Evaluation of the relationship between passive smoking and salivary electrolytes, protein, secretory IgA, sialic acid and amylase in young children

Protocol for CARES-HAPIN: an ambidirectional cohort study on exposure to environmental tobacco smoke and risk of early childhood caries

INTRODUCTION

Prenatal and postnatal exposure to environmental tobacco smoke (ETS) has been linked with early childhood caries (ECC), but the specific molecular mechanisms and pathways remain largely unknown. The Caries Risk from exposure to Environmental tobacco Smoke (CARES) within the Household Air Pollution Intervention Network (HAPIN) study aims to establish the association between ETS and ECC by employing epidemiological and novel biomarker-based approaches. Here, we outline the overall design and rationale of the project.

METHODS AND ANALYSIS

We will leverage the infrastructure and data from the HAPIN trial (India) to mount the CARES study. In this ambidirectional cohort study, children (n=735, aged: 3-5 years) will undergo ECC examination by a trained dentist using standard criteria and calibrated methods. Structured questionnaires will be used to gather information on sociodemographic variables, dietary habits, oral hygiene, oral health-related quality of life and current exposure to ETS. We will collect non-invasive or minimally invasive biospecimens (i.e., saliva, buccal cells, dried blood spots and urine) from a subset of HAPIN children (n=120) to assess a battery of biomarkers indicative of exposure to ETS, early biological effect and epigenetic modifications. Both self-reported and objective measures of ETS exposure collected longitudinally during in utero and early postnatal periods will be accessed from the HAPIN database. We will apply current science data techniques to assess the association and interrelationships between ETS, ECC, and multiple biomarkers.

ETHICS AND DISSEMINATION

Information gathered in this research will be published in peer-reviewed journals and summaries will be shared with the key stakeholders as well as patients and their parents/guardians involved in this study. Sri Ramachandra Institute of Higher Education and Research Ethics Board has approved the study protocol (IEC-NI22/JUL/83/82).

TRIAL REGISTRATION NUMBER

NCT02944682.

Passive Smoking and Oral Health of Infants, Preschoolers, and Children: A Systematic Review

INTRODUCTION

Almost half of the world's children experience passive smoking, which is linked to numerous oral health conditions. The aim is to synthesize data on the impact of passive smoking on oral health of infants, preschoolers, and children.

AIMS AND METHODS

A search was conducted across Medline (via EBSCOhost), PubMed, and Scopus up to February 2023. Risk of bias was assessed according to the Newcastle-Ottawa Scale (NOS).

RESULTS

The initial search produced 1221 records and after removal of duplicates, screening by title and abstract, and full-text assessment, 25 studies were eligible for review and data extraction. The majority of studies (94.4%) found a correlation between passive smoking and increased prevalence of dental caries with three studies suggesting a dose-response relationship. Prenatal passive smoking exposure in 81.8% of studies indicated an increased dental caries experience compared to postnatal exposure. Low parental education, socioeconomic status, dietary habits, oral hygiene, and gender affected the level of environmental tobacco smoke (ETS) exposure and dental caries risk.

CONCLUSIONS

The results of this systematic review strongly suggest a significant association between dental caries in the deciduous dentition and passive smoking. Early intervention and education on the effects of passive smoking on infants and children will allow for the improvement in oral health outcomes and reduction in smoking-associated systemic conditions. The results justify all health professionals paying more attention to passive smoking when conducting pediatric patient histories, contributing to improved diagnosis and appropriate treatment planning with more suitable follow-up schedules.

IMPLICATIONS

The evidence from this review that environmental tobacco smoke and passive smoking is a risk factor for oral health conditions, both prenatally and postnatally during early childhood, justifies all health professionals paying more attention to passive smoking when conducting pediatric patient histories. Early intervention and appropriate parental education regarding the effects of secondhand smoke on infants and children will allow for the minimization of dental caries, improvement in oral health outcomes and overall reduction in smoking-associated systemic conditions for the children exposed.

Effect of an Extremely Low-Frequency Electromagnetic Field on the Concentration of Salivary Immunoglobulin A

Extremely Low-Frequency Electromagnetic Field (ELF MF) therapy is effective in the treatment of injury, inflammation and postoperative complications. Its clinical applications relate to bone unification, pain reduction, soft tissue oedema and the decrease of electric potentials in the oral cavity. It enhances regeneration of periapical bone lesions. It is obvious that cells (leukocytes, platelets, keratinocytes, osteoblasts) and proteins (fibrin, collagen, elastin and growth factors) exhibit alterations when exposed to an Extremely Low-Frequency Electromagnetic Field. The aim of the study was to evaluate the effect of an Extremely Low-Frequency Electromagnetic Field (ELF MF) on the parotid gland on the concentration of salivary immunoglobulin A. The study group consisted of 24 patients, aged 14–16, who underwent ELF MF on the parotid gland region. The control group comprised 25 matching persons. The IgA concentration in saliva samples was established using radial immunodiffusion. Following ELF MF, a statistically significant increase in the concentration of secretory immunoglobulin A was found in the study group, whereas in the control group, no statistically significant differences were noted. It can be concluded that an Extremely Low-Frequency Electromagnetic Field increases the activity of the immune system of the parotid gland.

