Maternal smoking during pregnancy and early childhood dental caries in children: a systematic review and meta-analysis

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Abstract

Background

Early childhood dental caries, or ECC, is a significant global oral health concern associated with various adverse outcomes. This systematic review and meta-analysis aimed to investigate the potential link between maternal smoking during pregnancy and the occurrence of dental caries in children.

Method

Through a comprehensive search of PubMed, Scopus, and Google Scholar databases for studies examining the correlation between maternal smoking during pregnancy and childhood caries, we identified 609 relevant articles up to October 2023. Studies were selected, and data extraction was based on the pre-established eligibility criteria and items. Meta-analysis was executed utilizing Comprehensive Meta-analysis (CMA) with a random effects model, ensuring a robust synthesis of the gathered evidence.

Result

7 cohorts and five cross-sectional studies, totaling 12 studies, were included in our analysis. The combined results from the studies revealed a significant association between maternal smoking during pregnancy and an increased risk of dental caries in children (OR = 1.78, 95% CI = 1.55–2.05, I2 = 68.53). Sensitivity analyses confirmed the reliability of our results. However, there were indications of publication bias, as suggested by the funnel plot and Egger’s test ( P = 0.011) concerning the connection between prenatal smoking and childhood caries.

Conclusion

This review underscores the association between maternal smoking during pregnancy and childhood dental caries. Nevertheless, confounding variables influence this link, necessitating more large-scale, longitudinal studies with adjusted factors. Additional randomized control trials are needed to validate these findings due to the observed heterogeneity. Future research should investigate the precise reasons behind this association. It is essential to raise awareness among pregnant women about the risks of smoking through educational programs.

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Most cited references 20

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Association between infant breastfeeding and early childhood caries in the United States.

Hiroko Iida, Peggy Auinger, Ronald Billings … (2007)

Despite limited epidemiologic evidence, concern has been raised that breastfeeding and its duration may increase the risk of early childhood caries. The objective of this study was to assess the potential association of breastfeeding and other factors with the risk for early childhood caries among young children in the United States. Data about oral health, infant feeding, and other child and family characteristics among children 2 to 5 years of age (N = 1576) were extracted from the 1999-2002 National Health and Nutrition Examination Survey. The association of breastfeeding and its duration, as well as other factors that previous research has found associated with early childhood caries, was examined in bivariate analyses and by multivariable logistic and Poisson regression analyses. After adjusting for potential confounders significant in bivariate analyses, breastfeeding and its duration were not associated with the risk for early childhood caries. Independent associations with increased risk for early childhood caries were older child age, poverty, being Mexican American, a dental visit within the last year, and maternal prenatal smoking. Poverty and being Mexican American also were independently associated with severe early childhood caries, whereas characteristics that were independently associated with greater decayed and filled surfaces on primary teeth surfaces were poverty, a dental visit within the last year, 5 years of age, and maternal smoking. These data provide no evidence to suggest that breastfeeding or its duration are independent risk factors for early childhood caries, severe early childhood caries, or decayed and filled surfaces on primary teeth. In contrast, they identify poverty, Mexican American ethnic status, and maternal smoking as independent risk factors for early childhood caries, which highlights the need to target poor and Mexican American children and those whose mothers smoke for early preventive dental visits.

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Feeding and smoking habits as cumulative risk factors for early childhood caries in toddlers, after adjustment for several behavioral determinants: a retrospective study

Alessandra Majorana, Maria Cagetti, Elena Bardellini … (2014)

