the association between caries and socio-demographic and feeding factors with few studies exploring parents' attributes, attitudes, knowledge and beliefs, and none exploring possible pathways between the multiple layers of influences potentially accounting for how determinants of ECC operate and traverse individual, familial, community, and socio-cultural contexts. Collaboration between Psychologists and Dentists may accelerate the identification and understanding of mechanisms that underlie risk associated with ECC.
... Une revue de la littérature des études explorant les facteurs de risque des caries chez l'enfant a permis d'élaborer le questionnaire [8][9][10][11][13][14][15][16][17][18][19][20][21][22]. Les facteurs suivants ont été retenus : précarité socioéconomique ; absence de suivi dentaire régulier ; absence de brossage quotidien des dents ; absence d'exposition topique suffisante au fluor ; exposition systémique insuffisante au fluor [22] ; prise au coucher ou au-delà de 18 mois d'un biberon contenant autre chose que de l'eau ; grignotage (en dehors des repas et des collations) ; antécédents de caries chez la mère, le père et la fratrie [14] ; exposition au tabagisme de la mère pendant et en dehors de la grossesse et du père [18] ; présence de besoins de santé particuliers (exemple : handicap au brossage dentaire) [9] ; exposition à des traitements odontotoxiques ou diminuant le flux salivaire [8][9][10]. ...
... Une revue de la littérature des études explorant les facteurs de risque des caries chez l'enfant a permis d'élaborer le questionnaire [8][9][10][11][13][14][15][16][17][18][19][20][21][22]. Les facteurs suivants ont été retenus : précarité socioéconomique ; absence de suivi dentaire régulier ; absence de brossage quotidien des dents ; absence d'exposition topique suffisante au fluor ; exposition systémique insuffisante au fluor [22] ; prise au coucher ou au-delà de 18 mois d'un biberon contenant autre chose que de l'eau ; grignotage (en dehors des repas et des collations) ; antécédents de caries chez la mère, le père et la fratrie [14] ; exposition au tabagisme de la mère pendant et en dehors de la grossesse et du père [18] ; présence de besoins de santé particuliers (exemple : handicap au brossage dentaire) [9] ; exposition à des traitements odontotoxiques ou diminuant le flux salivaire [8][9][10]. Le statut socioéconomique a été évalué à l'aide du score EPICES pour 34 enfants atteints [23] ou sur la base d'autres critères comme la couverture maladie universelle (CMU), l'aide médicale d'état (AME) ou la connaissance du milieu familial de l'enfant. ...
... Concernant les antécédents familiaux de caries, notamment dans la fratrie, même si les mêmes causes mènent aux mêmes effets, les parents ayant déjà eu un enfant atteint du syndrome du biberon sont quelques fois plus sensibilisés à cette affection et rectifient les erreurs de comportements avec les plus jeunes. Concernant le tabac, il se révèle être à la fois un facteur de risque et un facteur de confusion puisqu'il existe une association entre le tabac chez les parents et la fréquence du brossage et du grignotage [18]. Quant au brossage quotidien des dents et à l'exposition topique et systémique au fluor, ils n'ont pas été identifiés comme facteurs protecteurs en analyse multivariée. ...
Article
Baby bottle tooth decay is a severe form of early childhood caries. This study aims to elaborate a screening tool for at risk children in order to facilitate primary prevention. A case-control study was conducted among children suffering from baby bottle tooth decay and children with no dental caries. Cases were children aged 5 years or less at diagnosis who experienced at least four caries with one or more affecting maxillary incisors. Controls were children matched for age and sex. Parents were interviewed by phone about their child's exposure to potential risk factors. We included 88 children suffering from baby bottle tooth decay and 88 children with no dental caries. In multivariate analysis, low social class (OR 6.39 [95% CI, 1.45-28.11]), prolonged bottle feeding or bedtime feeding (OR 153.2 [95% CI, 11.77-1994.96]), and snacking (OR 5.94 [95% CI, 1.35-26.2]) were significantly associated with baby bottle tooth decay. Regular dental visits were a significant protecting factor (OR 0.13 [95% CI, 0.02-0.77]). A score was developed using these significant risk factors and tested on the survey population. The mean score was 13/20 for cases and 4/20 for controls. These results are in accordance with the literature, except for brushing teeth, which was not significantly associated with baby bottle tooth decay in our study. A screening scale with a score of 20 points was proposed. Future validation is required. Pediatricians and general practitioners should encourage parents to change their habits.
... The remaining studies that included apparently unrelated articles, letters and review articles were excluded from the review. Based on a full-text review of the literature, we selected 15 studies131415161718192021222324252627 and excluded seven studies (citations not shown). ...
... Fourteen studies used a case-control format13141516171819202122232426,27], and one study used a cohort format [25] (Table 1). Nine studies focused on SHS14151618,20,21,23,24,26]. ...
... Fourteen studies used a case-control format13141516171819202122232426,27], and one study used a cohort format [25] (Table 1). Nine studies focused on SHS14151618,20,21,23,24,26]. Another study focused on social variables including SHS [13,22], low birth weight [17], breastfeeding [19], and associated factors [25,27]. ...
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Article
This review evaluated evidence of the relationship between secondhand smoke (SHS) and dental caries in children in epidemiological studies. Relevant literature was searched and screened, and the methodological quality was assessed. The search yielded 42 citations. High-quality studies including one cohort format and 14 case-control format studies were selected. Early childhood caries was examined in 11 studies. The independent association of SHS was significant in 10 studies, and the strength was mostly weak to moderate. One study did not select SHS as a significant variable. Three studies reported decreases in the risk of previous exposure, and the association was not significant. Dose-response relationships were evident in five studies. Permanent teeth were examined in seven studies. Five studies reported significant associations, which were mostly weak. The risk of previous exposure remained similar to that of current exposure, and a dose-response relationship was not evident in one study. The overall evidence for the causal association in early childhood caries is possible regarding epidemiological studies, and the evidence of permanent teeth and the effect of maternal smoking during pregnancy were insufficient. The results warrant further studies of deciduous teeth using a cohort format and basic studies regarding the underlying mechanism.
... [15] There is an increased production of melanin, which may provide a biologic defense against the noxious agents present in 10 (2.5%) 6 (0.02%) ***0.000 ≥ 50 2 (0.5%) 5 (1.25%) **** 0.000 Total 37 (9.25%) 34 (7.02%) *Significant difference between case and control group for age (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) years 10(25%) and 14(3.5%) at P0.029 level. **Highly significant difference between case and control group for age (30-39) years, 15(3.75%) and 9(2.5%) at P0.0012 level. ...
... Among family members, a husband and wife usually spend the most time with each other, thus, the effects of exposure to secondhand smoke would be greater on women's health compared to exposure to the secondhand smoke of parents during childhood. [24] It's worth noting that smoking by the father is less harmful than that by the mother. [25] According to our best knowledge, no similar study has investigated the effect of passive smoking on family members' order. ...
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Article
To determine the relationship of gingival pigmentation of different passive smoker age groups (both genders) with active household smokers in Erbil city/Iraq. Passive smoking is also called ETS (Environmental tobacco smoke) is the result of spontaneous cigarette burning, and contrarily, the result of the side-stream of cigarette smoke, as well as the smoke exhaled by active smokers. ETS produces numerous side effects including oral cavity of people who do not smoke like oral mucosal pigmentation, which is fundamentally, cigarette smoking affecting smile and esthetics. Health personnel should clearly present the data concerning the adverse results of smoking, in addition to the dangers to exposure to environmental tobacco smoke.
... These completely opposite results may be caused by various possible confounders because existing evidences suggest multiple factors like socioeconomic status, involuntary smoking, breastfeeding and its duration, maternal educational level and mode of delivery will affect the development of dental caries in children [19,[24][25][26][27][28]. Some studies have shown that children born in smoking households may be raised in a low socioeconomic level with insufficient nutrition [29] and have poorer oral hygiene with lower frequency of tooth brushing and more sugar intake [30,31], which are conducive to the occurrence of dental caries. ...
... In addition to these etiological evidences, there are grounds to assume that the association between prenatal smoking and caries in children is mainly due to socioeconomic factors. Generally, children with lower living standards exhibit higher caries rates [29][30][31]. It should be noted that post-partum smoking or household smoking has also been shown to be a possible predictor of dental caries in offspring since children would involuntarily inhale tobacco smoke. ...
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Article
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.
... Interestingly children in the ETS group were more likely to be using the recommended fluoride toothpaste. Hanioka et al. (2008), suggested that parents who smoke might have poorer oral health and health behaviours with more S. mutans that can be transmitted to their children. It has been suggested that nicotine results in promotion of growth of S. mutans, enhanced transmission of S. mutans from mothers and reduction in Vitamin C absorption with higher growth of S. mutans (Strauss, 2001). ...
... Leroy et al. (2011), found that previous exposure to ETS was significantly associated with the presence of gingivitis in 5 year-old children. The formation of primary teeth starts around the 13th week of gestation and exposure to nicotine during gestation may affect mineralisation with rough surfaces more likely to trap dental plaque (Hanioka et al. 2008;Tanaka et al. 2009). The current study found a higher prevalence of demarcated opacities in the ETS and ETSB groups. ...
