Association between environmental tobacco smoke and dental caries amongst 5-14 years old children in Karachi, Pakistan

Objective: To determine the association between environmental tobacco smoke and dental caries. Methods: This cross-sectional study was conducted in peri-urban and urban areas of Karachi, from February to August 2014, and comprised children aged 5-14 years. A pre-coded questionnaire for environmental tobacco smoke and food frequency questionnaire for dietary habits were used. Dental examination of children was done to detect caries. Cox-proportional hazard algorithm was used to measure the association of environmental tobacco smoke with dental caries at multivariable level. STATA version 12.0 was used for statistical analysis. Results: Of the 500 children, 250(50%) each were from peri-urban and urban localities. The prevalence of dental caries was 336(67.2%).Family members of 154(30.8%) participants reported smoking. After adjusting for junk food intake, in-between meals, age, plaque index, dental visits and socio-economic status, the association between environmental tobacco smoke and dental caries remained statistically significant (p<0.05). Compared to nonexposed children, the adjusted prevalence ratio was 1.25 (95% confidence interval: 1.08-1.46) and 1.36 (95% confidence interval: 1.09-1.70) for children with < 30 minutes and >30 minutes of environmental tobacco smoke exposure, respectively. Conclusion: Environmental tobacco smoke was found to be associated with dental caries.