Background Several maternal health determinants during the first period of life of the child, as feeding practice, smoking habit and socio-economic level, are involved in early childhood health problems, as caries development. The potential associations among early childhood caries, feeding practices, maternal and environmental smoking exposure, Socio-Economic Status (SES) and several behavioral determinants were investigated. Methods Italian toddlers (n = 2395) aged 24–30 months were recruited and information on feeding practices, sweet dietary habit, maternal smoking habit, SES, and fluoride supplementation in the first year of life was obtained throughout a questionnaire administered to mothers. Caries lesions in toddlers were identified in visual/tactile examinations and classified using the International Caries Detection and Assessment System (ICDAS). Associations between toddlers’ caries data and mothers’ questionnaire data were assessed using chi-squared test. Ordinal logistic regression was used to analyze associations among caries severity level (ICDAS score), behavioral factors and SES (using mean housing price per square meter as a proxy). Results Caries prevalence and severity levels were significantly lower in toddlers who were exclusively breastfed and those who received mixed feeding with a moderate–high breast milk component, compared with toddlers who received low mixed feeding and those exclusively fed with formula (p < 0.01). No moderate and high caries severity levels were observed in an exclusively breastfed children. High caries severity levels were significantly associated with sweet beverages (p < 0.04) and SES (p < 0.01). Toddlers whose mothers smoked five or more cigarettes/day during pregnancy showed a higher caries severity level (p < 0.01) respect to those whose mothers did not smoke. Environmental exposure to smoke during the first year of life was also significantly associated with caries severity (odds ratio =7.14, 95% confidence interval = 6.07-7.28). No association was observed between caries severity level and fluoride supplementation. More than 50% of toddlers belonging to families with a low SES, showed moderate or high severity caries levels (p < 0.01). Conclusions Higher caries severity levels were observed in toddlers fed with infant formula and exposed to smoke during pregnancy living in area with a low mean housing price per square meter.

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Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years : US Preventive Services Task Force Recommendation Statement

Karina Davidson, Michael Barry, Carol Mangione … (2021)

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Author and article information

Contributors

Alireza Mokhtari Sakhvidi: Dralirezamokhtari95@gmail.com

Niloofar Deravi: niloofarderavi@sbmu.ac.ir

Journal

Journal ID (nlm-ta): BMC Oral Health

Journal ID (iso-abbrev): BMC Oral Health

Title: BMC Oral Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6831

Publication date (Electronic): 12 July 2024

Publication date PMC-release: 12 July 2024

Publication date Collection: 2024

Volume: 24

Electronic Location Identifier: 781

Affiliations

[1 ]GRID grid.412888.f, ISNI 0000 0001 2174 8913, Tabriz University of Medical Sciences, ; Tabriz, Iran

[2 ]Hamadan University of Medical Sciences, ( https://ror.org/02ekfbp48) Hamadan, Iran

[3 ]GRID grid.411463.5, ISNI 0000 0001 0706 2472, Dental Branch, , Islamic Azad University, ; Tehran, Iran

[4 ]Faculty of Dentistry, Babol University of Medical Sciences, ( https://ror.org/02r5cmz65) Babol, Iran

[5 ]Faculty of Dentistry, Semmelweis University, ( https://ror.org/01g9ty582) Budapest, Hungary

[6 ]Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, ( https://ror.org/01c4pz451) Tehran, Iran

[7 ]GRID grid.444283.d, ISNI 0000 0004 0371 5255, Faculty of Dentistry, , Istanbul Okan University, ; Tuzla Campus Tuzla, Istanbul, 34959 Turkey

[8 ]School of Dentistry, Mazandaran University of medical sciences, ( https://ror.org/02wkcrp04) Dentist, Sari, Iran

[9 ]Faculty of Dentistry, Van Yüzüncü Yıl University, ( https://ror.org/041jyzp61) Van, Türkiye Turkey

[10 ]Student Research Committee, School of International Campus, Guilan University of Medical Sciences, ( https://ror.org/04ptbrd12) Rasht, Iran

[11 ]GRID grid.411463.5, ISNI 0000 0001 0706 2472, Dental Faculty, , Tehran Medical Sciences, Islamic Azad University, ; Tehran, Iran

[12 ]Student Research Committee, School of medicine, Shahid Beheshti University of Medical Sciences, ( https://ror.org/034m2b326) Tehran, Iran

[13 ]SBUMS, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran 19839-63113 Iran

Article

Publisher ID: 4548

DOI: 10.1186/s12903-024-04548-4

PMC ID: 11241989

PubMed ID: 38997699

SO-VID: e3163191-51ab-4c82-a355-2d4c53bb1059

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 17 March 2024

Date accepted : 1 July 2024

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ScienceOpen disciplines: Dentistry

Keywords: maternal smoking,pregnancy,dental caries,children,systematic review,meta-analysis

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ScienceOpen disciplines: Dentistry

Keywords: maternal smoking, pregnancy, dental caries, children, systematic review, meta-analysis

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Maternal smoking during pregnancy and early childhood dental caries in children: a systematic review and meta-analysis

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Most cited references 20

Association between infant breastfeeding and early childhood caries in the United States.

Feeding and smoking habits as cumulative risk factors for early childhood caries in toddlers, after adjustment for several behavioral determinants: a retrospective study

Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years : US Preventive Services Task Force Recommendation Statement

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