Jewish World Review March 13, 2003 / 9 Adar II, 5763

Smoking linked to cavities in kids

By Katrina Woznicki | (UPI) Young children exposed to secondhand smoke appear to have a greater risk of developing cavities and tooth decay, a study released Tuesday suggests.

Researchers led by Dr. C. Andrew Aligne, a pediatrician formerly with the University of Rochester and now the founder of Pediathink, a research consulting firm in Rochester, N.Y., examined the connection between secondhand smoke and oral health problems.

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 1988 to 1994. Information on 3,531 children, ages 4 to 11, 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 the March 12 issue of Journal of the American Medical Association, study results showed 25 percent of the children had at least one unfilled decayed tooth surface or cavity and 33 percent of the kids had at least one tooth filling, indicating a prior history of cavities.

Researchers also found more than half the study group -- 53 percent -- had cotinine levels indicating secondhand smoke 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 so many health problems in kids, some that are related to cavities," Aligne told United Press International. "It's probably not that cotinine in and 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, Aligne explained. He added secondhand smoke exposure also might 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's difficult to connect that to how many cigarettes Mom is smoking," Aligne said. 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," Paul Casamassimo, chairman of pediatric dentistry at Ohio State University College of Dentistry in Columbus and a spokesman for the American Academy of Pediatric Dentistry, told UPI. He said the secondhand smoke link to children's cavities might reflect the association of poverty to children's oral health problems.

If the findings are verified, he said, "this is another nail in the coffin for people not to smoke around children."

Casamassimo noted, however, "you'd think (adult) smokers would have a lot of cavities, but they don't."

Tooth decay is the most common childhood disease in the United States, running up annual treatment costs of about $4.5 billion, according to researchers. Aligne said pediatric tooth decay has declined dramatically over the last 50 years, but it remains a major public health problem for children from low-income families.

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