Main

Aligne CA, Moss ME et al. JAMA 2003; 289: 1258–1264

There are good biological reasons why tobacco smoke increases periodontitis, but it is less clear whether it can affect caries, though both smoking and caries are commoner in the economically-deprived. This study used data from a US sample of 3531 children who had dental examinations and concurrent serum cotinine measurements. Cotinine is a marker of environmental tobacco smoke (ETS) inhalation. Children aged 12+ yrs, or with more than 10 ng/ml cotinine in their serum, had been excluded to avoid possible young active smokers.

Logistic regression analysis was used to control for various socio-economic variables. There were significant but rather low odds ratios for ETS exposure and decayed and filled surfaces in deciduous teeth (18 and 14 respectively), but not in permanent teeth (12 and 09). However, the ETS dose relationship with caries was not fully consistent. The authors were not able to exclude a common behavioural factor in relation to smoking and caries, because data on dental hygiene and dietary habits were not collected.