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Article
Aims: This study investigated the association between the prevalence of oral health problems (caries, gingivitis, mucosal pigmentation and enamel defects in one to 5 year-old children exposed and not exposed to environmental tobacco smoke before and/or after birth. Exposure to environmental tobacco smoke (ETS) in childhood may have significant health effects. Methods: A structured questionnaire was used to collect data on a child's current and previous illnesses, oral health behaviours, dietary habits, parental smoking behaviours and parents' dental history. The intraoral examination recorded dental caries (dmfs), enamel defects, gingival health, melanin pigmentation and soft tissue health. Stimulated saliva was collected. Total sIgA levels were quantified using indirect competitive ELISA with a SalimetricsTM kit. Results: The 44 children (aged 15-69 months) recruited were divided into two groups: ETS and non-ETS (control). There were 22 children in each: 16 who were exposed to ETS during and after gestation were identified as the ETSB subgroup. Participants exposed to ETS were more likely to have had upper respiratory tract and middle ear infections during the neonatal period and had higher mean dmft, mean dmfs, mean percent of surfaces with demarcated opacities and mean GI than the non-ETS participants. The children exposed to ETS before and after birth had the highest occurrence of enamel opacities showed a higher risk for dental caries even though more children in this group used the recommended fluoride toothpaste (1000 ppm fluoride). Mothers who smoked either never breastfed their children or breastfed their children for less than the recommended period of 6 months. Children exposed to ETS were shown to have higher mean total sIgA (μg/ml) than the children in the control group. Conclusions: Associations between ETS exposure before and after gestation and oral health, including salivary changes in young children were shown in the present study. Dental health professionals should include a question about household smoking in children's dental histories, which would allow opportunities to discuss the impact of smoking on child oral health. Longitudinal oral health studies should include a history of maternal smoking during pregnancy and afterwards.
... The effect of environmental tobacco smoke and maternal smoking status on increased risk of caries among children is very much relevant to Aboriginal peoples, who have a markedly higher smoking rate than the non-Aboriginal peoples (40% vs. 20%). [31][32][33] What is significant is that many Aboriginal mothers smoke during pregnancy. 33 The association of ECC with paternal smoking (OR = 1.52) and maternal smoking (OR = 2.25) is well-documented. ...
... 33 The association of ECC with paternal smoking (OR = 1.52) and maternal smoking (OR = 2.25) is well-documented. 32 In Schroth et al.'s (2013) study, Aboriginal children whose mothers smoked during pregnancy were 1.7 times more likely to have S-ECC. 29 ...
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Early childhood caries (ECC) is an oral disease affecting primary teeth of children below the age of 6. ECC is a major health concern, negatively affecting the infants' and young children's oral and general health as untreated carious lesions can lead to pain, disruption of growth and development, and in rare cases, life-threatening infections. Dental decay in Aboriginal children in Canada is epidemic and disproportionately affects disadvantaged Canadian communities. Multiple risk factors are associated with ECC and should be recognized to provide appropriate preventive strategies. The risk factors for ECC, which are particularly relevant to Aboriginal children include poverty, diet factors, and parents' smoking tobacco, in addition to multiple other factors common to dental caries. Recommended strategies to combat tooth decay in Aboriginal children include oral health promotion, caries prevention using fluoride and sealants, and access to publicly funded oral health programs and services. This requires close collaboration between dental professionals, health professionals, policymakers, child health advocates, Aboriginal communities, and researchers, to address social determinants of health and other social disadvantages affecting Aboriginal communities.
... For example being of higher birth order is associated with lower level of medical surveillance 69 , immunisation 70 , and medical consultation 71 , smaller stature 72 and eating more 'junk food' 73 compared to lower-level siblings. In this review higher birth order is also associated with higher caries rates 30,32,36,39,62 , as is having a larger family size 27,33,40,46 , although this association was not universal 24,28,,59,64 . ...
... These psychological variables can influence the extent to which parents engage in proactive behaviours because of perceived lack of power to make change, as a result they may reduce efforts to do so. Three studies tested smoking in parents and found it to be a risk factor 21,30,32 . Smoking may reflect poor health behaviours in general so higher rates of caries in children of smokers may be just one of several poor health outcomes for children however this was not reported in the included studies. ...
Article
Background Low socio-economic status (SES) is a significant risk factor for childhood overweight and obesity (COWOB) in high-income countries. Parents to young children buffer and accentuate social and cultural influences, and are central to the development of this disease. An understanding of the parent-related mechanisms that underlie the SES-COWOB relationship is needed to improve the efficacy of prevention and intervention efforts. ObjectiveA systematic review of relevant literature was conducted to investigate the mechanisms by which levels of SES (low, middle and high) are associated to COWOB, by exploring mediation and interaction effects. Method Six electronic databases were searched yielding 5155 initial records, once duplicates were removed. Studies were included if they investigated COWOB, SES, parent-related factors and the multivariate relationship between these factors. Thirty studies were included. Factors found to be mediating the SES-COWOB relationship or interacting with SES to influence COWOB were categorized according to an ecological systems framework, at child, parent, household and social system level factors. ResultsHigh parent body mass index, ethnicity, child-care attendance, high TV time (mother and child), breastfeeding (early weaning), food intake behaviours and birthweight potentially mediate the relationship between SES and COWOB. Different risk factors for COWOB in different SES groups were found. For low SES families, parental obesity and maternal depressive symptoms were strong risk factors for COWOB, whereas long maternal working hours and a permissive parenting style were risk factors for higher SES families. None of the studies investigated parental psychological attributes such as attitudes, beliefs, self-esteem and so on as potential mechanisms/risk factors. Conclusions Families from different SES groups have different risk and protective factors for COWOB. Prevention and intervention efforts may have improved efficacy if they are tailored to address specific risk factors within SES.
... Recently, a growing body of evidence has indicated that secondhand smoke (SHS) exposure may play a role in the development of dental caries in children (Williams et al., 2000;Aligne et al., 2003, Shenkin et al., 2004Tanaka et al., 2006;Leroy et al., 2008;Hanioka et al., 2008;Tanaka et al., 2010;Christensen et al., 2010;Al-Mendalawi and Karam, 2014;Watanabe et al., 2014;Nakayama and Mori, 2015). The Iowa Fluoride study showed that residing with a regular smoker at home was positively associated with the prevalence of dental caries in children aged 4 to 7 years (Shenkin et al., 2004). ...
... Our finding that postnatal SHS exposure was significantly associated with an increased prevalence of dental caries is consistent with the findings of several previous cross-sectional studies showing a positive association between SHS exposure and dental caries (Aligne et al., 2003;Shenkin et al., 2004;Leroy et al., 2008;Hanioka et al., 2008;Tanaka et al., 2010;Christensen et al., 2010;Watanabe et al., 2014;Nakayama and Mori, 2015;Majorana et al., 2014) but at variance with the results of other previous studies in Japan (Tanaka et al., 2006) and Iraq (Al-Mendalawi and Karam, 2014) which showed no association between postnatal SHS exposure and dental caries. Our results also provide evidence for a positive exposure-response relationship between cumulative postnatal SHS exposure and dental caries. ...
Article
Background: Epidemiological studies of the association between smoking exposure and dental caries are limited. Objective: The purpose of this cross-sectional study was to examine the association between prenatal and postnatal secondhand smoke (SHS) exposure and the prevalence of dental caries in primary dentition in young Japanese children. Methods: Study subjects were 6412 children aged 3 years. Information on exposure to maternal smoking during pregnancy and postnatal SHS exposure at home was collected via parent questionnaire. Children were classified as having dental caries if one or more primary teeth had decayed or had been filled. Results: Compared with never smoking during pregnancy, maternal smoking in the first trimester of pregnancy was significantly associated with an increased prevalence of dental caries in children (adjusted odds ratio=1.37, 95% confidence interval: 1.03-1.80). Postnatal SHS exposure was also positively associated with dental caries, with a significant positive exposure-response relationship. Compared with children not exposed to prenatal maternal smoking or postnatal SHS at home, those exposed to both prenatal and postnatal smoking had higher odds of dental caries (adjusted odds ratio=1.62, 95% confidence interval: 1.23-2.11). Conclusion: Our findings suggest that maternal smoking during pregnancy and postnatal SHS exposure may be associated with an increased prevalence of dental caries in primary dentition.
... In many countries, dental caries is a major oral health problem in children [1]. Various factors may contribute to the development of dental caries in children, such as the frequent consumption of sugar-containing snacks or beverages [2][3][4][5][6], less frequent tooth brushing habits, parental smoking [7][8][9][10], and breastfeeding (prolonged breastfeeding or falling asleep while breastfeeding, etc.) [11][12][13][14][15][16]. In Japan, on the basis of the Maternal and Child Health Law, dental examinations for children are performed at the age of 18 months and 3 years. ...
... Childhood caries were more frequent in children who lived with family members who smoked than children who lived with family members who did not smoke, and the OR of caries for children living with family members who smoked was 1.49 (95% CI: 1.34, 1.52) (Tables 2 and 3). These results agreed with the results reported by Hanioka [9], who also found that the OR of caries for Japanese children with parents who smoked was 1.52 (95% CI: 1.01, 2.30). A recent systematic review has confirmed the association of secondhand smoke with early childhood caries [7]. ...
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The present cohort study examined how lifestyle, household environment, and caries activity test score of Japanese children at age 1.5 years affected their dental caries incidence at age 3. Inclusion criteria were 1.5-year-old children with no dental caries. Dental examinations were performed for 33,655 children who participated in routine dental examinations at 1.5 years of age, and the exam was repeated approximately 21 months later (at age 3) at the Kobe City Public Health Center in Japan. After excluding 622 children who had caries at age 1.5 and 1831 children with missing lifestyle and household environment data in the questionnaires, the final data analysis was performed on a total of 31,202 children (16,052 boys, 15,150 girls).The multivariate logistic regression analysis indicated a strong association of the consumption of sugar-sweetened beverages/snacks, less frequent tooth brushing by the parents, lack of fluoride varnish, family history of smoking, with the risk of developing dental caries. A child's late bedtime is also one of the major risk factors for dental caries development. Further investigation is needed to examine whether the short duration or the irregularity of the sleep-wake cycle would affect early childhood oral health and whether there is a relationship between late bedtime and late night snack intake.
... However the association between passive smoke exposure and dental caries is controversial. Some studies indicate such an association exists in pre-school children [6][7][8][9][10][11], in older children [12,13], and in animal models [14]; while two reviews suggested the evidence is weak or of poor quality [15,16]; and other studies failed to find an association [17][18][19]. ...
... The results of this study indicate that CSHCN have an independent association of recent caries (within the previous 6 months) and passive smoke (someone in the household used cigarettes, cigars, or pipe tobacco). These results are consistent with previous studies supporting such an association in children who did not have SHCN [6][7][8][9][10][11]. For example, maternal smoking was independently associated with caries in pre-school children in an adjusted analysis including socioeconomic status, diet/nutritional status, and confectionery spending [21]. ...