Supragingival microbiome alternations as a consequence of smoking different tobacco types and its relation to dental caries

This study aimed to assess the effect of smoking different tobacco types on the supragingival microbiome and its relation to dental caries. Forty supragingival plaque samples were collected from smokers of a single tobacco type and non-smokers seeking treatment at the University Dental Hospital Sharjah, UAE. DMFT (decayed, missing and filled teeth) was determined for all participants who were divided into two groups: no-low caries (NC-LC: DMFT = 0-4; n = 18) and moderate-high caries (MC-HC: DMFT = 5-20; n = 22). 16S rRNA gene was sequenced using third-generation sequencing with Nanopore technology. Microbiome composition and diversity were compared. Caries was most common among cigarette smokers. Supragingival microbiota were significantly altered among smokers of different tobacco types. In cigarette smokers, cariogenic bacteria from genus Streptococcus (including S. mutans) were significantly more among subjects with NC-LC, while Lactobacilli (including L. fermentum) were more among subjects with MC-HC. In medwakh smokers, several periodontopathogens were significantly elevated in subjects with NC-LC, while other pathogenic bacteria (as Klebsiella pneumoniae) were more in those with MC-HC. Cigarette and alternative tobacco smoking had a significant impact on the supragingival microbiome. Indeed, further studies are required to unravel the consequences of oral dysbiosis triggered by smoking. This could pave the way for microbiota-based interventional measures for restoring a healthy oral microbiome which could be a promising strategy to prevent dental caries.

Review of paediatric gastrointestinal physiology relevant to the absorption of orally administered medicines

Despite much progress in regulations to improve paediatric drug development, there remains a significant need to develop better medications for children. For the design of oral dosage forms, a detailed understanding of the specific gastrointestinal (GI) conditions in children of different age categories and how they differ from GI conditions in adults is essential. Several review articles have been published addressing the ontogeny of GI characteristics, including luminal conditions in the GI tract of children. However, the data reported in most of these reviews are of limited quality because (1) information was cited from very old publications and sometimes low quality sources, (2) data gaps in the original data were filled with textbook knowledge, (3) data obtained on healthy and sick children were mixed, (4) average data obtained on groups of patients were mixed with data obtained on individual patients, and (5) results obtained using investigative techniques that may have altered the outcome of the respective studies were considered. Consequently, many of these reviews draw conclusions that may be incorrect. The aim of the present review was to provide a comprehensive and updated overview of the available original data on the ontogeny of GI luminal conditions relevant to oral drug absorption in the paediatric population. To this end, the PubMed and Web of Science metadatabases were searched for appropriate studies that examined age-related conditions in the oral cavity, esophagus, stomach, small intestine, and colon. Maturation was observed for several GI parameters, and corresponding data sets were identified for each paediatric age group. However, it also became clear that the ontogeny of several GI traits in the paediatric population is not yet known. The review article provides a robust and valuable data set for the development of paediatric in vitro and in silico biopharmaceutical tools to support the development of age-appropriate dosage forms. In addition, it provides important information on existing data gaps and should provide impetus for further systematic and well-designed in vivo studies on GI physiology in children of specific age groups in order to close existing knowledge gaps and to sustainably improve oral drug therapy in children.

Multi-Micronutrient Supplementation and Immunoglobulin Response in Well-Fed Firefighters

