母親の喫煙習慣と歯科保健行動および子どもの口腔状態との関連性

小児の受動喫煙とう蝕罹患との関連性が報告されている。また、喫煙習慣を持つ母親は自身や子どもに対する歯科健康意識が低いと推察される。そこで本研究では、母親の喫煙習慣と歯科保健行動および子どもの口腔状態との関連性を分析し、乳歯う蝕罹患に関わる因子を明らかにすることを目的とした。
徳島県N市にて実施した1歳6か月児健康診査および3歳児健康診査を両方受診した母子を対象とした。調査対象児165名の母親を、非喫煙者（152名）と喫煙者（13名）の2群に分け、3歳児の歯科健診結果および母親からのアンケート調査結果を突合して分析した。
乳歯う蝕罹患率は喫煙者群では46.2％で、非喫煙者群の21.1％と比較して有意にう蝕罹患の割合が高かった（p＜0.05）。アンケート調査項目の母親の現在の定期歯科健診において、「受診なし」の者の割合が喫煙者群では76.9％、非喫煙者群では46.1％で、2群間に有意な差が認められた（p＜0.05）。妊婦中の歯科健診の項目において、喫煙者群の「受診なし」の者の割合は76.9％、非喫煙者群では43.7％で有意な差が認められた（p＜0.05）。また、喫煙者群では非喫煙者群に比べて、母親の年齢において若年層の割合が有意に高く、母親以外の家族の喫煙習慣ありの割合も高かった（各々p＜0.01，p＜0.05）。さらに、3歳児のう蝕経験の有無を目的変数として二項ロジスティック回帰分析を行った結果、「清掃状態」（オッズ比：2.92，p＜0.05）、「間食時間の決定」（オッズ比：3.99，p＜0.01）、「母親の喫煙習慣」（オッズ比：4.13，p＜0.05）において有意な関連が認められた。
以上の結果より、喫煙習慣を有する母親は、年齢が低い者の割合が高く、他の家族の喫煙率も高く、そして、妊娠期および現在も歯科健診受診の割合が低いことが示された。また、母親の喫煙習慣が3歳児の乳歯う蝕罹患に関連することが示唆された。

Objective: It is known that secondhand smoke exposure is associated with dental caries in children, and it is also speculated that mothers with smoking habits may have little awareness of their dental health and their children. The purpose of this study was to analyze the relationship between smoking habits of mothers and dental health behavior or the oral health condition of their children, and to clarify the factors involved in dental caries of deciduous teeth.
Methods: The subjects enrolled in this study were mothers and their children who received health checkup for both 18-month-old children and 3-year-old children in N City, Tokushima Prefecture, Japan. One hundred sixty-five subjects (mothers) were divided into two groups, non-smoker group (n=152) and smoker group (n=13). The results of dental examinations for 3-year-old children and the questionnaire surveys from mothers were collated and analyzed.
Results: Dental caries prevalence of deciduous teeth was 46.2% in children of the smoker group, which was significantly higher than that of 21.1% in children of the non-smoker group (p<0.05). Among the questionnaire survey items regarding the regular dental checkup of mothers, the percentage of “no visit“ in the smoker group was 76.9% and 46.1% in the non-smoker group, and it showed a significant difference (p<0.05). In the item of the dental examination for pregnant woman, the percentage of “did not receive” in the smoker group was 76.9% and 43.7% in the non-smoker group, and it showed a significant difference (p<0.05). There were significant differences between the presence and absence of smoking habits of mothers regarding the age of mother (p<0.01) and smoking habits of the other families (p<0.05). In addition, the binomial logistic regression analysis showed that oral hygiene condition (OR=2.92, p<0.05), regular between meal eating (OR=3.99, p<0.01) and smoking habits of mothers (OR=4.13, p<0.05) were significantly corelated with the presence of dental caries in 3-year-old children.
Conclusions: These results suggest that the mothers in the smoking group was younger and higher rate that included smoker families, in addition to poor regular dental check-up during pregnancy and currently. It was also suggested that smoking habits of mothers were associated with dental caries in 3-year-old children.