Article
The purpose of this study was to determine a relationship between passive tobacco smoke exposure (secondhand and third hand tobacco smoke exposure) and dental caries in Children with Special Health Care Needs (CSHCN) ages 0-17 years. This study used data from the 2007 National Survey of Children's Health involving 17,901 CSHCN. Telephone survey data were used to determine recent caries experience and passive tobacco smoke exposure (secondhand and third hand tobacco smoke exposure). Recent caries was defined as a positive response to if CSHCN had "decayed teeth or cavities within the past 6 months." Passive smoke was defined as a positive response to if someone in the household used cigarettes, cigars, or pipe tobacco. A statistically significant relationship was determined between passive tobacco smoke exposure and recent caries in CSHCN (adjusted odds ratio: 1.23 (95% CI: 1.02, 1.50; p-value= 0.0352). A positive independent association of passive tobacco smoke exposure and dental caries was determined in Children with Special Health Care Needs (CSHCN.
... Babies whose mothers reported smoking during pregnancy were less likely to be breastfed [6,7]. Moreover, the development of caries in children may be associated with prenatal maternal smoking and postnatal environmental smoke exposure [8][9][10][11]. Maternal smoking during pregnancy appears to be a proxy for the mother's unhealthy diet and poor oral hygiene practices [9][10][11]. ...
... Moreover, the development of caries in children may be associated with prenatal maternal smoking and postnatal environmental smoke exposure [8][9][10][11]. Maternal smoking during pregnancy appears to be a proxy for the mother's unhealthy diet and poor oral hygiene practices [9][10][11]. ...
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Several maternal health determinants during the first period of life of the child, as feeding practice, smoking habit and socio-economic level, are involved in early childhood health problems, as caries development. The potential associations among early childhood caries, feeding practices, maternal and environmental smoking exposure, Socio-Economic Status (SES) and several behavioral determinants were investigated. Italian toddlers (n = 2395) aged 24-30 months were recruited and information on feeding practices, sweet dietary habit, maternal smoking habit, SES, and fluoride supplementation in the first year of life was obtained throughout a questionnaire administered to mothers. Caries lesions in toddlers were identified in visual/tactile examinations and classified using the International Caries Detection and Assessment System (ICDAS). Associations between toddlers' caries data and mothers' questionnaire data were assessed using chi-squared test. Ordinal logistic regression was used to analyze associations among caries severity level (ICDAS score), behavioral factors and SES (using mean housing price per square meter as a proxy). Caries prevalence and severity levels were significantly lower in toddlers who were exclusively breastfed and those who received mixed feeding with a moderate-high breast milk component, compared with toddlers who received low mixed feeding and those exclusively fed with formula (p < 0.01). No moderate and high caries severity levels were observed in an exclusively breastfed children. High caries severity levels were significantly associated with sweet beverages (p < 0.04) and SES (p < 0.01). Toddlers whose mothers smoked five or more cigarettes/day during pregnancy showed a higher caries severity level (p < 0.01) respect to those whose mothers did not smoke. Environmental exposure to smoke during the first year of life was also significantly associated with caries severity (odds ratio =7.14, 95% confidence interval = 6.07-7.28). No association was observed between caries severity level and fluoride supplementation. More than 50% of toddlers belonging to families with a low SES, showed moderate or high severity caries levels (p < 0.01). Higher caries severity levels were observed in toddlers fed with infant formula and exposed to smoke during pregnancy living in area with a low mean housing price per square meter.
... For example, as far as socio-demographic factors are concerned, age and sex [2][3][4][5][6][8][9][10] seem to be associated with caries in different ways, depending on whether the primary or the permanent dentitions are examined. Other studies have found that the order of birth of the child may be a risk indicator for dental caries, but this relationship has not been fully confirmed [11][12][13]. With regard to socioeconomic factors, it is a common finding that with worse socioeconomic conditions, oral health status is deteriorated [4,6,14]. ...
... We can speculate that the reason for this finding could be the relatively narrow distribution of SEP in the Nicaraguan study population. Finally, although some studies mention birth order as a risk indicator for the presence of dental caries [11,12], we did not find this association, just as it has not been found in other studies [12,13]. ...
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Background Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. Material/Methods A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. Results Mean age was 7.49±1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54±3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. Conclusions The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators.
... Subsequently, Gokhale and Nuvvula previously reported that children of lower socioeconomic status and children whose parents both have jobs are at a higher risk for dental caries [30]. Our results did not show a similar trend which relates parental smoking status and dental caries in children; however, a previous study had demonstrated that the dental caries prevalence in 3 year-olds was associated with parental smoking status [31]. However, these relationships may change depending on maternal or paternal smoking status. ...
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Recently, sleeping status has attracted attention for its relationship with oral health. In the present study, we have investigated the association between early childhood caries and sleeping status. A multicentre observational cross-sectional study was conducted among 332 preschoolers (aged 3–6 years) and their parents in Chitose, Japan. Dental caries and sleeping status were assessed in the children and the sleep quality and health literacy of the parents were also assessed. Univariate and multivariate regression analyses were used in order to investigate the effect of the sleeping status of the parents and their children on dental caries. Among the children, the prevalence of dental caries experience was 12.7%. The children without caries slept significantly longer and their parents had a better Pittsburgh Sleep Quality Index (PSQI) score than those with caries experience. The sleeping status and the numbers of caries in the children were significantly correlated. Health literacy was better in those without caries experience. Parents’ PSQI was significantly positively correlated with the numbers of caries in the children (r = 0.19, p = 0.0004). The children’s sleep durations, screen time, and parental smoking status were independently associated with early childhood caries. Poor sleeping status of children and their parents is related to dental caries among preschoolers.
... This aspect could be better evaluated considering the exposure to environmental smoke in the 1 st years of the child's life. [31,32] Our data do not confirm the associations with the gestational age or birth weight of the child or breastfeeding at birth, nor with the body mass index calculated at the 6-year assessment. [33][34][35][36][37] Possible selection biases related to the 6-year series may be involved. ...
... Email: lisa.jamieson@adelaide.edu have considered second-hand smoke to be a risk factor for ECC (Aligne et al., 2003;Haniokaa et al., 2008;Leroy et al., 2008;Shenkin et al., 2004;Tanaka et al., 2009;. In a systematic review, Hanioka and colleagues concluded that the strength of this association was weak to moderate (Hanioka et al., 2011). ...
Article
Objective: This study aimed to test the association between maternal smoking during pregnancy and parental-reported experience of dental caries in Indigenous Australian children. Methods: Data were from the Longitudinal Study of Indigenous Children (LSIC); a population-based cohort study in Australia. Participants were 1,687 Indigenous Australian children aged 5 or less. Biological, social and behavioural variables were tested using log-linear modelling with binomial regression to determine the association with parental-reported experience of dental caries. Markov Chain Monte Carlo methods were used for multiple imputation of missing data. Results: Overall 25.8% of Indigenous Australian children had dental caries as reported by a carer. In the multivariable model, increased prevalence of parental-reported caries was significantly associated with low maternal education levels (RR=1.60, 95%CI 1.17,2.20) and high sugar consumption (RR= 1.60, 95%CI 1.26,2.02). In the group of children whose mothers smoked tobacco during pregnancy, the association with parent-reported dental caries approached the threshold of significance, but was not significantly associated with caries status in children (RR=1.19, 95%CI 0.99,1.43). After multiple imputation, the most significant association was evident in children of the least educated mothers (RR=1.57, 95%CI 1.25,1.95), breastfeeding more than 12 months (RR=1.26, 95%CI 1.01,1.56), sweet intake more than 30% (RR=1.42, 95%CI 1.15,1.74) and 20-30% (RR=1.29 95%CI 1.04,1.59) and residing in outer regional (RR=1.56, 95%CI 1.19,2.05) or inner regional locations (RR=1.50, 95%CI 1.19,1.88). Mothers' tobacco smoking status showed a weak association with parent-reported dental decay (RR=1.42, 95%CI 1.20,1.68). Conclusion: This study suggests there is a weak association between maternal smoking during pregnancy and prevalence of parentally-reported dental caries in Indigenous Australian children.
... Mothers smoking cigarettes paid less attention to salivation and rarely used non-pharmacological treatment. The connection has been proved between maternal smoking and presence of caries in children [32,33]. It is considered that tobacco smoke at home is an indicator of poor oral hygiene among children and may affect oral health. ...
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Background The results of the study support the view that teething is not associated with severe general symptoms. They present factors influencing their perception by mothers and methods to solve teething problems. Aim The aim was to identify the teething symptoms and factors influencing their prevalence and the mothers’ perception of teething and ways of solving them. Methods A study was conducted among children aged 5–36 months and their mothers in Warsaw. It included questionnaire data (socio-demographic data, those related to nursing care, the baby's general condition, teething symptoms) and childrens’ clinical examination. Results Of 630 children included in the study (the mean age: 21.84 ± 8.28 months) teething problems were reported in 79.7% of the patients: excessive salivation, swollen and reddened gum, an increased temperature and nervousness, anorexia, diarrhoea, cold-like symptoms, insertion of fingers/objects into the mouth. Teething problems were mildly associated with socio-demographic factors, birth weight and season of birth. Mothers used teething rings (66.8%), topical gels (63.3%), gingival massage (45.7%), comforting bottles (2.7%). In 16.8% of patients tooth brushing was started since the eruption of the first tooth. The choice of methods was influenced by the type of observed symptoms, education and maternal smoking habits. Pediatricians were the main source of knowledge. Conclusion The general teething symptoms are associated with gingival swelling. The results demonstrate an overuse local remedies and negative impact of maternal smoking and lower level of education upon the solution problems. The hygienic neglect and feeding with a bottle indicates the significance of education.
... Other effects in the oral cavity have been reported regarding tooth discoloration [14], gingival and lip pigmentation [15], accumulation of dental calculus [16], oral mucosal lesion [17], and negative treatment outcomes of dental implants [18] and periodontal disease [19]. Passive smoking also has an impact on periodontal disease [20], early childhood dental caries [21,22] and gingival pigmentation in children [23]. Dental professionals can therefore choose appropriate topics for administering effective feedback to smokers. ...