Intensive physical training programs can affect the immune system. This study aims to verify the multi-micronutrient supplementation effects on serum immunoglobulins levels prior to and after a five-week physical training program. Twenty-four male recruit firefighters were randomly allocated into supplemented (with Prisfar Ever-Fit Plus over 35 consecutive days) and placebo groups (n=12 each). Serum immunoglobulins G, A, and M were assessed. Supplementation effect was detected for immunoglobulin G (eta-squared, η ² : 0.09; p =0.035; power: 0.56), A (η ² : 0.24; p =0.001; power: 0.95), and M (η ² : 0.09; p =0.036; power: 0.56). Although immunoglobulin A was different between groups at baseline (mean difference: 42.58; 95%CI: 7.00 to 78.16 mg/dL; p =0.021; d =2.48), within-group (before vs . after five weeks) showed no differences for both supplemented and control groups. In addition, even if immunoglobulin G and M were similar at baseline, immunoglobulin G decreased (mean diff.: 46.4; 95%CI: 6.7 to 86.1 mg/dL; p =0.03; d =0.74) and immunoglobulin M increased (mean diff.: -10.7; 95%CI: -15.8 to -5.5 mg/dL; p =0.001; d =-1.33) in the control group. Although mean values remained within the reference values, changes observed for immunoglobulin G and M may reflect some immune protection for firefighters engaged in recruit training.

Elevated levels of lead exposure and impact on the anti-inflammatory ability of oral sialic acids among preschool children in e-waste areas

The oral health of preschool children in an electronic waste (e-waste) area is susceptible to lead (Pb) exposure increasing the risk of dental caries and causing periodontitis and other oral diseases. The aim of the present study is to investigate the relationship between chronic exposure to Pb and oral anti-inflammatory potential of preschool children. For this analysis, 574 preschool children from 2.5 to 6 years of age were recruited between November and December 2017, in which 357 preschool children were from Guiyu (n = 357), an e-waste-contaminated town, and 217 from Haojiang Shantou. We measured the levels of child blood Pb, salivary sialic acid, serum interleukin-6 (IL-6) and serum tumor necrosis factor-α (TNF-α), and investigated the prevalence of dental caries in deciduous teeth. The medians of blood Pb levels, serum IL-6 and TNF-α were significantly higher in the Guiyu children than in Haojiang children. Concomitantly, salivary sialic acids were lower in the Guiyu children [9.58 (3.97, 18.42) mg/dL] than in Haojiang [17.57 (5.95, 24.23) mg/dL]. Additionally, the prevalence of dental caries in deciduous teeth was significantly higher in the Guiyu children than in Haojiang (62.5% vs. 53.9%). Blood Pb levels were negatively correlated with salivary sialic acids, in which IL-6 played as a mediator of the association between blood Pb levels and saliva sialic acid concentrations according to the mediation model. To our knowledge, this is the first report on the potential association between chronic Pb exposure and the anti-inflammatory ability of oral sialic acids among preschool children. These results suggest that the chronic Pb exposure can reduce salivary sialic acid levels, attenuate oral anti-inflammatory potential and increase the potential risk of dental caries in deciduous teeth among preschool children in an e-waste site.

Effect of using tobacco on taste perception

Background:

Impaired taste perception has impact on quality of life. Tobacco is a perilous factor that contributes to an impaired taste.

Objective:

To evaluate and compare taste perception among tobacco chewers and nonchewers.

Materials and Methods:

Sixty subjects (30 tobacco chewers + 30 nonchewers as controls) were enrolled in the study for evaluating taste perception. Taste identification time using four aqueous solutions of basic tastes – sweet, salty, sour, and bitter – was recorded (in seconds) and compared between tobacco chewers and controls. The data were analyzed using Student's t-test and analysis of variance using SPSS 20 version software.

Results:

A statistically significant increase in taste identification time for salty taste in tobacco chewers (12.32 s) was noted compared with nonchewers (10.21 s) (P = 0.03). The average taste identification time was higher for tobacco chewers than nonchewers for sweet and salty taste. However, the average taste identification time was lower for tobacco chewers than nonchewers for sour and bitter taste. In nonchewers, the average taste identification time was 13.01, 10.21, 8.43, and 7.56 s for sweet, salty, bitter, and sour taste, respectively. In tobacco chewers, the average taste identification time was 15.16, 12.32, 7.75, and 7.04 s for sweet, salty, bitter, and sour taste, respectively.

Conclusion:

The results of the study demonstrated noticeable decrease in taste perception to salty taste among tobacco chewers when compared with tobacco nonchewers. There is a remarkable difference in taste perception to basic tastes among tobacco chewers and controls.

The effect of smoking on caries-related microorganisms

INTRODUCTION

Epidemiological studies have shown a close relationship between smoking and dental caries. Bacteria are one of the essential factors of caries formation. The imbalance of cariogenic bacteria and commensal bacteria in dental plaque results in higher production of acid that can corrode dental hard tissue. The aim of our review is to summarize the effect of smoking on caries-related bacteria.

METHODS

English articles available in Pubmed and ScienceDirect databases and published before December 2018 were searched. A variety of evidence was collected including not only the influence of cigarette products on bacteria strains in vitro but also their effect on bacterial composition in saliva and dental plaque in vivo. We particularly emphasize the mechanisms by which nicotine acts on oral bacteria.

