Passive Smoking and Oral Health of Infants, Preschoolers, and Children: A Systematic Review

Abstract

Introduction Almost half of the world’s children experience passive smoking, which is linked to numerous oral health conditions. The aim is to synthesise data on the impact of passive smoking on oral health of infants, preschoolers, and children. Methods A search was conducted across Medline (via EBSCOhost), PubMed, and Scopus up to February 2023. Risk of bias was assessed according to the Newcastle-Ottawa Scale. Results The initial search produced 1,221 records and after removal of duplicates, screening by title and abstract, and full text assessment, 25 studies were eligible for review and data extraction. The majority of studies (94.4%) found a correlation between passive smoking and increased prevalence of dental caries with three studies suggesting a dose-response relationship. Prenatal passive smoking exposure in 81.8% of studies indicated an increased dental caries experience compared to postnatal exposure. Low parental education, socioeconomic status, dietary habits, oral hygiene and gender affected the level of environmental tobacco smoke exposure and dental caries risk. Conclusions The results of this systematic review strongly suggest a significant association between dental caries in the deciduous dentition and passive smoking. Early intervention and education on the effects of passive smoking on infants and children will allow for the improvement in oral health outcomes and reduction in smoking-associated systemic conditions. The results justify all health professionals paying more attention to passive smoking when conducting paediatric patient histories, contributing to improved diagnosis and appropriate treatment planning with more suitable follow-up schedules. IMPLICATIONS The evidence from this review that environmental tobacco smoke and passive smoking is a risk factor for oral health conditions, both prenatally and postnatally during early childhood, justifies all health professionals paying more attention to passive smoking when conducting paediatric patient histories. Early intervention and appropriate parental education regarding the effects of second-hand smoke on infants and children will allow for the minimisation of dental caries, improvement in oral health outcomes and overall reduction in smoking-associated systemic conditions for the children exposed.

Epidemiology and risk factors of oral frailty among older people: an observational study from China

“…Another interesting finding in this study is that there was no significant association between smoking and oral frailty, but passive smoking was found to be a risk factor with an OR value of around 2. Massive research with a big sample size has already reported that exposure to smoking had harmful effects on dental health [36,37].…”

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

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

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

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