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Article
We explored the impact of addressing personally relevant effects of smoking in the mouth on promoting the motivation to quit in a dental setting at personal and public levels. Stages of behavior change and attempts to quit smoking by smokers were recorded during dental visits. Dentists selected and gave motivational information from 24 topics relevant to a patient's oral health status, risk, or dental treatment. During the dental visit, each topic was presented to patients. Topics of gingival melanin pigmentation and periodontal disease risk were most frequently presented. Progression through stages of behavior change and attempts to quit smoking were observed after presentation of each topic. At a personal level, progression through stages was most frequently observed after the patient was shown an image of pediatric dental caries and smoker's palate, and attempts to quit was most frequently observed after the patient shown an image of the effects of smoking cessation and pediatric dental caries. At the public level, enhancing the motivation to progress through stages and attempts to quit was most frequently observed after the presentation of effects of smoking cessation and discoloration of teeth, although the intensity of enhanced motivation significantly correlated with the frequency of presentation, which was not the highest for these topics. Although various smoking effects on the mouth have potential impact on promoting the motivation to quit, the impact on enhancing motivation is not necessarily consistent at personal and public levels.
... Among American Indigenous populations, ECC has been found to be associated with parenting practices such as prolonged use of the bottle or training cups with sugar-containing drinks and a high frequency of sugary snacks per day (19)(20)(21)(22)(23). Environmental tobacco smoke and maternal smoking status have been associated with an increased risk of caries among children (24,25). ...
... Among American Indigenous populations, ECC has been found to be associated with parenting practices such as prolonged use of the bottle or training cups with sugar-containing drinks and a high frequency of sugary snacks per day [19]- [23] . Environmental tobacco smoke and maternal smoking status have been associated with an increased risk of caries among children [24] [25] . ...
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The oral health of Indigenous children of Canada (First Nations, Inuit and Métis) and the United States (American Indian and Alaska Native) is a major child health issue. This is exemplified by the high prevalence of early childhood caries (ECC) with resulting adverse health effects, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. The present statement includes recommendations for oral health preventive and clinical care for young infants and pregnant women by primary health care providers, community-based health promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride varnish program access. Further community-based research on the epidemiology, prevention, management and microbiology of ECC in Indigenous communities would be beneficial.
... Tobacco use and secondhand smoke exposure are significant global public health problems. Secondhand smoke is a factor in heart disease, lung cancer, asthma attacks, respiratory and ear infections, sudden unintentional infant death syndrome [2][3][4][5] and early childhood caries [6,7]. There are over 7000 components in secondhand smoke and some are more concentrated than in firsthand smoke [1,8,9]. ...
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Objective: There are many factors influencing dental behavior. The relationship of smokers who smoked inside the home toward preventive care (measured as dental sealant placement) of the children living in their homes is examined in this study. Methods: Data from the National Health and Nutrition Examination Surveys in 2001-2002 and in 2011-2012 were analyzed. Data included variables to someone smoking inside the home, dental sealant placement in children ages 6-less than 20 years, and sociodemographics which were obtained from a dental examination and a home interview. Results: There were 3,352 eligible participants in 2001-2002 and 2,374 in 2011-2012. The unadjusted odds ratio for not having dental sealants when there was someone who smoked inside the home as compared with not having dental sealants when there was no one who smoked inside the home was 1.57 (95%CI: 1.17, 2.10) in 2001-2002. The unadjusted odds ratio was 1.56 (95% CI: 1.20, 2.03) in 2011-2012. When the data were adjusted for age, sex, race/ethnicity, insurance, and income to poverty ratio, the 2001-2002 adjusted odds ratio was 1.31 (95%CI: 0.97, 1.78). The adjusted odds ratio in 2011-2012 was 1.41 (95% CI:1.01, 1.95). Conclusions: Children who lived in homes in which someone smoked inside the home were more likely to not have dental sealants compared with children who lived in homes in which no one smoked inside the home. These results are important for understanding the factors related to access to dental care issues for children.
... Among American Indigenous populations, ECC has been found to be associated with parenting practices such as prolonged use of the bottle or training cups with sugar-containing drinks and a high frequency of sugary snacks per day [19]- [23] . Environmental tobacco smoke and maternal smoking status have been associated with an increased risk of caries among children [24] [25] . ...
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Article
The oral health of Indigenous children of Canada (First Nations, Inuit, and Metis) and the United States (American Indian, Alaska Native) is a major child health issue: there is a high prevalence of early childhood caries (ECC) and resulting adverse health effects in this community, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. This statement includes recommendations for preventive oral health and clinical care for young infants and pregnant women by primary health care providers, community-based health-promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride-varnish program access. Further community-based research on the epidemiology, prevention, management, and microbiology of ECC in Indigenous communities would be beneficial. Pediatrics 2011;127:1190-1198
... [2][3][4][5] Recently, it was suggested that children exposed to environmental tobacco smoke (ETS) also have an increased risk of dental caries in the deciduous dentition. [6][7][8][9][10][11][12][13] Furthermore, breastfeeding has been identified as a risk factor for ECC. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Heldeman et al 16 conducted a cohort study in Myanmer and reported that nocturnal breastfeeding after the age of 12 months poses a risk of developing ECC. ...
Article
Early childhood caries (ECC) is one of the most prevalent chronic diseases among children. The aim of this cross-sectional study was to investigate the association between nocturnal breastfeeding, snacking habits, or other risk factors and ECC in 18- to 23-month-old Japanese children. Study subjects were 1675 children aged 18 to 23 months. A self-administered questionnaire was completed by parents or guardians of the children. The survey contents included such things as number of decayed, missing, and filled teeth per child, smokers in the home, nocturnal breastfeeding habit, snack times, kinds of snacks consumed ≥4 days a week, kinds of drinks consumed ≥4 days a week, parents brushing their child's teeth daily, and the use of fluoride toothpaste. Logistic regression analysis was performed to estimate the odds of ECC. The average number of decayed, missing and filled teeth was 0.10. The prevalence of dental caries was 3.3%. Nocturnal breastfeeding habits were reported in 357 subjects (21.3%). After excluding items of multicollinearity, significant associations were observed between ECC and nocturnal breastfeeding, drinking or eating sweets after dinner every day, and the intake of candy, soda and/or isotonic drinks ≥4 days a week. This study suggests that nocturnal breastfeeding and snacking habits are correlated with ECC.
... The relationship between both pre-and post-natal passive smoking exposure and the health status of children has been reported in many investigations [Ferris et al., 2010]. In addition, there are a number of studies on oral health in relation to passive smoking in young children [Avsar et al., 2008;Avsar et al., 2009;Hanioka et al., 2008;Leroy, 2008]. ...
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To assess dental development in young children who have been exposed to passive smoking by comparing dental ages with the corresponding features in a healthy control group. A total of 90 passive smokers (PS) with a mean age of 5.49 years and 90 healthy age-matched controls were included in this study. The children were investigated for stimulated salivary cotinine level. Three categories were formed with respect to the number of cigarettes smoked. Dental development was analysed using panoramic radiographs. The dose-response relationship between the cotinine levels of the PS subjects and the number of cigarettes smoked per day was found to be significantly different for the three exposure categories. A significant difference was found between the chronological and dental ages of PS subjects when compared with those of the control group, but there were no significant differences in dental ages related to gender in both groups. We could clearly conclude that young children who were PS subjects had delayed dental development.
... Our finding that family structure was not associated with caries is inconsistent with a previous study reporting that children from one-parent families had significantly higher caries rates than those from two-parent families [34]. Our results are also inconsistent with previous studies that link caregiver smoking and caries [35,[53][54][55]. One potential explanation is social desirability bias regarding reliable reporting of smoking status [56]. ...
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Article
Anecdotal evidence suggests that low-income preschoolers with developmental delays are at increased risk for dental caries and poor oral health, but there are no published studies based on empirical data. The purpose of this pilot study was two-fold: to examine the relationship between developmental delays and dental caries in low-income preschoolers and to present a preliminary explanatory model on the determinants of caries for enrollees in Head Start, a U.S. school readiness program for low-income preschool-aged children. Data were collected on preschoolers ages 3--5 years at two Head Start centers in Washington, USA (N = 115). The predictor variable was developmental delay status (no/yes). The outcome variable was the prevalence of decayed, missing, and filled surfaces (dmfs) on primary teeth. We used multiple variable Poisson regression models to test the hypothesis that within a population of low-income preschoolers, those with developmental delays would have increased dmfs prevalence than those without developmental delays. Seventeen percent of preschoolers had a developmental delay and 51.3% of preschoolers had >=1 dmfs. Preschoolers with developmental delays had a dmfs prevalence ratio that was 1.26 times as high as preschoolers without developmental delays (95 % CI: 1.01, 1.58; P < .04). Other factors associated with increased dmfs prevalence ratios included: not having a dental home (P = .01); low caregiver education (P < .001); and living in a non-fluoridated community (P < .001). Our pilot data suggest that developmental delays among low-income preschoolers are associated with increased primary tooth dmfs. Additional research is needed to further examine this relationship. Future interventions and policies should focus on caries prevention strategies within settings like Head Start classrooms that serve low-income pre-school aged children with additional targeted home- and community-based interventions for those with developmental delays.
... Among American Indigenous populations, ECC has been found to be associated with parenting practices such as prolonged use of the bottle or training cups with sugar-containing drinks and a high frequency of sugary snacks per day (19)(20)(21)(22)(23). Environmental tobacco smoke and maternal smoking status have been associated with an increased risk of caries among children (24,25). ...
Full-text available
Article
The oral health of Indigenous children of Canada (First Nations, Inuit and Métis) and the United States (American Indian and Alaska Native) is a major child health issue. This is exemplified by the high prevalence of early childhood caries (ECC) with resulting adverse health effects, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. The present statement includes recommendations for oral health preventive and clinical care for young infants and pregnant women by primary health care providers, community-based health promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride varnish program access. Further community-based research on the epidemiology, prevention, management and microbiology of ECC in Indigenous communities would be beneficial.
