Severe early childhood caries (S-ECC) has serious consequences for primary dentition, affecting the overall health, well-being, and quality of life of the child. The aim of this study was to investigate the association of risk factors, including environmental tobacco smoke (ETS), with S-ECC in 3-year-old Japanese children by a cross-sectional study. Study subjects were 2,825 children aged 3 years old. Of these individuals, after excluding the study subjects with missing values, a total of 2,277 children were included in the present analysis. The self-administered questionnaire included such items as sex, whether a smoker resides in the home, the number of smokers in the home, snack time, drinking or eating sweets after dinner, frequency of parents brushing their child’s teeth, the use of fluoride toothpaste, and socioeconomic status. We obtained the number of decayed, missing, or filled teeth per person (dmft) from dental examinations. Logistic regression analysis was performed to estimate the odds ratio for S-ECC. The average number of decayed, missing, and filled teeth (dmft index) was 0.77. The prevalence of dental caries was 20.6%. There was at least 1 smoker in the homes of 1,370 subjects (60.2%). After excluding items of multicollinearity, the results of multivariate analysis were as follows: drinking or eating sweets after dinner, irregular snack times, parents brushing their child’s teeth less frequently, existence of smokers in the home, and no residence tax were significantly associated with S-ECC. This study suggests that there is a significant association between ETS from family members and S-ECC.

1.
Aligne CA, Moss ME, Auinger P, Weitzman M: Association of pediatric dental caries with passive smoking. JAMA 2003; 289: 1258–1264.
2.
Alvarez JO, Lewis CA, Saman C, Caceda J, Montalvo J, Figueroa ML, Izquierdo J, Caravedo L, Navia JM: Chronic malnutrition, dental caries, and tooth exfoliation in Peruvian children aged 3–9 years. Am J Clin Nutr 1988; 48: 368–372.
3.
American Academy on Pediatric Dentistry; American Academy of Pediatrics: Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent 2008–2009; 30: 40–43.
4.
Doğan D, Dülgergil CT, Mutluay AT, YıIdırım I, Hamidi MM, Colak H: Prevalence of caries among preschool-aged children in a central Anatolian population. J Nat Sci Biol Med 2013; 4: 325–329.
5.
Evans EH, Hayes C, Palmer CA, Bermudez OI, Cohen SA, Must A: Dietary intake and severe early childhood caries in low-income, young children. J Acad Nutr Diet 2013; 113: 1057–1061.
6.
Feldens CA, Rodrigues PH, de Anastácio G, Vítolo MR, Chaffee BW: Feeding frequency in infancy and dental caries in childhood: a prospective cohort study. Int Dent J 2018; 68: 113–121.
7.
Hanioka T, Nakamura E, Ojima M, Tanaka K, Aoyama H: Dental caries in 3-year-old children and smoking status of parents. Pediatr Perinatal Epidemiol 2008; 22: 546–550.
8.
Ibrahim S, Nishimura M, Matsumura S, Rodis OMM, Nishida A, Yamanaka K, Shimono T: A longitudinal study of early childhood caries risk, dental caries, and life style. Pediatr Dent J 2009; 19: 174–180.
9.
Kum-Nji P, Meloy L, Herrod HG: Environmental tobacco smoke exposure: prevalence and mechanisms of causation of infections in children. Pediatrics 2006; 117: 1745–1754.
10.
Leroy R, Hoppenbrouwers K, Jara A, Declerck D: Parental smoking behavior and caries experience in preschool children. Community Dent Oral Epidemiol 2008; 36: 249–257.
11.
Li Y, Wulaerhan J Liu Y, Abudureyimu A, Zhao J: Prevalence of severe early childhood caries and associated socioeconomic and behavioral factors in Xinjiang, China: a cross-sectional study. BMC Oral Health 2017; 17: 144.
12.
Lindemeyer RG, Baum RH, Hsu SC, Going RE: In vitro effect of tobacco on the growth of oral cariogenic streptococci. J Am Dent Assoc 1981; 103: 719–722.
13.
Mangle RG, Kapur R, Dhindsa A, Madan M: Prevalence and associated risk factors of severe early childhood caries in 12- to 36-month-old children of Sirmaur district, Himachal Pradesh, India. J Clin Pediatr Dent 2017; 10: 183–187.
14.
Maruyama S, Teramoto S, Miyazawa H: Epidemiological study of dental disease factors among young Japanese children. Pediatr Dent J 2008; 18: 156–166.
15.
Means RT, Krantz SB: Progress in understanding the pathogenesis of the anemia of chronic disease. Blood 1992; 80: 1639–1647.
