The effects of maternal environmental tobacco smoke exposure on periodontal health and mother-infant bonding in relation to salivary cotinine level
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Abstract
Background: Environmental tobacco smoking is produced by active smokers burning the tip of a cigarette and breathed by nonsmokers and measured by cotinine level. It has the potential to raise the risk of periodontal disease. One of the most frequent chronic diseases in adults is periodontal disease. The lower maternal-fetal attachment has been found to predict smoking status in previous studies, but no research has examined whether maternal-fetal attachment predicts environmental tobacco smoking. This study assessed the effects of maternal environmental tobacco smoke exposure on periodontal health and mother-infant bonding concerning salivary cotinine levels. Materials and methods: This is a comparative cross-sectional study comparing environmental tobacco smoke on exposed and non-exposed mothers aged between 20-35 years with their infants aged up to one year who attended primary health care centers in rural areas of AL-Karkh sector/Baghdad. Along with the essential socio-demographic data, a secondhand smoke exposure scale and postpartum bonding questionnaire were employed. Collection of unstimulated saliva from mothers was done according to Navazesh and Kumer in 2008. After that, the clinical Assessment of gingival bleeding and periodontal pockets was performed by using Community Periodontal Index according to the world health organization in 1997. Results: Out of 150 subjects,67(44.66%) were exposed to environmental tobacco whereas the non-exposed mothers were composed of 83 (55.33%). The highest mean number of CPI0(healthy gingiva) and CPI1(gingival bleeding) were among the non-exposed mothers while the highest mean number of CPI2(dental calculus), CPI3 (shallow pocket 4-5mm) and CPI4(deep pocket 6mm or more) were among the exposed mothers. The mean value of cotinine level among the non-exposed mothers was lower than exposed mothers with significant results. A higher salivary cotinine level was linked to a lower maternal-fetal bonding score. Conclusions: Mother’s exposure to environmental tobacco smoke significantly negatively impacts periodontal disease. Furthermore, mothers who have a stronger sense of attachment and affiliation to their fetus have lower salivary cotinine concentrations than mothers who have a less sense of fetal attachment.
Received date: 08-05-2022
Accepted date: 10-06-2022
Published date: 15-06-2023
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References
Leone A, Landini L , Leone A. What is tobacco smoke? Sociocultural dimensions of the association with cardiovascular risk. Curr Pharm Des. 2010;16:2510-2517.
Cuthbertson L, Britton J. Passive smoking and children's health. Clin Med (Lond). 2010;10:113-114.
Lung Z, Kelleher M, Porter R, Gonzalez J, Lung R. Poor patient awareness of the relationship between smoking and periodontal diseases. Br Dent J. 2005;199:731-725.
Rheu G-B, Ji S, Ryu J-J, Lee J-B, Shin C, Lee JY, et al. Risk assessment for clinical attachment loss of periodontal tissue in Korean adults. J Adv Prosthodont. 2011;3:25-32.
Javed F, Samaranayake LP, Al-Askar M, Al-Hezaimi K. Periodontal disease in habitual cigarette smokers and nonsmokers with and without prediabetes. Am J Med Sci. 2013;345:94-98.
Nanakaly HT, Ismail AE, Othmn DA. Influence of smoking on salivary interleukin-8 levels in chronic periodontitis. J Bagh Coll Dent. 2020;32:28-34.
Mohammed AY, Hoobi NM. Dental Caries Experience and Salivary Total Protein among 5 Years Passive Smokers in Tikrit City, Iraq. Indian j. public health. 2019;10:1773-1777.
Ueno M, Ohara S, Sawada N, Inoue M, Tsugane S, Kawaguchi Y. The association of active and secondhand smoking with oral health in adults: Tob Induc Dis. 2015;13:19.
Sanders AE, Slade GD, Beck JD, Ágústsdóttir H. Secondhand smoke and periodontal disease: atherosclerosis risk in communities study. Am J Public Health. 2011;101:S339-S346.
SRNT Subcommittee on Biochemical Verification. Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002;4:149-159.
Kim S. Overview of cotinine cutoff values for smoking status classification. Int J Environ Res Public Health. 2016;13:1236.
Sohanian S, Ghorbani R, Mirmohammadkhani O, Delavari H. Association of Passive Smoking with Dental Caries and Cotinine Biomarker among 8 to 12-Year-Old Children. Int. J. Pediatr. 2021;9:14680-8.
Ramdzan AN, Almeida MIG, McCullough MJ, Segundo MA, Kolev SD. Determination of salivary cotinine as tobacco smoking biomarker. Trends Analyt Chem. 2018;105:89-97.
Binnie V, McHugh S, Macpherson L, Borland B, Moir K, Malik K. The validation of self‐reported smoking status by analysing cotinine levels in stimulated and unstimulated saliva, serum and urine. Oral Dis. 2004;10:287-293.
Yamamoto Y, Nishida N, Tanaka M, Hayashi N, Matsuse R, Nakayama K, et al. Association between passive and active smoking evaluated by salivary cotinine and periodontitis. J Clin Periodontol. 2005;32:1041-1046.
Kim YJ, Kim YK, Kho HS. Effects of smoking on trace metal levels in saliva. Oral Dis. 2010;16:823-830.
Hrubý R, Hašto J, Minárik P. Attachment in integrative neuroscientific perspective. Neuro Endocrinol Lett. 2011;32:111-120.
Magee SR, Bublitz MH, Orazine C, Brush B, Salisbury A, Niaura R, et al. The relationship between maternal–fetal attachment and cigarette smoking over pregnancy. Matern Child Health J. 2014;18:1017-1022.
Patra P. Sample size in clinical research, the number we need. Int J Med Sci Public Health. 2012;1:5-9.
Cohen J, Statistical power analysis for the behavioral sciences, 2nd Edition, New York, 1989.