... Asimismo la experiencia de caries y el índice cod y sus componentes se mostraron significativamente más elevados en aquellos que conviven con alguna persona fumadora en el domicilio. En la literatura, se han descrito resultados similares 3,4 . El estudio de Aligne et al 5 , además relacionó la presencia de caries clínica con los niveles de cotinina en suero, encontrando una asociación significativa entre niveles elevados de cotinina y caries en dentición temporal. ...
Article
Objective: To evaluate the associations between time-varying factors (mother's oral health, oral hygiene, smoking habits, diet, food insecurity and stress) socioeconomic factors (mother's employment, marital status, household income, insurance status, household size) and medical history on children's risk of developing a carious lesion in the first 3 years of life. Methods: Longitudinal data from the Center for Oral Health Research in Appalachia Cohort Two (COHRA2) were analysed. Pregnant women ≥18 years in the USA were recruited during pregnancy; all consenting women delivering at term and their babies had regular dental assessments and complete in-person surveys and telephone interviews regarding sociodemographic factors, medical and dental history, and oral health behaviours. Results: In a logistic regression model adjusting for covariates, children whose mother had two or more prior pregnancies, smoked cigarettes post-partum, or had a recent unfilled carious lesion were at least twice as likely to experience a dental lesion by the three-year visit. The magnitude of these associations varied by maternal education and state of residence. Conclusions: Untreated maternal decay but not maternal oral hygiene or diet were associated with cumulative risk of childhood caries by age three but were modified by maternal education and state of residence. Addressing structural and behavioural issues that reduce use of restorative dental care are needed to prevent the adverse impacts associated with early childhood caries.
Article
Active smoking is associated with many adverse health outcomes, including important negative effects on oral health. It is increasingly recognized the secondhand exposure to tobacco smoke pollution can also adversely impact health, particularly in children who are at increased risk of involuntary exposure. Several recent epidemiological studies have focused on a possible relationship between secondhand smoke exposure and childhood dental caries. This chapter discusses several plausible biological mechanisms that could lead to adverse effects of secondhand smoke on oral health in both children and adults. Oral health care professionals can play an important role in helping patients quit smoking for the benefit of both active those exposed passively to tobacco smoke pollution.
Article
Dental caries are of serious concern as increasing numbers of cases of early childhood caries are seen. Oral hygiene and the development of dental caries is a challenging issue to address in any child. However, children in lower socioeconomic groups are disproportionately affected when compared with their higher-income peers. Low-income children are found to be twice as likely to have dental problems, with a reported prevalence of up to 50 %. Several environmental factors have been found to play a role in this difference, including passive smoke exposure, lead exposure, and poor nutritional intake. While lead exposure and nutrition have been studied extensively, the association between passive smoke exposure and dental caries in children is less well known. This review will consider these environmental risk factors, focusing primarily on passive smoke exposure and its association with the development of dental caries. We will also propose potential strategies, on the basis of a comprehensive understanding of both existing published research and communitybased interventions, as a means of addressing the health disparities that contribute so dramatically to this problem.
Article
The aim of this study was to investigate the association of environmental tobacco smoke (ETS) and other risk factors with early childhood caries (ECC) in 3-year-old Japanese children by a cross-sectional study. Study subjects were 1,801 children aged 3 years old. The self-administered questionnaire was completed by parents or guardians of the children. The survey contents included such things as if there was a smoker in the home, snack times, the kinds of snacks consumed more than or equal to four times a week, the kinds of drinks consumed more than or equal to four times a week, parents brushing their child's teeth daily, and the use of fluoride toothpaste. We obtained the number of decayed, missing, or filled teeth per person (dmft) from the dental examinations. Logistic regression analysis was performed to estimate odds ratio of ECC. The average number of decayed, missing and filled teeth (dmft index) was 1.00. The prevalence of dental caries was 22.4 percent. There was at least one smoker in the homes of 1,121 subjects (62.2 percent). After excluding items of multicollinearity, the results of multivariate analysis were as follows: drinking or eating sweets after dinner, irregular snack times, frequent intake of chocolate, frequent intake of sugar-sweetened gum, frequent intake of isotonic drink, and maternal smoking were significantly associated with the risk of ECC. This study suggests that there is a significant correlation between ETS from family members and snacking habits and ECC. © 2015 American Association of Public Health Dentistry.
Article
Die frühkindliche Karies stellt das häufigste Problem in der kinderzahnärztlich spezialisierten Praxis dar. Als Hauptursache für die frühzeitige und umfangreiche Zerstörung der Zahnhartsubstanz ist eine frequente Aufnahme zuckerhaltiger Getränke und Nahrungsmittel zu nennen. Zudem wird die Aktivität des kariösen Prozesses durch eine ausbleibende bzw. unzureichende Entfernung des Biofilms auf der Zahnoberfläche begünstigt. Aus präventiver Sicht kommt daher der zahngesunden Ernährung und Sicherstellung einer qualitativ guten Mundhygiene höchste Priorität zu. Die grundsätzliche Therapiestrategie wird primär von der Kooperationsbereitschaft des Kindes und dem Umfang der Gebisszerstörung beeinflusst und ist individuell festzulegen. Als Behandlungsansätze sind hierbei, neben der kindgerechten und minimalinvasiven Kariestherapie mit bzw. ohne Lokalanästhesie, die Sedierung und Allgemeinanästhesie zu nennen.
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Background: Recently, it has focused the role of exposure to environmental tobacco smoke in the etiology of dental caries, so we plan to evaluate the association between environmental tobacco smoke inhalation and caries experience in 10-15-years-old children. Methods: A transversal descriptive study was designed. Carried out in the Primary Dentistry Unit. 9th Health Department. Valencian Country (Spain). 380 children random sample was selected (following the inclusion criteria). Each participant was clinically explored, then answered a self-administered opinion test about contact with tobacco smoke. Measurements: DMF-T and df-t indexes and their components, plaque and gingival indexes, contact with tobacco smoke frequency (at home or not), own opinion about tobacco effects and present or future tobacco consumption. Results: Children living with smokers at home showed a decayed teeth average of 1,9 ± 2,34, while those not living with smokers had 1,03± 1,46 ( p<0,001). df and DMF average indexes for children exposed and not exposed to tobacco smoke were 0,27 ±0,78 (df)and 1,62± 2,21 (DMF) and 0,10 ±0,47 (df) and 0,92 ±1,40 (DMF) respectively (p=0,039 y p<0,001). Conclusions: In our study conditions, coexistence with environmental tobacco smoke is associated with a higher caries prevalence in both deciduous and permanent dentitions in 10-15-years-old children.
Article
Objective Baby bottle tooth decay is a severe form of early childhood caries. This study aims to elaborate a screening tool for at risk children in order to facilitate primary prevention. Methods A case-control study was conducted among children suffering from baby bottle tooth decay and children with no dental caries. Cases were children aged 5 years or less at diagnosis who experienced at least four caries with one or more affecting maxillary incisors. Controls were children matched for age and sex. Parents were interviewed by phone about their child's exposure to potential risk factors. Results We included 88 children suffering from baby bottle tooth decay and 88 children with no dental caries. In multivariate analysis, low social class (OR 6.39 [95% CI, 1.45–28.11]), prolonged bottle feeding or bedtime feeding (OR 153.2 [95% CI, 11.77–1994.96]), and snacking (OR 5.94 [95% CI, 1.35–26.2]) were significantly associated with baby bottle tooth decay. Regular dental visits were a significant protecting factor (OR 0.13 [95% CI, 0.02–0.77]). A score was developed using these significant risk factors and tested on the survey population. The mean score was 13/20 for cases and 4/20 for controls. Discussion These results are in accordance with the literature, except for brushing teeth, which was not significantly associated with baby bottle tooth decay in our study. Conclusion A screening scale with a score of 20 points was proposed. Future validation is required. Pediatricians and general practitioners should encourage parents to change their habits.
Article
Initially, tobacco was considered as a decorative plant and only later began to be treated as a herb with special therapeutic properties. With time, it was found that tobacco had strong insecticidal and addictive properties. There also occurred reports about the negative influence of tobacco on human health. The World Health Organization (WHO) classifies smoking as a chronic, progressive disease which is also 'contagious'. It is also considered to be a neurobiotic addiction. Nicotine addiction does not cause changes in the behaviour or functioning of a smoker; however, it adversely affects his or her general health status and the health status of people within their environment. Passive smoking (so-called ETS - Environmental Tobacco Smoke), which means accompanying smokers negatively influences the health of passive smokers. Environmental tobacco smoke, on the one hand, is the result of spontaneous cigarette burning and, on the other hand, the result of the side-stream of cigarette smoke, as well as the smoke exhaled by active smokers. Health personnel should clearly and convincingly present the data concerning the adverse results of smoking, as well as the dangers of exposure to environmental tobacco smoke, thereby making their patients aware that breaking their addiction will not only be beneficial for their own health, but will also protect non-smokers in their environment from the adverse effects of exposure to environmental tobacco smoke.
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Article
Recently, it has focused the role of exposure to environmental tobacco smoke in the etiology of dental caries, so we plan to evaluate the association between environmental tobacco smoke inhalation and caries experience in 10-15-years-old children. A transversal descriptive study was designed. Carried out in the Primary Dentistry Unit. 9th Health Department. Valencian Country (Spain). 380 children random sample was selected (following the inclusion criteria). Each participant was clinically explored, then answered a self-administered opinion test about contact with tobacco smoke. Measurements: DMF-T and df-t indexes and their components, plaque and gingival indexes, contact with tobacco smoke frequency (at home or not), own opinion about tobacco effects and present or future tobacco consumption. Children living with smokers at home showed a decayed teeth average of 1,9 ± 2,34, while those not living with smokers had 1,03 ± 1,46 ( p<0,001). df and DMF average indexes for children exposed and not exposed to tobacco smoke were 0,27 ± 0,78 (df)and 1,62 ± 2,21 (DMF) and 0,10 ± 0,47 (df) and 0,92 ± 1,40 (DMF) respectively (p=0,039 y p<0,001). In our study conditions, coexistence with environmental tobacco smoke is associated with a higher caries prevalence in both deciduous and permanent dentitions in 10-15-years-old children.