RESULTS

The components of cigarettes promote the growth of cariogenic microorganisms. The mechanisms of how nicotine enhances Streptococcus mutans, Lactobacilli, Streptococcus gordonii, Actinomyces and Candida albicans are described separately in detail. The commensal bacteria, Streptococcus sanguinis, show less competitive capability in the presence of nicotine. Smoking influences saliva by lowering the buffer capability, altering its chemical agent and bacterial components, and therefore promotes the formation of a caries-susceptible environment.

CONCLUSIONS

Cigarette smoking and nicotine exposure promote the cariogenic activity of oral microorganisms and the formation of a caries-susceptible environment. This suggests that smokers should quit smoking, amongst other health reasons, also for their oral health.

Effects of active and passive smoking on salivary cytokines levels in rats: A pilot study

Cigarette smoking is an established risk factor for some oral diseases. As an essential fluid in the oral cavity, saliva is crucial to maintain oral health. Relative to active smoking, there are very few studies assessing the effect of passive smoking on salivary cytokines levels. In the present study, we established the rat models by the means of the intraoral cigarette smoking or whole body cigarette smoke exposure to simulate human active or passive smoking, respectively. The effects of active or passive smoking on salivary cytokines levels were assessed by using ProcartaPlex multiplex immunoassays. The results of the current study indicated that both active and passive smoking diminished the body weights of rats and increased the levels of some blood counts. Intriguingly, active smoking enhanced the salivary levels of IL-6 and IL-12 p70 and passive smoking elevated the salivary IL-6 level. Moreover, active smoking appeared to have a more prominent activation effect on the salivary IL-6 level. It was noted that active or passive smoking had no significant effect on the salivary IFN-γ level. Active or passive smoking could have potential effects on the salivary levels of some pro-inflammatory cytokines.

Effects of environmental tobacco smoke on the oral health of preschool children

AIMS

This study investigated the association between the prevalence of oral health problems (caries, gingivitis, mucosal pigmentation and enamel defects in one to 5 year-old children exposed and not exposed to environmental tobacco smoke before and/or after birth. Exposure to environmental tobacco smoke (ETS) in childhood may have significant health effects.

METHODS

A structured questionnaire was used to collect data on a child's current and previous illnesses, oral health behaviours, dietary habits, parental smoking behaviours and parents' dental history. The intraoral examination recorded dental caries (dmfs), enamel defects, gingival health, melanin pigmentation and soft tissue health. Stimulated saliva was collected. Total sIgA levels were quantified using indirect competitive ELISA with a SalimetricsTM kit.

RESULTS

The 44 children (aged 15-69 months) recruited were divided into two groups: ETS and non-ETS (control). There were 22 children in each: 16 who were exposed to ETS during and after gestation were identified as the ETSB subgroup. Participants exposed to ETS were more likely to have had upper respiratory tract and middle ear infections during the neonatal period and had higher mean dmft, mean dmfs, mean percent of surfaces with demarcated opacities and mean GI than the non-ETS participants. The children exposed to ETS before and after birth had the highest occurrence of enamel opacities showed a higher risk for dental caries even though more children in this group used the recommended fluoride toothpaste (1000 ppm fluoride). Mothers who smoked either never breastfed their children or breastfed their children for less than the recommended period of 6 months. Children exposed to ETS were shown to have higher mean total sIgA (μg/ml) than the children in the control group.

CONCLUSIONS

Associations between ETS exposure before and after gestation and oral health, including salivary changes in young children were shown in the present study. Dental health professionals should include a question about household smoking in children's dental histories, which would allow opportunities to discuss the impact of smoking on child oral health. Longitudinal oral health studies should include a history of maternal smoking during pregnancy and afterwards.

Correlation of environmental tobacco smoke to gingival pigmentation and salivary alpha amylase in young adults

OBJECTIVE

Passive smoking leads to melanin pigmentation on gingiva. However, documentation of gingival pigmentation and salivary amylase activity in passive smokers relative to the duration of exposure to environmental tobacco smoke (ETS), is incomplete and requires further investigation. Thus, this study aimed to assess effects of ETS exposure on gingival pigmentation in young adults. In addition, to correlate a number of years of exposure to an extent, the intensity of gingival pigmentation and salivary amylase activity.

