WHENEVER parents or guardians bring children to my clinic for treatment and I see that most of their teeth are very decayed, I usually ask if anyone who lives in their home smokes.

This is because young children exposed to secondhand smoke appear to have a greater risk of developing tooth decay. Researchers of Rochester and now the founder of Pediathink, a research consulting firm in Rochester, New York, examined the connection between secondhand smoke and oral health problems among children and confirmed what they have always suspected: Cigarette smoke results in children’s teeth becoming rotten.
The team used data collected from the Centers for Disease Control and Prevention’s Third National Health and Nutrition Examination Survey, which was collected from 2005 to 2010. Information on 3,600 children, aged four to 12, were analyzed, including blood level measurements of cotinine, a byproduct of nicotine that serves as a marker for environmental tobacco smoke exposure.
As reported in a recent issue of The Journal of the American Medical Association, study results showed 25 per cent of the children had at least one unfilled decayed tooth surface or cavity, and 33 per cent of the kids had at least one tooth filling, indicating a prior history of cavities.
Researchers found more than half the study group — that is 53 per cent — had cotinine levels indicating secondhand exposure. They reported, however, the association between cotinine levels and cavities was not as statistically significant in children’s permanent teeth.
Passive smoking is known to cause many health problems in children, and some are related to cavities. It is probably not that cotinine of itself in your blood is causing cavities. Instead, secondhand smoke might cause children to breathe through their mouths more, creating dry mouth. Saliva protects the teeth from decay, so dry-mouth could increase the risk of cavities. Secondhand smoke exposure might also suppress children’s immune systems, making them more vulnerable to illness, even oral health illness.
Although the study looked at blood levels of cotinine, the measurements did not indicate how often household members surrounding the child were smoking. It is difficult to connect that to how many cigarettes mom is smoking, for instance. However, this is one more piece of evidence that passive smoking harms children.
Smoking is likely concentrated in people of less education and less affluence. The secondhand-smoke link to children’s cavities often reflects the association of poverty to children’s oral health problems, although, obviously, wealth is not necessarily directly connected to oral health. This is another nail in the coffin for people not to smoke around children. But strangely, you would think that adult smokers would have more cavities than nonsmokers, but the statistics show that they do not.
Tooth decay is the most common childhood disease in Guyana, running up annual treatment costs of about US$2M.
While this disease has declined dramatically over the last 20 years, it still remains a major public health problem for children, especially those from low-income families.
Nonetheless, parents who smoke must realize that it has been proven that their habit can contribute to their child’s dental problems.