Article
Tobacco dependence education (TDE) continues to be a vital component of dental hygiene curricula-made even more important by the fact that tobacco cessation in adults in the United States has stagnated over the past ten years. This study was undertaken to assess the salient characteristics of TDE in U.S. dental hygiene programs. A fifty-one question survey was mailed to the program directors of all 283 accredited dental hygiene programs during the 2007-08 school year (this number does not include the programs in Illinois, which were excluded since they had participated in a previous study). A total of 187 schools returned the survey for a return rate of 66 percent. Curricular content, minutes spent on each topic, existing level of clinical competence measured, expected level of clinical competence, and resources used were assessed. Respondents reported an average of 6.7 hours spent on all identified components of tobacco education. While 77 percent of respondents reported formally assessing whether a student asked if a patient used tobacco, only 26 percent indicated having a formal competency utilizing all of the U.S. Public Health Service's Clinical Practice Guideline 5 As and 5 Rs. In contrast, 72 percent of program directors reported expecting their graduates to be competent in a moderate intervention that included all 5 As. Though there is a clear commitment to TDE among dental hygiene programs in the United States, we recommend training to a more intensive level of TDE in order to facilitate broader adoption of comprehensive, evidence-based guidelines.
Article
This study aimed to investigate pre- and perinatal determinants as risk factors for caries development in offspring. In this longitudinal register-based cohort study, we included all children (n = 18,142), of 13 years of age who resided in the county of Stockholm, Sweden, in 2000. The cohort was followed until individuals were 19 years of age. In total, 15,538 subjects were examined. Dental caries (decayed, missing and filled teeth/surfaces), were collected from the Public Health Care Administration in Stockholm. Data concerning pre- and perinatal factors, as well as parental socio-demographic determinants, were collected from the Swedish Medical Birth Register and Swedish National Registers at Statistics Sweden. Mean approximal caries increment (DMFSa) was 1.34 +/- 2.74. The results showed that the prenatal factors, "maternal smoking" and "maternal overweight" exhibited an increased risk of approximal caries increment, (OR 1.33; 95% CI = 1.22-1.44) and (OR 1.21; 95% CI = 1.07-1.37), respectively. Concerning maternal overweight, the excess risk enhanced in relation to the magnitude of the caries increment and maternal smoking was significant across the various DMFSa outcome cut-off levels. In conclusion, this study demonstrates that the prenatal factors, maternal overweight, as well as smoking, are risk factors for approximal caries development in offspring during the teenage period.
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Objective: Environmental tobacco smoke (ETS) has been associated with a number of negative health outcomes for exposed children. The goal of this study was to assess the association between ETS and dental caries in a pediatric population. Methods: This study included 637 Iowa Fluoride Study children whose parents provided socioeconomic information, completed at least three questionnaires during the first year of life, and had a primary dentition exam at age 4–7 years. Households reporting in all questionnaires that someone smoked in the home were categorized as regularly smoking homes. Socioeconomic status (SES) was divided into three groups (low, middle, and high) based on family income and mother's education. Children were classified as having caries if any of the primary teeth had fillings or cavitated lesions at the primary dentition exam. Results: Overall, children residing in regularly smoking homes had a higher prevalence of caries. For the middle SES group and overall, the children from smoking homes had a significantly higher prevalence of caries compared to nonregular/nonsmoking homes (52% vs 24%, P=.05 and 44% vs 25%, P=.002, respectively). After adjusting for age, SES, toothbrushing frequency, total ingested fluoride, and combined intake of soda pop and powdered drink beverages, the relationship of smoking and caries still remained significant (odds ratio [OR]=3.38; P=.001). Conclusions: Environmental tobacco smoke was associated with an increased risk of caries among children.
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Since dental caries may present soon after tooth eruption, we hypothesized that colonization of Streptococcus mutans can occur in the predentate stages. In this study, we examined S. mutans colonization and its association with oral developmental nodules (Bohn's nodules) in 60 pre-term and 128 full-term, three-month-old infants. Overall, S. mutans was cultured from 30% (56/188) of the infants, and oral developmental nodules were noted in 55% (103/188). Compared with the pre-term, full-term infants showed a higher prevalence of S. mutans (34% vs. 20%, p < 0.02) as well as developmental nodules (61% vs. 42%, p < 0.05). In both groups, S. mutans was positively associated with numbers of developmental nodules in a dose-response relationship (p < 0.001), and with maternal salivary levels of the bacteria (p = 0.03). The permanence of S. mutans infection was confirmed by repeat saliva sampling at 6 months of age. Our results thus showed that many infants have already acquired S. mutans at 3 months of age, prior to tooth eruption.
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Dental decay is the most common chronic disease of children and it disproportionately affects those living in poverty, but the reasons for this are not clear. Passive smoking may be a modifiable risk factor for dental caries. To examine the relationship between dental caries and serum cotinine levels. Cross-sectional data from the Third National Health and Nutrition Examination Survey (1988-1994) of 3531 children aged 4 to 11 years, who had had both dental examinations and a serum cotinine level measurement. Passive smoking defined as serum cotinine levels of 0.2 to 10 ng/mL and caries defined as decayed (unfilled) or filled tooth surfaces. Twenty-five percent of the children had at least 1 unfilled decayed tooth surface and 33% had at least 1 filled surface. Fifty-three percent had cotinine levels consistent with passive smoking. Elevated cotinine level was significantly associated with both decayed (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5-2.9) and filled (OR, 1.4; 95% CI, 1.1-1.8) tooth surfaces in deciduous but not in permanent teeth. This relationship persisted after adjusting for age, sex, race, family income, geographic region, frequency of dental visits, and blood lead level. For dental caries in deciduous teeth, the adjusted OR was 1.8 (95% CI, 1.2-2.7) for the risk of decayed surfaces and 1.4 (95% CI, 1.1-2.0) for filled surfaces. We estimated the population attributable risk from passive smoking to be 27% for decayed and 14% for filled tooth surfaces. There is an association between environmental tobacco smoke and risk of caries among children. Reduction of passive smoking is important not only for the prevention of many medical problems, but also for the promotion of children's dental health.
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Infants' healthy growth and development are predicated, in part, on regular functioning of the gastrointestinal (GI) tract. In the first 6 months of life, infants typically double their birth weights. During this period of intense growth, the GI tract needs to be highly active and to function optimally. Identifying modifiable causes of GI tract dysregulation is important for understanding the pathophysiologic processes of such dysregulation, for identifying effective and efficient interventions, and for developing early prevention and health promotion strategies. One such modifiable cause seems to be maternal smoking, both during and after pregnancy. Purpose. This article brings together information that strongly suggests that infants' exposure to tobacco smoke is linked to elevated blood motilin levels, which in turn are linked to an increased risk of GI dysregulation, including colic and acid reflux. We base this hypothesis on evidence supporting a link between maternal smoking and infantile colic (IC) and on additional evidence proposing increased motilin release, attributable to exposure to tobacco smoke and its metabolites, as a physiologic mechanism linking maternal smoking with infantile GI dysregulation. We critically review and synthesize epidemiologic, physiologic, and biological evidence pertaining to smoking and colic, smoking and motilin levels, and motilin and colic. Six studies have investigated the link between maternal smoking and IC, but IC was defined according to Wessel's rule of threes (crying for > or =3 hours per day, > or =3 days per week, for > or =3 weeks) in only 1 of these studies. The remaining studies used definitions that ranged from less-stringent variations of Wessel's criteria to definitions that would suggest excessive crying but not necessarily colic. Results from 5 of these studies suggest that there is an independent association between maternal smoking and excessive crying, as well as IC. Recent studies of the GI system provide strong, but indirect, corroborating evidence suggesting physiologic pathways through which maternal smoking can be linked to IC. This physiologic evidence can be outlined as follows: (1) smoking is linked to increased plasma and intestinal motilin levels and (2) higher-than-average levels of motilin are linked to elevated risks of IC. Although these findings from disparate fields suggest a physiologic mechanism linking maternal smoking with IC, the entire chain of events has not been examined in a single cohort. A prospective study, begun in pregnancy and continuing through the first 4 months of life, could provide definitive evidence linking these disparate lines of research. Key points for such a study are considered. New epidemiologic evidence suggests that exposure to cigarette smoke and its metabolites may be linked to IC. Moreover, studies of the GI system provide corroborating evidence that suggests that (1) smoking is linked to increased plasma and intestinal motilin levels and (2) higher-than-average intestinal motilin levels are linked to elevated risks of IC. In the United States, nearly one-half of all women smokers continue to smoke during their pregnancies. This amounts to approximately 12% of all women who give birth. Moreover, it is estimated that 50% to 80% of employed adults have regular exposure to environmental tobacco smoke and that >30% of nonsmokers live with smokers. If, as we suspect, exposure to cigarette smoke increases the risk of colic, then this would provide additional incentives to parents to abstain from smoking. Decreased exposure to tobacco smoke can be expected to provide widespread and long-term health benefits to maternal and child populations.
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Personal smoking and gender are determinants of adult rheumatoid arthritis. We assessed the independent and joint effects of maternal smoking in pregnancy and gender on the development of rheumatoid arthritis and other inflammatory polyarthropathies (RA&IP, ICD-9 code 714) in particular juvenile rheumatoid arthritis (JRA, ICD-9 code 714.3) in the first 7 years of life in a cohort of Finnish children born in 1987. We identified 58 841 singleton births from the Finnish Medical Birth Registry and followed-up on them through other nationwide registries for 7 years. The birth registry provided categorical information on the mother's smoking during pregnancy: no smoking as a reference, low exposure (<10 cigarettes per day) and high exposure (>10 cigarettes per day). There were 75 cases of RA&IP yielding an incidence rate of 18.5 per 100 000 person-years. Of these, 31 were classified as JRA with an incidence rate of 7.6 per 100 000 person-years. In logistic regression, both the risks of RA&IP (adjusted odds ratio (OR) 2.10; 95% confidence interval (CI) 1.30-3.40) and JRA (3.03; 1.36-6.76) were increased in girls. High exposure to tobacco smoke increased the risks of RA&IP (2.57; 1.13-5.89) and JRA (2.98; 0.95-8.78) in girls, but not in boys. The adjusted ORs for girls with heavy exposure were 4.64 (1.94-11.07) for RA&IP and 6.76 (2.00-22.9) for JRA compared with unexposed boys. This is an original finding of a potential effect of foetal exposure to tobacco smoke on the risks of RA&IP and JRA in girls.
