Young children who are exposed to secondhand smoke have a much higher rate of caries than do children who do not grow up around smokers, according to a study published in the March 12 issue of the Journal of the American Medical Association.
According to a press release issued by the Agency for Healthcare Research and Quality, which supported the study, this is the first study in the United States to associate secondhand smoking with caries—a public health problem that costs an estimated $4.5 billion annually. Although the occurrence of dental caries in children has declined dramatically in the United States, little headway has been made in reducing it among children living in poverty, who generally have less access to dental care and appear to be more vulnerable to caries.
Based on data from household interviews and health examinations of about 4,000 children aged 4 to 11 years, the study found that children had an increased risk of developing caries if they had high levels of cotinine, a byproduct of nicotine that is consistent with secondhand smoke exposure.
About 32 percent of the children with cotinine levels consistent with secondhand smoke exposure had carious surfaces in their primary teeth, compared with 18 percent of children with lower levels of cotinine. The higher risk of developing cavities in tobacco-exposed children persisted after controlling for other factors such as poverty and frequency of dental visits. The study, however, did not find a similar association between secondhand smoke exposure and cavities in permanent teeth.
Previous research has shown that nicotine promotes the growth of the bacteria that can cause caries, so when mothers or others who smoke kiss children, they would tend to pass on these bacteria.
According to the study’s lead author, C. Andrew Aligne, M.D., of Pediathink, a child health think tank in Rochester, N.Y., the results provide further evidence that passive smoking is harmful and that all children should be allowed to grow up in a smoke-free environment.