Vardavas C, Agaku I, Filippidis F, Kousoulis AA, Girvalaki C, Symvoulakis E, et al. The Secondhand Smoke Exposure Scale (SHSES): A hair nicotine validated tool for assessing exposure to secondhand smoke among elderly adults in primary care. Tob Prev Cessat. 2017;3:9.
Brockington IF, Oates J, George S, Turner D, Vostanis P, Sullivan M, et al. A screening questionnaire for mother-infant bonding dis-orders. Arch of Womens Ment Health. 2001;3:133-40.
Issa RN, Diab BS. The Impact of Mother-Infant Bonding on Periodontal Health Status in the Postpartum Period. J Bagh Coll Dent. 2018; 30:76-9.
Navazesh M, Kumar S. University of Southern California School of Dentistry. Measuring salivary flow: challenges and oppor-tunities. J Am Dent Assoc. 2008;139:35S-40.
Organization WH, Oral health survey-basic method, 4th edition, Geneva, 1997.
Saleh MA, Hamza RA, El-Asheer OM, El Shehaby DM, Ibrahim AK. Cotinine level as a biochemical indicator of toxic effects of passive smoking exposure on infant’s anthropometric measures. Egypt. J. Forensic Appl Toxicol. 2021;21:55-68.
Hawthorne SB, Azzolina N, Finn JT. Tracing contributions of benzene from outdoor to indoor air. Environ Forensics. 2008;9:96-106.
Gautam D, Jindal V, Gupta S, Tuli A, Kotwal B, Thakur R. Effect of cigarette smoking on the periodontal health status: A com-parative, cross sectional study. J Indian Soc Periodontol. 2011;15:383-387.
Tjahajawati S, Rafisa A, Lestari EA. The Effect of Smoking on Salivary Calcium Levels, Calcium Intake, and Bleeding on Probing in Female. Int J Dent. 2021;2021:7.
Palmer R, Scott D, Meekin T, Poston R, Odell E, Wilson R. Potential mechanisms of susceptibility to periodontitis in tobacco smokers. J Periodontal Res. 1999;3:363-369.
Hutcherson JA, Scott DA, Bagaitkar J. Scratching the surface–tobacco-induced bacterial biofilms. Tob Induc Dis. 2015;13:1-6.
Nishida N, Yamamoto Y, Tanaka M, Kataoka K, Kuboniwa M, Nakayama K, et al. Association between involuntary smoking and salivary markers related to periodontitis: a 2‐year longitudinal study. J Periodontol. 2008;79:2233-40.
Sayers NM, James JA, Drucker DB, Blinkhorn AS. Possible potentiation of toxins from Prevotella intermedia, Prevotella ni-grescens, and Porphyromonas gingivalis by cotinine. J Periodontol.. 1999;70:1269-75.
Chatrchaiwiwatana S, Ratanasiri A. Association between exhaled carbon monoxide and oral health status in active and passive smokers. J Med Assoc Thai. 2011;94:601-609.
Tanaka K, Miyake Y, Hanioka T, Arakawa M. Active and passive smoking and prevalence of periodontal disease in young Japanese women. J Periodontal Res. 2013;48:600-605.
Hassanzad M, Khalilzadeh S, Nobari SE, Bloursaz M, Sharifi H, Mohajerani SA, et al. Cotinine level is associated with asthma severity in passive smoker children. Iran J Allergy Asthma Immunol. 2015;14:67-73.
Castelino RL, Babu SG, Kumari S, Madi M, Bhat S, Ullal H. Salivary Cotinine Levels as a Biomarker of Tobacco Use-A Bio-chemical Study. J. Krishna Inst. Med. Sci. Univ. 2017;6:96-104 .
Menon I, Bhat N. Association of passive smoking with dental caries and salivary biomarkers among 5–10 years old children of Muradnagar, Ghaziabad. J Family Med Prim Care. 2019;8:2633-2639.
Brockington IF, Fraser C, Wilson D. The postpartum bonding questionnaire: a validation. Arch Womens Ment Health. 2006;9:233-242.
Mineur YS, Picciotto MR. Nicotine receptors and depression: revisiting and revising the cholinergic hypothesis. Trends Pharmacol Sci. 2010;31:580-586.
Philip NS, Carpenter LL, Tyrka AR, Price LH. Nicotinic acetylcholine receptors and depression: a review of the preclinical and clinical literature. Psychopharmacology (Berl). 2010;212:1-12.
Radoš SN, Matijaš M, Anđelinović M, Čartolovni A, Ayers S. The role of posttraumatic stress and depression symptoms in mother-infant bonding. J Affect Disord. 2020;268:134-140.
Chen H-L, Cai J-Y, Zha M-L, Shen W-Q. Prenatal smoking and postpartum depression: a meta-analysis. J Psychosom Obstet Gy-naecol. 2019;40:97-105.
Munafò MR, Heron J, Araya R. Smoking patterns during pregnancy and postnatal period and depressive symptoms. Nicotine Tob Res. 2008;10:1609-1620.
Stock SJ, Bauld L. Maternal smoking and preterm birth: An unresolved health challenge. PLoS Med. 2020;17:e1003386.
Fegran L, Helseth S, Fagermoen MS. A comparison of mothers’ and fathers’ experiences of the attachment process in a neonatal intensive care unit. J Clin Nurs. 2008;17:810-816.
Kim P, Feldman R, Mayes LC, Eicher V, Thompson N, Leckman JF, et al. Breastfeeding, brain activation to own infant cry, and maternal sensitivity. J Child Psychol Psychiatry. 2011;52:907-915.
Leung GM, Lam TH, Ho LM. Breast-feeding and its relation to smoking and mode of delivery. Obstet Gynecol. 2002; 99:785-94.