MATERIALS AND METHODS

A total of 200 nonsmokers aged 18-35 years with a positive history of ETS exposure were recruited for the study. Duration and source of ETS were assessed using a questionnaire. Gingival pigmentation was assessed using gingival pigmentation index for the extent and Dummett oral pigmentation index for intensity. The skin color of all patients was also assessed. Pearson Chi-square test and one-way ANOVA was used to statistically analyze the data.

RESULTS

Number of years of exposure to passive smoking was highly significant to the extent and intensity of gingival pigmentation (P < 0.001). ETS from home environment was highly significant to the intensity of pigmentation. Environmental sources of ETS contributed to pigmentation as the majority of patients reported exposure from vehicles and workplace. The salivary amylase levels were inversely proportional to the duration of exposure to ETS.

CONCLUSION

Within limitations of this cross-sectional observational study, it was concluded that there was a strong correlation between ETS exposure and gingival pigmentation. Duration of exposure was significant to an extent, the intensity of pigmentation and salivary amylase activity.

Salivary secretory IgA concentration and dental caries in children with Down syndrome

PURPOSE

To evaluate the relationship between salivary secretory immunoglobulin A (sIgA) concentration and dental caries in children with Down syndrome (DS) and compare it with findings in non-DS children.

METHODS

The sample comprised 61 DS children and 52 non-DS children, aged 6 to 14 years. Caries experience, plaque index (PI), and gingival bleeding index (GBI) were recorded. Saliva samples were collected from all children. Total salivary sIgA concentrations were determined using an enzymatic assay method.

RESULTS

Caries experience in primary and permanent dentitions were similar in DS and non-DS children. However, PI and GBI values were significantly lower in DS compared to non-DS children. DS children had higher salivary sIgA concentrations compared to non-DS children. No difference in sIgA concentration was observed between children with and without caries experience in either group.

CONCLUSIONS

DS children have higher salivary sIgA concentrations than non-DS children. However, this finding did not correlate with caries experience in the study population.

Effect of cigarette smoke on gustatory sensitivity, evaluation of the deficit and of the recovery time-course after smoking cessation

BACKGROUND

Study results have shown that chronic exposure to cigarette smoke affects the taste function in humans. However, neither the quantitative impact on taste sensitivity nor the time-course of taste recovery on stopping smoking have been precisely examined.

METHODS

The experimental design included 2 phases, (i) a case-control phase comparing the taste sensitivity level measured by Electrogustometric (EGM) thresholds from various parts of the tongue (locus) between smokers (n = 83) and non-smokers (n = 48), (ii) a follow-up study looking at the taste sensitivity recovery in smokers after smoking cessation (n = 24) and compared with non-smokers.

RESULTS

Smokers exhibited significantly lower taste sensitivity than non-smokers - the higher the nicotine dependence (Fagerström scores), the lower the taste sensitivity. After smoking cessation, EGM thresholds decreased progressively, and reached the taste sensitivity range of non-smokers depending on locus and time. After 2 weeks a recovery could be observed on the 3 Tip and the 2 edge loci; the recovery in the posterior loci was complete after 9 weeks, and in the dorsal loci recovery was observed only after 2 months or more.

CONCLUSIONS

Smoking cessation does lead to a rapid recovery of taste sensitivity among smokers, with recovery time found to differ based on the sensitivity of loci of the tongue. The use of EGM could potentially be explored as a motivational tool for smoking cessation.

Relationship between salivary stress biomarker levels and cigarette smoking in healthy young adults: an exploratory analysis

Background

This study investigated the relationships among salivary stress biomarkers, cigarette smoking, and mood states.

Methods

The study population comprised 49 healthy sixth-year dental students at Fukuoka Dental College (39 men, 10 women; age, 23–31 years). Lifetime exposure to smoking was calculated using the Brinkman index (BI). Resting saliva samples were collected, and concentrations of cortisol, secretory immunoglobulin A (SIgA), interleukin (IL)-1β, interleukin-6, and tumor necrosis factor (TNF)-α were determined. Mood states (tension-anxiety, depression-dejection, anger-hostility, fatigue, confusion, and vigor) over the previous week were assessed using the Profile of Mood States - Brief Japanese Version.

Results

Salivary IL-1β levels were significantly higher in smokers than non-smokers (P = 0.044), regardless of the BI or mood state. A significant positive correlation was evident between the TNF-α level and the BI (P = 0.036), and the SIgA level was positively correlated with the BI (P = 0.067) but did not reach statistical significance. In terms of mood states, higher fatigue scores and lower vigor scores were observed in smokers. The TNF-α level and vigor score were negatively correlated (r = –0.229, P = 0.135), but the correlation did not reach statistical significance. However, the SIgA level and fatigue score were significantly positively correlated (r = 0.410, P = 0.005).

