Association between passive tobacco exposure and caries in children and adolescents. A systematic review and meta-analysis

Abstract

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.

Associations of nutritional status, sugar and second-hand smoke exposure with dental caries among 3- to 6-year old Malaysian pre-schoolers: a cross-sectional study

“…The present study revealed that the second-hand smoke exposure was associated with untreated caries in the primary teeth among pre-schoolers, which was in agreement with the findings from previous studies [12,15,46]. A meta-analysis reported that the children who were exposed to second-hand smoke during infancy had 1.72 times higher risk of having caries in their primary teeth than the children who were not exposed [46]. The association of second-hand smoke exposure and dental caries could be explained through one of the toxins found in the smoke: nicotine.…”

“…Further investigations are needed to understand the differences in the effect of nutritional status on the development of dental caries between developed and developing countries. The present study revealed that the second-hand smoke exposure was associated with untreated caries in the primary teeth among pre-schoolers, which was in agreement with the findings from previous studies [12,15,46]. A meta-analysis reported that the children who were exposed to second-hand smoke during infancy had 1.72 times higher risk of having caries in their primary teeth than the children who were not exposed [46].…”

“…Despite these possible mechanisms, González-Valero et al [46] suggested that second-hand smoke exposure and dental caries could share similar sociodemographic and behavioural factors. Jakhete and Gitterman [49] found that exposure to second-hand smoke and poor nutrition increased the risk of dental caries in children from low socioeconomic background.…”

Global Prevalence of Tobacco Use in Adolescents and Its Adverse Oral Health Consequences

“…The literature consistently shows an association between smoking and increased risk of caries during adolescence [32], [33], [34]. Tobacco consumption (tobacco and smokeless tobacco) is a significant risk factor for caries development.…”

“…Passive tobacco exposure also contributes to the development of caries in adolescents. A recent meta-analysis of 21 studies found a moderate association between passive smoking and dental caries in children and adolescents [34].…”