The association of maternal smoking and other sociobehavioral factors with dental caries in toddlers: A cross-sectional study

BACKGROUND: Severe early childhood caries (S-ECC) is a form of dental caries in toddlers, which can strongly affect general health and quality of life. Studies on factors that can contribute to the development of caries immediately after tooth eruption are sparse. The aim of this study was to assess the role of sociobehavioural factors and pre- and postnatal exposure to tobacco smoke in the aetiology of dental caries in children up to 3 years old. METHODS: A cross-sectional study was conducted between 2011 and 2017 to assess oral health and teething in urban children 0–4 years of age. The number of teeth and surfaces with white spot lesions (d(1,2)), as well as decayed (d), missing (m), and filled (f) teeth classified according to ICDAS II was evaluated in a dental office setting. d(1,2)dmft and d(1,2)dmfs were calculated. Severe early childhood caries was diagnosed for d(1,2)dmfs > 0. Parents completed a self-administered questionnaire on socioeconomic factors, maternal health, course of pregnancy, child's perinatal parameters, hygiene and dietary practices, as well as maternal smoking during and after pregnancy. Data on children aged 12–36 months were collected and analysed statistically using the t-test, Spearman rank correlations and Poisson regression. Significance level was set at 0.05. RESULTS: Dental caries was found in 46% of 496 children aged 12–36 months. Mean d(1,2)dmft and d(1,2)dmfs were 2.62 ± 3.88 and 4.46 ± 8.42, respectively. Tobacco smoking during and after pregnancy was reported by 8.9% and 24.8% of women, respectively. Spearman's rank correlation analysis confirmed a relationship between S-ECC and parental education, maternal smoking, bottle feeding, avoiding springy foods, number of meals, and the age of tooth brushing initiation. Pre- and postnatal exposure to tobacco smoke increased the risk of S-ECC especially in children in age 19–24 months. Maternal smoking was correlated with the level of education and dietary practices. CONCLUSION: Our study confirmed that prenatal smoking is associated with increased risk of severe-early childhood caries (S-ECC) while the association with post-natal smoking is also evident, the increase in risk is not statistically clear. Both maternal smoking and the child's tooth decay are associated with poor parental education and other improper oral health behaviours. The positive impact of quitting smoking on the oral health in children should be part of anti-smoking advice.