16.
Ministry of Health, Labour and Welfare: Community health and health promotion report in 2015 (in Japanese). 2017. http://www.mhlw.go.jp/toukei/list/32-19.html.
17.
Nakayama Y, Mori M: Association of environmental tobacco smoke and snacking habits with the risk of early childhood caries among 3-year-old Japanese children. J Public Health Dent 2015; 75: 157–162.
18.
Nakayama Y, Mori M: Risk factors associated with early childhood caries in 18- to 23-month-old children in a Japanese city. J Natl Inst Public Health 2017; 66: 545–552.
19.
Özen B, Strijp AJPV, Özer L, Olmus H, Genc A, Cehreli: Evaluation of possible associated factors for early childhood caries and severe early childhood caries: a multicenter cross-sectional survey. J Clin Pediatr Dent 2016; 40: 118–123.
20.
Peres KG, Nascimento GG, Peres MA, Mittinty MN, Demarco FF, Santos IS, Matijasevich A, Barros AJD: Impact of prolonged breastfeeding on dental caries: a population-based birth cohort study. Pediatrics 2017, DOI: 10.1542/peds.2016-2943.
21.
Preston AM, Rodriguez C, Rivera CE, Sahai H: Influence of environmental tobacco smoke on vitamin C status in children. Am J Clin Nutr 2003; 77: 167–172.
22.
Ramamurthy PH, Swamy HS, Bennete F, Rohini M, Nagarathnamma T: Relationship between severe-early childhood caries, salivary mutans streptococci, and lactobacilli in preschool children of low socioeconomic status in Bengaluru city. J Indian Soc Pedod Prev Dent 2014; 32: 44–47.
23.
Schroth RJ, Harrison RL, Moffatt ME: Oral health of indigenous children and influence of early childhood caries on childhood health and well-being. Pediatr Clin North Am 2009; 56: 1481–1499.
24.
Schroth RJ, Halchuk S, Star L: Prevalence and risk factors of caregiver reported severe early childhood caries in Manitoba first nations children: results from RHS phase 2 (2008–2010). Int J Circumpolar Health 2013a; 72: 21167.
25.
Schroth RJ, Levi JA, Sellers EA, Friel J, Kliewer E, Moffatt MEK: Vitamin D status of children with severe early childhood caries: a case-control study. BMC Pediatrics 2013b; 13: 174.
26.
Schroth RJ, Levi J, Kliewer E, Friel J, Moffatt MEK: Association between iron status, iron deficiency anaemia and severe early childhood caries: a case-control study. BMC Pediatrics 2013c; 13: 22.
27.
Shenkin JD, Broffitt B, Levy SM, Warren JJ: The association between environmental tobacco smoke and primary tooth caries. J Public Health Dent 2004; 64: 184–186.
28.
Sun HB, Zhang W, Zhou XB: Risk factors associated with early childhood caries. Clin J Dent Res 2017; 20: 97–104.
29.
Tanaka K, Hanioka T, Miyake Y, Ojima M, Aoyama H: Association of smoking in household and dental caries in Japan. J Public Health Dent 2006; 66: 279–281.
30.
Tanaka K, Miyake Y, Sasaki S: The effect of maternal smoking during pregnancy and postnatal household smoking on dental caries in young children. J Pediatr 2009; 155: 410–415.
31.
Tanaka K, Miyake Y: Association between breastfeeding and dental caries in Japanese children. J Epidemiol 2012; 22: 72–77.
32.
Turton B, Durward C, Manton D, Bach K, Yos C: Socio-behavioural risk factors for early childhood caries (ECC) in Cambodian preschool children: a pilot study. Eur Arch Paediatr Dent 2016; 17: 97–105.
33.
Väänänen MK, Markkanen HA, Tuovinen VJ, Kullaa AM, Karinpää AM, Luoma H, Kumpusalo EA: Dental caries and mutans streptococci in relation to plasma ascorbic acid. Scand J Dent Res 1994; 102: 103–108.
34.
Watanabe M, Wang DH, Ijichi A, Shirai C, Zou Yu, Kubo M, Takemoto K, Masatomi C, Ogino K: The influence of lifestyle on the incidence of dental caries among 3-year-old Japanese children. Int J Environ Res Public Health 2014; 11: 12611–12622.
35.
Williams SA, Kwan SYL, Parsons S: Parental smoking practices and caries experience in pre-school children. Caries Res 2000; 34: 117–122.
36.
World Health Organization: Oral health surveys: basic methods – 5th edition. 2014. http://www.who.int/oral_health/publications/9789241548649/en/.
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