Association of pediatric dental caries with passive smoking
Association of pediatric dental caries with passive smoking
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DOI：
10.1001/jama.289.10.1258
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发表时间：
2003-03-12
影响因子：
120.7
通讯作者：
Weitzman, M
中科院分区：
文献类型：
--
作者：
Aligne, CA;Moss, ME;Weitzman, M
背景 蛀牙是儿童最常见的慢性疾病，对生活贫困的人影响尤为严重，但其原因尚不清楚。被动吸烟可能是龋齿的一个可改变的危险因素。目的 探讨龋齿与血清可替宁水平之间的关系。设计、设置和参与者 横断面数据来自第三次全国健康与营养检查调查（1988-1994 年），对 3531 名 4 至 11 岁儿童进行了牙科检查和血清可替宁水平测量。主要结果指标 被动吸烟定义为血清可替宁水平0.2 至 10 ng/mL，龋齿定义为腐烂（未填充）或填充的牙齿表面。结果 25% 的儿童至少有 1 个未填充的腐烂牙齿表面，33% 的儿童至少有 1 个填充表面。百分之五十三的可替宁水平与被动吸烟一致。可替宁水平升高与乳牙的腐烂（比值比 [OR]，2.1；95% 置信区间 [CI]，1.5-2.9）和填充（OR，1.4；95% CI，1.1-1.8）牙齿表面显着相关，但与恒牙无关。在调整饲料、性别、种族、家庭收入、地理区域、看牙医频率和血铅水平后，这种关系仍然存在。对于乳牙龋齿，腐烂表面风险的调整 OR 为 1.8 (95% CI, 1.2-2.7)，填充表面风险的调整 OR 为 1.4 (95% CI, 1.1-2.0)。我们估计，由于被动吸烟造成的龋齿风险和补牙表面风险分别为 27% 和 14%。 结论 环境烟草烟雾与儿童龋齿风险之间存在关联。减少被动吸烟不仅对于预防许多健康问题很重要，而且对于促进儿童的牙齿健康也很重要。
Context Dental decay is the most common chronic disease of children and it disproportionately affects those living in poverty, but the reasons for this are not clear. Passive smoking may be a modifiable, risk factor for dental caries.Objective To examine the relationship between dental caries and serum cotinine levels.Design, Setting, and Participants Cross-sectional data from the Third National Health and Nutrition Examination Survey (1988-1994) of 3531 children aged 4 to 11 years, who had had both dental examinations and a serum cotinine level measurement.Main Outcome Measures Passive smoking defined as serum cotinine levels of 0.2 to 10 ng/mL and caries defined as decayed (unfilled) or filled tooth surfaces.Results Twenty-five percent of the children had at least 1 unfilled decayed tooth surface and 33% had at least 1 filled surface. Fifty-three percent had cotinine levels consistent with passive smoking. Elevated cotinine level was significantly associated with both decayed (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5-2.9) and filled (OR, 1.4; 95% CI, 1.1-1.8) tooth surfaces in deciduous but not in permanent teeth. This relationship persisted after adjusting forage, sex, race, family income, geographic region, frequency of dental visits, and blood lead level. For dental caries in deciduous teeth, the adjusted OR was 1.8 (95% CI, 1.2-2.7) for the risk of decayed surfaces and 1.4 (95% CI, 1.1-2.0) for filled surfaces. We estimated the population attributable risk-from passive smoking to be 27% for decayed and 14% for filled tooth surfaces.Conclusions There is an association between environmental tobacco smoke and risk of caries among children. Reduction of passive smoking is important not only for the prevention of many medical problems, but also for the promotion of children's dental health.