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To investigate the associations of maternal and grandmaternal smoking before, during, and after pregnancy with childhood asthma. We conducted a case-control study nested within the Children's Health Study in southern California. The case patients consisted of 338 children with asthma that had been diagnosed in the first 5 years of life, and 570 control subjects were countermatched on in utero exposure to maternal smoking within grade, sex, and community of residence. Detailed maternal and household smoking histories and other asthma risk factor information was obtained by telephone interview. The participation rates were 72.3% and 82.5%, respectively, for control subjects and case patients. In utero exposure to maternal smoking was associated with increased risk for asthma diagnosed in the first 5 years of life (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.0 to 2.3), and for persistent asthma (OR, 1.5; 95% CI, 1.0 to 2.3). The associations did not differ in children with early transient asthma compared to those with early persistent asthma. Relative to never-smokers, children whose mothers smoked throughout the pregnancy had an elevated risk of asthma in the first 5 years of life (OR, 1.6; 95% CI, 1.0 to 2.6). Children of mothers who quit smoking prior to the pregnancy showed no increased risk (OR, 0.9; 95% CI, 0.5 to 1.5). We were unable to assess the association of smoking cessation during pregnancy because very few mothers were reported to have done so (15%). Asthma risk did not increase in a monotonic pattern with smoking intensity during pregnancy. Postnatal secondhand smoke exposure was not independently associated with asthma. Grandmaternal smoking during the mother's fetal period was associated with increased asthma risk in her grandchildren (OR, 2.1; 95% CI, 1.4 to 3.2). Maternal and grandmaternal smoking during pregnancy may increase the risk of childhood asthma.
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Little is known about the socioeconomic differences in health-related behaviours in Japan. The present study was performed to elucidate the effects of individual and regional socioeconomic factors on selected health risk behaviours among Japanese adults, with a particular focus on regional variations. In a nationally representative sample aged 25 to 59 years old (20,030 men and 21,076 women), the relationships between six risk behaviours (i.e., current smoking, excessive alcohol consumption, poor dietary habits, physical inactivity, stress and non-attendance of health check-ups), individual characteristics (i.e., age, marital status, occupation and household income) and regional (N = 60) indicators (per capita income and unemployment rate) were examined by multilevel analysis. Divorce, employment in women, lower occupational class and lower household income were generally associated with a higher likelihood of risk behaviour. The degrees of regional variation in risk behaviour and the influence of regional indicators were greater in women than in men: higher per capita income was significantly associated with current smoking, excessive alcohol consumption, stress and non-attendance of health check-ups in women. Individual lower socioeconomic status was a substantial predictor of risk behaviour in both sexes, while a marked regional influence was observed only in women. The accumulation of risk behaviours in individuals with lower socioeconomic status and in women in areas with higher income, reflecting an urban context, may contribute to their higher mortality rates.
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The association between gingival pigmentation and active smoking has been established. This investigation is the first to address the relationship between gingival pigmentation in children and passive smoking. A case-control study was performed involving 59 nonsmoking children who were selected from patient records of a dental clinic in a rural town in Japan. The number of subjects was based on a power calculation. Two calibrated examiners independently observed labial gingiva via oral photographs. An interview determined that 61% of children had at least 1 smoking parent. Gingival pigmentation was observed in 71% to 78% of children. Interexaminer agreement was satisfactory (kappa = 0.73). Percentage of smoking parents was higher in children with gingival pigmentation (70-71%) than in those who lacked pigmentation (35%). Odds ratios of parental smoking adjusted by age and gender were 5.6 (95% confidence interval: 1.5-20.0) and 5.4 (1.4-21.2) for the 2 examiners. These findings suggest that excessive pigmentation in the gingiva of children is associated with passive smoking. The visible pigmentation effect in gingiva of children could be useful in terms of parental education.
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Environmental tobacco smoke (ETS) exposure is probably one of the most important public health hazards in our community. Our aim with this article is to (1) review the prevalence of ETS exposure in the United States and how this prevalence is often measured in practice and (2) summarize current thinking concerning the mechanism by which this exposure may cause infections in young children. We conducted a Medline search to obtain data published mainly in peer-reviewed journals. There is still a very high prevalence of ETS exposure among US children ranging from 35% to 80% depending on the method of measurement used and the population studied. The mechanism by which ETS may be related to these infections is not entirely clear but may be through suppression or modulation of the immune system, enhancement of bacterial adherence factors, or impairment of the mucociliary apparatus of the respiratory tract, or possibly through enhancement of toxicity of low levels of certain toxins that are not easily detected by conventional means. The prevalence of ETS exposure in the United States is still very high, and its role in causing infections in children is no longer in doubt even if still poorly understood. Research, therefore, should continue to focus on the various mechanisms of causation of these infections and how to best reduce the exposure levels.
Article
Context Dental decay is the most common chronic disease of children and it disproportionately affects those living in poverty, but the reasons for this are not clear. Passive smoking may be a modifiable risk factor for dental caries.Objective To examine the relationship between dental caries and serum cotinine levels.Design, Setting, and Participants Cross-sectional data from the Third National Health and Nutrition Examination Survey (1988-1994) of 3531 children aged 4 to 11 years, who had had both dental examinations and a serum cotinine level measurement.Main Outcome Measures Passive smoking defined as serum cotinine levels of 0.2 to 10 ng/mL and caries defined as decayed (unfilled) or filled tooth surfaces.Results Twenty-five percent of the children had at least 1 unfilled decayed tooth surface and 33% had at least 1 filled surface. Fifty-three percent had cotinine levels consistent with passive smoking. Elevated cotinine level was significantly associated with both decayed (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5-2.9) and filled (OR, 1.4; 95% CI, 1.1-1.8) tooth surfaces in deciduous but not in permanent teeth. This relationship persisted after adjusting for age, sex, race, family income, geographic region, frequency of dental visits, and blood lead level. For dental caries in deciduous teeth, the adjusted OR was 1.8 (95% CI, 1.2-2.7) for the risk of decayed surfaces and 1.4 (95% CI, 1.1-2.0) for filled surfaces. We estimated the population attributable risk from passive smoking to be 27% for decayed and 14% for filled tooth surfaces.Conclusions There is an association between environmental tobacco smoke and risk of caries among children. Reduction of passive smoking is important not only for the prevention of many medical problems, but also for the promotion of children's dental health.
Article
Objectives: The study investigated the relationship between smoking in the household and dental caries in Japanese children using nationally representative cross-sectional data. Methods: This study included 925 children aged 1-14 years. A child was considered to have decayed and/or filled teeth if a dentist diagnosed these conditions in deciduous or permanent teeth. Smoking in the household was defined as positive if someone in the household reported smoking cigarettes. Results: No statistically significant relationship was observed between household smoking and caries experience. However, smoking in the household was independently associated with an increased prevalence of decayed teeth. The adjusted mean of filled teeth among children exposed to household smoking was higher than that among non-exposed children. Conclusions: The results of the study failed to substantiate a positive association between passive smoking and caries experience in Japanese children.
Article
Seventy-eight 4-year-old children, examined earlier for the presence of mutans streptococci at 4-month intervals from 15 months of age, were recalled for recording of dental caries and salivary sampling. The saliva samples were analysed for the presence of mutans streptococci, including the species Streptococcus mutans and Streptococcus sobrinus and lactobacilli. The results showed that the earlier the mutans streptococci had been detected in the children, the higher the caries experience. Eighty-nine percent of the children colonized at 2 years of age had experienced caries and had a mean dfs of 5.0 compared with 25% of the non-colonized 4-year-olds with a mean dfs of 0.3. S. mutans was the predominant species. S. sobrinus was usually found in combination with S. mutans, except in 2 children where S. sobrinus was the only species detected. More children with multiple species had higher numbers of total mutans streptococci and a tendency to higher caries prevalence than children with only S. mutans.
Article
Most pouch and plug chewing tobaccos with high sugar contents are able to support the growth of S mutans and S sanguis in vitro. Snuff and unprocessed tobacco, although not able to stimulate growth of these organisms, do not inhibit growth. Inhibitory agents present in tobacco leaves do not preclude use of tobacco sugars by the organisms tested. Because factors other than bacterial populations play an important role in caries initiation, clinical studies are needed to identify the effects of commercial tobacco on the human dentition.
Article
There are a variety of methodological problems with published studies of parental smoking and sudden infant death syndrome (SIDS), with over-control the most consistent and problematic. Nevertheless, even though this is likely to minimise the true magnitude of relationships, the results are consistent. There are five cohort studies with prospectively collected information on maternal smoking in pregnancy: all show strong and statistically significant relationships that were dose dependent-the more cigarettes the mother had smoked, the more at risk was the baby of SIDS. Similar results have been shown from the case-control studies in which information has been collected retrospectively from parents or birth certificates. There are data from several studies indicating that environmental tobacco smoke (ETS) is also important. Since it has not yet been possible to determine conclusively whether associations are with smoking (or ETS) during pregnancy or postnatally, it is concluded that both should be discouraged.