Conclusions

The TNF-α and SIgA levels were both positively correlated with the BI. Furthermore, the TNF-α level was negatively correlated with the vigor score, whereas the SIgA level was positively correlated with the fatigue score. Thus, salivary levels of TNF-α and SIgA may be used as biomarkers of mood states in healthy young smokers.

Salivary Sialic Acid Levels in Smokeless Tobacco Users

BACKGROUND

Smokeless tobacco chewing is one of the known risk factors for oral cancer. It is consumed widely by residents of southeastern Iran.

OBJECTIVES

In this study, salivary free and total sialic acid, and total protein were compared in paan consumers and non-consumers.

PATIENTS AND METHODS

In this cross-sectional study, unstimulated saliva of 94 subjects (44 paan consumers and 50 non-consumers) who were referred to the oral medicine department of the dentistry school of Zahedan were collected. Salivary free and total sialic acid, and total protein concentration were measured by standard biochemical methods, and the obtained data were analyzed using SPSS 20 through the non-parametric Mann-Whitney test.

RESULTS

The concentration of salivary free sialic acid (23.21 ± 18.98 mg/L) was significantly increased in paan consumers. The concentration of salivary Total sialic acid (TSA) (39.57 ± 26.58 mg/L) and total protein (0.77 ± 0.81 mg/mL) showed increases in paan consumers, however, the results were not statistically significant.

CONCLUSIONS

Salivary free and total sialic acid, and total protein were higher in the paan consumers compared to non-consumers. Due to the carcinogenic effect of smokeless tobacco, measurement of these parameters in saliva may be useful in early detection of oral cancer.

Secondhand smoke and incidence of dental caries in deciduous teeth among children in Japan: population based retrospective cohort study

STUDY QUESTION

Does maternal smoking during pregnancy and exposure of infants to tobacco smoke at age 4 months increase the risk of caries in deciduous teeth?

METHODS

Population based retrospective cohort study of 76 920 children born between 2004 and 2010 in Kobe City, Japan who received municipal health check-ups at birth, 4, 9, and 18 months, and 3 years and had information on household smoking status at age 4 months and records of dental examinations at age 18 months and 3 years. Smoking during pregnancy and exposure of infants to secondhand smoke at age 4 months was assessed by standardised parent reported questionnaires. The main outcome measure was the incidence of caries in deciduous teeth, defined as at least one decayed, missing, or filled tooth assessed by qualified dentists without radiographs. Cox regression was used to estimate hazard ratios of exposure to secondhand smoke compared with having no smoker in the family after propensity score adjustment for clinical and lifestyle characteristics.

STUDY ANSWER AND LIMITATIONS

Prevalence of household smoking among the 76 920 children was 55.3% (n=42 525), and 6.8% (n=5268) had evidence of exposure to tobacco smoke. A total of 12 729 incidents of dental caries were observed and most were decayed teeth (3 year follow-up rate 91.9%). The risk of caries at age 3 years was 14.0% (no smoker in family), 20.0% (smoking in household but without evidence of exposure to tobacco smoke), and 27.6% (exposure to tobacco smoke). The propensity score adjusted hazard ratios of the two exposure groups compared with having no smoker in the family were 1.46 (95% confidence interval 1.40 to 1.52) and 2.14 (1.99 to 2.29), respectively. The propensity score adjusted hazard ratio between maternal smoking during pregnancy and having no smoker in the family was 1.10 (0.97 to 1.25).

WHAT THIS STUDY ADDS

Exposure to tobacco smoke at 4 months of age was associated with an approximately twofold increased risk of caries, and the risk of caries was also increased among those exposed to household smoking, by 1.5-fold, whereas the effect of maternal smoking during pregnancy was not statistically significant.

FUNDING, COMPETING INTERESTS, DATA SHARING

This study was supported by a grant in aid for scientific research 26860415. The authors have no competing interests or additional data to share.

Determination of thiocyanate (biomarkers of ETS) and other inorganic ions in human nasal discharge samples using ion chromatography

Environmental tobacco smoke (ETS) is a mixture of air and tobacco smoke containing more than 4000 chemical substances. In view of the health risks of many of these substances, studies are needed to determine biomarkers of exposure to ETS constituents in people who actively or passively are exposed to the toxic compounds. The methodologies for determining most biomarkers from saliva, urine and blood samples are known, but methods for analyzing these compounds in nasal discharges are not available. The objective of this work was to develop an analytical procedure for the determination of thiocyanate and other biomarker compounds in samples of nasal discharge using ion chromatography.

