Burden of dental caries among 5-14 years old children and role of environmental tobbaco smoke in urban and peri-urban areas of Karachi, Pakistan

Date of Award


Document Type


Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Dental caries is a multi-factorial disease caused by a combination of physical, biological, environmental, behavioral and life style related risk factors. Recent studies have shown the association of environmental tobacco smoke and dental caries. In Pakistan the burden of smoking is increasing with time and children are readily exposed to smoke and burden increases when adults prefer indoor smoking. This study aims to establish the relationship between dental caries and environmental tobacco smoke in children of age 5-14 years living in peri-urban and urban settlement namely Radho Jhokio and Aga Khani neighborhoods of Karachi, Pakistan. OBJECTIVE: To understand the relationship between environmental tobacco smoke and dental caries among child population in Karachi, Pakistan METHODS: This study was done in the Peri-urban and urban sites of Gadap town and Aga khani neighborhoods. A pre-coded questionnaire having main exposure of in house environmental tobacco smoke and other variables like socioeconomic condition, literacy of parents, tooth brushing habit was used to collect data. Food frequency questionnaire was used to assess the dietary habits. Weight and height were measured to calculate HMI. Dental examination of each child was done by dentist to detect dental caries. RESULTS: A total of 500 children from peri-urban and urban sites of Karachi, Pakistan were recruited. Prevalence of dental caries was found to be 67.2 percent CI (63.1-71.3). One third of study participant's family member reported smoking. The prevalence ratio for environmental tobacco smoke was significantly associated with dental caries with prevalence ratio of 1.18 CI (1.02-1.37) for children who were exposed to 30 minutes and less and 1.33 CI (L09-1.62) for children who were exposed to more than 30 minutes compared to un-exposed children. After adjusting for junk food intake in between meals, age, plaque index, dental visit and socio-economic status association of environmental smoking remain significant with dental caries. Adjusted prevalence ratio of dental caries was 1.25 for those who were exposed for less than or equal to 30 minutes CI (1.08-1.46) in comparison to those children who were not exposed. Adjusted prevalence ratio of dental caries was of 1.36 for those who were exposed for more than 30 minutes CI (1.09- 1.70) in comparison to those children who were not exposed. CONCLUSION: This study shows that environmental tobacco smoke is associated with dental caries among children residing at urban and peri-urban settlements of study sites. However further studies are required to establish causal association of environmental tobacco smoke with dental caries. Moreover reduction of environmental tobacco smoke is important for improving oral health of children and for prevention of many chronic illnesses.

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