Article
"Children's Dental Health in Europe" is a collaborative study of a total of 3200 children, comprising samples of 5- and 12-year-old children from eight EU-countries [Belgium, Germany, Greece, Ireland, Italy, Scotland (United Kingdom), Spain and Sweden] who have undergone clinical examination by well calibrated dentists. This study analyses the influence of a number of sociodemographic factors on the dental health of the actual children. Father's and/or mother's occupational status was used to determine the social class of the family, after construction of a family-social class variable, SocFam, and the accuracy of this variable was tested. In 15 of the 16 samples, both treatment provided and unmet treatment need were higher in children from low social class. The treatment need in children from low social class was significantly greater in the Belgium, German, Greek and Italian 5-year-old samples. The differences in both treatment need and treatment already received for children from high respectively low social class were significant in the Scottish and Spanish 12-year-old samples. Taking into account the total material of 1600 children in each age-group, risk indicators for caries, identified by logistic and multiple regression analyses, were social class of the family, the mother's smoking habits, and in the 5-year-olds the number of siblings.
Article
Voluntary and involuntary smoking influence general health. Links between voluntary smoking and oral health are confirmed for periodontal diseases and oral cancer/precancer. Since recent reports have suggested an association between parental smoking and caries experience in young children, this study aimed to explore varying patterns of parental smoking, adjusted for social class, with caries prevalence, using data derived from the UK National Diet and Nutrition Survey (1995). Data analysis was confined to 749 children aged 3.0-4.5 years, to avoid confounding effects of unerupted teeth. Bivariate analysis indicated that the prevalence of maternal rather than paternal smoking was significantly related to caries and substantially attenuated social class differences. The reported number of cigarettes smoked was not important. To compensate for the association between social class and maternal smoking, data were dichotomised by social class (manual/non-manual). With caries prevalence as the dependent variable, logistic regression analysis recorded maternal smoking as a significant independent variable in each case, with odds ratios of 1.55/1.96, respectively. The process was repeated for the combined dataset, using the more extensive (six) social class categories. This further analysis yielded an odds ratio for maternal smoking of 1.54 compared with 1.46 for social class. Nutrition status (as growth parameters) and dietary intake (as household spending on confectionery) were not significant independent variables in these equations. The rationale for these findings is discussed. Further research is required to determine mechanisms underlying these observations. It is concluded that maternal smoking is a significant factor to be considered as an additional risk indicator beyond social class when predicting caries risk in young children.
Article
Cigarette smoking is a leading risk factor for periodontal disease. This cross-sectional study investigated the relation between environmental tobacco smoke (ETS) and periodontal disease in the United States. Data were obtained from the Third National Health and Nutrition Examination Survey (1988-1994). The outcome was periodontal disease, defined as 1 or more periodontal sites with attachment loss of 3 mm or greater and a pocket depth of 4 mm or greater at the same site. Exposure to ETS at home and work was self-reported. The study analyzed 6611 persons 18 years and older who had never smoked cigarettes or used other forms of tobacco. Exposure to ETS at home only, work only, and both was reported by 18.0%, 10.7%, and 3.8% of the study population, respectively. The adjusted odds of having periodontal disease were 1.6 (95% confidence interval = 1.1, 2.2) times greater for persons exposed to ETS than for persons not exposed. Among persons in the United States who had never used tobacco, those exposed to ETS were more likely to have periodontal disease than were those not exposed to ETS.
Article
Environmental tobacco smoke (ETS) has been associated with a number of negative health outcomes for exposed children. The goal of this study was to assess the association between ETS and dental caries in a pediatric population. This study included 637 Iowa Fluoride Study children whose parents provided socioeconomic information, completed at least three questionnaires during the first year of life, and had a primary dentition exam at age 4-7 years. Households reporting in all questionnaires that someone smoked in the home were categorized as regularly smoking homes. Socioeconomic status (SES) was divided into three groups (low, middle, and high) based on family income and mother's education. Children were classified as having caries if any of the primary teeth had fillings or cavitated lesions at the primary dentition exam. Overall, children residing in regularly smoking homes had a higher prevalence of caries. For the middle SES group and overall, the children from smoking homes had a significantly higher prevalence of caries compared to nonregular/nonsmoking homes (52% vs 24%, P=.05 and 44% vs 25%, P=.002, respectively). After adjusting for age, SES, toothbrushing frequency, total ingested fluoride, and combined intake of soda pop and powdered drink beverages, the relationship of smoking and caries still remained significant (odds ratio [OR]=3.38; P=.001). Environmental tobacco smoke was associated with an increased risk of caries among children.
Article
It is generally accepted that maternal smoking has more detrimental effects than paternal smoking on the respiratory health of children. The objective of this study was to assess the effects of postnatal exposure due to the smoking behaviour by father and mother in the home, and prenatal exposure from maternal smoking during pregnancy, on the respiratory symptoms in children. The parents of 484 children, aged 3-6 years, completed a questionnaire about smoking and respiratory symptoms in children. Bivariate and logistic regression analyses were used to examine the associated factors with respiratory symptoms. The final model of logistic regression analysis showed that prenatal exposure by maternal smoking during pregnancy increased the risk of wheezing with colds (adjusted OR=2.00, 95% CI:1.13-3.55) with respect to those children whose mothers reported no smoking during pregnancy. Postnatal exposure by maternal smoking in the home, in the presence of the child, increased the risk of cough with phlegm (adjusted OR=2.79, 95% CI:1.23-6.30) with respect to those children whose mothers did not smoke in their presence. Paternal smoking was associated with wheezing and cough in the bivariate analysis, but did not remain significant in the multivariate analysis. Our results underline a greater influence of exposure to maternal smoking (prenatal and postnatal) than postnatal paternal smoking on the development of respiratory symptoms in young children.
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There have been comparatively few large-scale cohort studies analyzing all-cause mortality due to cigarette smoking. The goal of this analysis is to investigate the relationship between smoking status and all-cause mortality, and to evaluate the effect of smoking in the Japanese. The baseline data were collected between 1992 and 1995. Ultimately, 10,873 Japanese (4,280 males and 6,593 females) aged 19 years or older from 12 rural communities located across Japan participated in the study. This analysis is based on the results, including the information on those who died and moved out of the communities, obtained by December 31, 2001. The Cox's proportional hazards model was used to calculate the hazard ratio (HR) of mortality for smoking with adjustment for age, systolic blood pressure, total cholesterol, body mass index, alcohol drinking habit and education. The mean follow-up period was 8.2 years, during which time, 284 males and 192 females died. The multivariate-adjusted HRs for total mortality among former and current smokers compared with never smokers were 1.09 (95% confidence interval [CI]: 0.73-1.61) and 1.65 (95% CI: 1.16-2.35) in males, and 0.98 (95% CI: 0.40-2.42) and 0.91 (95% CI: 0.42-1.95) in females, respectively. Those for the consumption of 1-14, 15-24, and 25+ cigarettes per day among male smokers were 1.62, 1.57, and 1.89, respectively. In females, there was no great difference in all-cause mortality between smokers and never smokers. The results of our study confirm an increased risk in males of premature death from all causes among Japanese with a smoking habit.
Article
The purpose of this longitudinal study was to determine factors associated with mutans streptococci (MS) infection and development of caries lesions in a group of children 21 to 72 months old. The 63 caries-free children, recruited since birth, were divided into: (1) a study group of 24 children who were colonized with MS; and (2) a control group of 39 children without MS. The children were recalled every 3 months for approximately 24 months, and their social, medical, and dental histories were updated. At each recall, the teeth were checked for presence or absence of plaque, enamel hypoplasia, and caries lesions, and their MS status was assessed using a commercial test kit. MS infection was associated with: (1) visible plaque (P < .01); (2) enamel hypoplasia (P < .05); (3) commencement of tooth-brushing after 12 months of age (P < .05); (4) lack of parental assistance with tooth-brushing (P < .025); and (5) increased hours of child care/school (P < .05). Four children (20%) were colonized at an age range of 21 to 36 months, 9 (45%) at 37 to 48 months, and 7 (35%) at 49 to 72 months (P < .001). Eight children who developed caries lesions: (1) had more hypoplastic teeth (P < .001); (2) ate sugar-containing snacks (P < .05); and (3) did not brush regularly with chlorhexidine gel (P < .01) compared to those who remained free of caries lesions. Lack of oral hygiene, consumption of sugar-containing snacks, and enamel hypoplasia are significant factors for both MS infection and caries lesion initiation.
Article
The aim of this study was to test the hypothesis of association between low birthweight and dental caries. This study used data from the Third National Health and Nutritional Examination Survey, 1988-94 (NHANES III) including 7- to 11-year-old children with complete dental caries information (n = 2439). Two case definitions for dental caries were used: presence of the disease in more than one tooth, and more than 10% of teeth with dental caries. Low birthweight was defined as those children born weighing <2500 g. Other covariates used in the analysis were sex, age, poverty level, race/ethnicity, frequency of dental visit, education of head of household, daily sucrose intake, blood lead level and blood cotinine level. A separate analysis was conducted for each case definition of dental caries. Bivariable and stratified analysis was performed followed by multivariable Poisson regression. The Stata 8.0 statistical package was used to take into consideration the multistage complex sample. For the definition of more than one tooth with dental caries, the prevalence ratios (PRs) for bivariable and multivariable analyses were 1.28 [95% confidence interval (CI): 0.48, 3.42] and 1.01 [95% CI: 0.41, 2.49] respectively. For the definition of >10% of teeth with dental caries, the PRs for bivariable and multivariable analyses were 1.33 [95% CI: 0.60, 2.96] and 1.32 [95% CI: 0.75, 2.30] respectively. This study could not demonstrate an association between low birthweight and dental caries in permanent teeth of 7- to 11-year-old American children.
Association of smoking in household and dental caries in Japan Association of streptococcus mutans infection and oral developmental nodules in pre-dentate infants
  • K Tanaka
  • T Hanioka
  • Y Miyake
  • M Ojima
  • H Aoyama
  • Akl Wan
  • Wk Seowl
  • Lj Walsh
  • P Bird
  • Di Tudehope
  • Dm Purdie
16 Tanaka K, Hanioka T, Miyake Y, Ojima M, Aoyama H. Association of smoking in household and dental caries in Japan. Journal of Public Health Dentistry 2006; 66:279–281. 17 Wan AKL, Seowl WK, Walsh LJ, Bird P, Tudehope DI, Purdie DM. Association of streptococcus mutans infection and oral developmental nodules in pre-dentate infants. Journal of Dental Research 2001; 80:1945–1948.