Association of dental caries and salivary sIgA with tobacco smoking

BACKGROUND

Salivary secretory IgA (sIgA) is said to play an important role in the immune response against dental caries. This study aimed to determine the salivary sIgA levels in healthy smokers and non-smokers, and its correlation with dental caries.

METHODS

A total of 70 healthy subjects were selected and classified into four groups according to dental caries and tobacco smoking habits: smoking with caries (Group 1, n = 15); smoking without caries (Group 2, n = 15); non-smoking with caries (Group 3, n = 15); and non-smoking without caries (Group 4, n = 25). Salivary sIgA was measured using ELISA. The fissure and proximal caries were examined clinically and radiographically. Caries status was determined according to the decay surface index.

RESULTS

Smokers showed a higher number of caries and the lowest concentration of sIgA. The highest levels of sIgA were observed in non-smoking and caries-free subjects compared to caries-active smokers (123.2 ± 19.9 vs. 13.3 ± 4.1 μg/ml respectively, p < 0.001). Also, the mean level of sIgA in Group 4 was significantly higher than Group 3 (p = 0.009). More importantly, higher and significant levels of sIgA were found in Group 3 versus Group 1 (p < 0.0001) and Group 2 (p = 0.0004).

CONCLUSIONS

Our findings indicate that low concentrations of salivary sIgA are correlated with a higher prevalence of dental caries in smokers.

The biological effects of individual-level PM(2.5) exposure on systemic immunity and inflammatory response in traffic policemen

BACKGROUND

Ambient fine-particle particulate matter (PM2.5) exposure is associated with the decline in pulmonary function, prevalence of coronary heart disease and incidence of myocardial infarction. The study is to observe the effects of ambient PM2.5 on the cardiovascular system and to explore the potential inflammatory and immune mechanisms.

METHODS

The subjects included 110 traffic policemen in Shanghai, China, who were aged 25-55 years. Two-times continuous 24 h individual-level PM2.5 measurements were performed in winter and summer, respectively. The inflammatory marker (high-sensitivity C-reactive protein, hs-CRP), immune parameters (IgA, IgG, IgM and IgE) and lymphocyte profiles (CD4 T cells, CD8 T cells, CD4/CD8 T cells) were measured in blood. The associations between individual-level PM2.5 and inflammatory marker and immune parameters were analysed by multiple linear regression.

RESULTS

The average concentration of 24 h personal PM2.5 for participants was 116.98 μg/m(3) and 86.48 μg/m(3) in winter and summer, respectively. In the main analysis, PM2.5 exposure is associated with the increases in hs-CRP of 1.1%, IgG of 6.7%, IgM of 11.2% and IgE of 3.3% in participants, and decreases in IgA of 4.7% and CD8 of 0.7%, whereas we found no statistical association in CD4 T cells and CD4/CD8 T cells. In the adjusted model, the results showed that the increase of PM2.5 was associated with the changes of inflammatory markers and immune markers both in winter and summer.

CONCLUSIONS

Traffic policeman have been a high-risk group suffering inflammatory response or immune injury because of the high exposure to PM2.5. These findings provided new insight into the mechanisms linking ambient PM2.5 and inflammatory and immune response.

Inflammatory and Immunitary Modifications in Saliva of Subjects with Labial and Tongue Piercing

Piercing is the practice of puncturing some parts of the body, including the area of the stomach, to apply ornamental objects. The presence of oral and perioral piercings are a risk factor for numerous acute and chronic complications, such as chipping of the dental enamel, lesions of the gums and infection. The presence of piercings in the oral cavity may also act as a stimulant for inflammation and determine modifications in the components of the saliva. The aim of this study is to evaluate whether there is a variation in the inflammatory or immunitary components of the saliva of adult patients with labial and tongue piercings. Twenty-five adult patients were examined (11 males and 14 females with an average age of 23.4±3.6 years) who had had a minimum of one labial or tongue piercing for at least 1 year. A questionnaire was compiled for each patient and the composition of the saliva was examined, before and for the 72 hours after removal of the piercings. The data was analyzed using the student's t-test for independent samples and the level of significance was placed at p< 0.05. The examination of the saliva showed a statistically significant increase (p< 0.05) of interleukin-1 and −8, of lysozyme and amylase. A more basic value of pH (p< 0.05) was also found and a decrease in the immunoglobulins, in particular of IgA (p< 0.05). After the removal of the piercings, the parameters of the saliva returned to the reference values, with the exception of the immunoglobulins, whose values remained the same as in the first saliva examination. The presence of piercings in labial areas or in the tongue is accompanied by chronic inflammation in the components of the saliva, with an increase in the level of the interleukins. Furthermore, in patients who have had an oral piercing for a longer period, the level of interleukins is even higher. This inflammatory situation, however, may recede in a few days after the removal of the irritating agent. Labial or tongue piercings also determine an increase in the flow of saliva, an increase in saliva enzymes, of lysozyme in particular, and a more basic pH value.

Anti-dentine antibodies with root resorption during orthodontic treatment

The aim of this study was to analyse serum IgG levels and salivary secretory IgA (sIgA) levels in human dentine extract (HDE) before (T0) and 6 months after (T6) orthodontic treatment and to correlate anti-HDE autoantibodies to root resorption. Fifty orthodontic patients were selected, 19 males (15.6 ± 8.5 years) and 31 females (21.4 ± 11.2 years), 19 in the mixed dentition (10.3 ± 1.9 years) and 31 in the permanent dentition (24.6 ± 9.9 years). Fifty individuals not undergoing orthodontic treatment matched by gender and age were selected as the controls. Periapical radiographs of the upper central incisors and saliva sampling were obtained of all patients at T0 and T6. Serum samples were collected from the permanent dentition patients (n = 31). Antibody levels were determined by means of immunoenzyme assay. At T6, root resorption was classified as grade 0 (no resorption), grade 1 (slight resorption), and grade 2 (moderate to severe resorption). Differences between antibody levels at T0 and T6 and among different grades of resorption were determined by paired t- and Kruskal-Wallis tests, respectively. Spearman's rank correlation coefficient was applied to detect correlation between sIgA and IgG levels, and logistic regression to determine the association of root resorption grade and the studied variables. Differences were considered significant at P < 0.05. Serum anti-HDE IgG levels decreased (P < 0.01) in grade 2 root resorption patients during treatment and was not correlated to salivary sIgA levels or other variables. Patients who had grade 2 root resorption at T6 showed higher levels of anti-HDE sIgA (P < 0.001). Anti-HDE sIgA levels at T0 and root shape were the main factors associated with the degree of root resorption. The results suggest that variations to systemic and local humoural immune response to dentine antigens may occur during orthodontic treatment. High levels of salivary sIgA before treatment were associated with more advanced lesions after 6 months of treatment.

Developmental profiles of mucosal immunity in pre-school children

This study investigated the effect of attending pre-school on mucosal immunity. Children 3.5 to 5 years of age who attended pre-school were observed for a 10 month period. Demographic information was collected on previous childcare experiences, the home environment and clinical information relating to the child and the family. A daily illness log was kept for each child. A multivariate longitudinal analysis of the relation between immunoglobulins in saliva and age, gender, childcare experience, pre-school exposure, number of siblings, environmental tobacco smoke (ETS), atopy and hospitalisation was conducted. There was a positive association of higher IgA levels with the winter season and with children being older than 4 years (P < .001), having attended childcare prior to commencing pre-school (P < .05), and having been exposed to ETS at home (P < .05). Lower IgA levels were associated with being atopic (P < .05). Higher IgG levels were associated with exposure to ETS (P < .001), while lower levels were associated to having atopy. Higher IgM levels were associated with previous childcare experience (P < .01) whilst having been hospitalised was associated with having low salivary IgM levels (P < .01). Lagged analyses demonstrated that immunological parameters were affected by the number of respiratory infections in the preceding 2 months.

Increased calcium and decreased magnesium and citrate concentrations of submandibular/sublingual saliva in sialolithiasis

OBJECTIVE

The purpose of the present study was to investigate the electrolyte alterations of submandibular/sublingual saliva in submandibular sialolithiasis patients compared with saliva from healthy controls.

DESIGN

Submandibular/sublingual saliva was collected from 10 submandibular sialolithiasis patients and from 10 sex- and age-matched healthy controls. Ion chromatography was performed to determine the concentrations of inorganic cations (potassium, calcium, magnesium, and sodium), inorganic anions (chloride, phosphate, nitrate, and sulphate) and organic anions (thiocyanate, lactate, acetate, and citrate).

RESULTS

The calcium concentration was significantly higher in sialolithiasis patients than in controls (P<0.05). In contrast, the levels of magnesium and citrate in the saliva of sialolithiasis patients were significantly reduced compared to the values obtained in controls (P<0.05). No significant differences were detected among other ions.

CONCLUSIONS

Our findings indicate that saliva electrolyte composition of sialolithiasis patients is substantially altered with respect to crystallisation mechanisms. Increased calcium ion as a crystallisation substance and decreased magnesium and citrate ions as crystallisation inhibitors may be involved in the etiopathology of calculi formation.