Sains Malaysiana 43(11)(2014):
1729–1735
Is
Household Smoking a Risk Factor for Caries? A Case-Control Study
(Adakah Asap Rokok di Rumah Faktor Risiko untuk Karies? Suatu
Kajian Kes
A.M. ZURINA1, M.
ASMA'4*,
R.J.
RAJA
LATIFAH2
& Y.
NORIAH3
1Ministry
of Health, Blok E1, E3, E6, E7 & E10, Kompleks E, Pusat Pentadbiran
Kerajaan Persekutuan, 62590 Putrajaya, Malaysia
2International
Islamic University Malaysia, Jalan Sungai Pusu, 53100 Gombak, Selangor,
Malaysia
3Faculty
of Dentistry, Universiti Kebangsaan Malaysia (Kampus KL), Jalan Raja Muda Abd.
Aziz
50300
Kuala Lumpur, Malaysia
4Department
of Community Oral Health and Clinical Prevention, Faculty of Dentistry,
University
of Malaya, 50603 Kuala Lumpur, Malaysia
Diserahkan:
20 September 2013/Diterima: 7 April 2014
ABSTRACT
Recent studies suggested that exposure to household smoking (HHS)
could be a modifiable risk factor for caries development among children.
Majority of the studies were cross sectional in nature. Therefore, a
case-control study was designed to test the hypothesis that HHS is a risk factor to
caries experience in permanent teeth. Calculation of sample size was based on
the ratio of 1 case to 4 controls. Case was defined as a child aged 13-14 years
old with caries in at least one second permanent molar and control was defined
as a child from the same age and school with no caries second permanent molars.
Matching was done for gender and ethnicity. School dental records provided
information on oral health status and oral hygiene status. Information on HHS,
socio-economic status, child’s smoking status and child’s oral health practices
were obtained from a self- administered questionnaire, completed by the
children and their parents. The result showed that 55.9% of the case group was
exposed to HHS,
as compared to 44.1% among the control group. In the final multiple logistic regression
model after controlling for important risk factors for caries, children with
caries were almost twice as likely to have been exposed to HHS for more than 10
years as compared to children with no caries, (Adjusted OR=1.90 and 95% CI=1.35,
2.60). In addition, children who only received dental care from the school
dental service had reduced risk of having dental caries by more than one third
(36%) as compared with those who received dental care from school dental
service (SDS)
as well as had additional dental problem solving visit outside SDS (Adjusted OR=0.64
and 95% CI=0.50,
0.90). It is concluded that exposure to HHS for a long duration (> than 10 years)
increase the risk to have caries experience in permanent teeth of children.
Keywords: Children; dental caries; household smoking; risk factor
ABSTRAK
Kajian terkini menunjukkan bahawa pendedahan kepada asap rokok di
rumah (HHS)
boleh menjadi faktor risiko yang boleh diubah untuk pembentukan karies dalam
kalangan kanak-kanak. Kebanyakan kajian adalah kajian keratan rentas. Oleh itu,
satu kajian kes-kawalan telah dirancang untuk menguji hipotesis bahawa HHS adalah
faktor risiko kepada karies pada gigi kekal. Pengiraan saiz sampel adalah
berdasarkan kepada nisbah satu kes kepada empat kawalan. Kes ditakrifkan
sebagai seorang kanak-kanak berumur 13-14 tahun dengan kerosakan gigi di
sekurang-kurangnya satu gigi geraham kekal kedua dan kawalan pula ditakrifkan
sebagai kanak-kanak yang sama umur (dan dari sekolah yang sama) tanpa karies
gigi geraham kekal kedua. Padanan telah dilakukan untuk jantina dan keturunan.
Maklumat mengenai status kesihatan mulut dan status kebersihan mulut diambil
daripada rekod pergigian sekolah. Maklumat HHS, status
sosio-ekonomi, status merokok kanak-kanak dan amalan kesihatan mulut
kanak-kanak diperoleh menggunakan borang soal selidik yang diisi oleh anak-anak
dan ibu bapa mereka. Hasilnya menunjukkan bahawa 55.9% daripada kes terdedah
kepada HHS,
berbanding dengan 44.1% dalam kalangan kumpulan kawalan. Dalam model regresi
logistik berganda akhir selepas mengawal faktor-faktor risiko yang penting
untuk karies, kanak-kanak dalam kumpulan kes hampir dua kali ganda
berkemungkinan telah terdedah kepada HHS selama lebih daripada 10 tahun berbanding
dengan kanak-kanak tanpa karies, (Adjusted OR=1.90 dan 95% CI=1.35,
2.60). Di samping itu, kanak-kanak yang hanya menerima rawatan pergigian daripada
perkhidmatan pergigian sekolah mengurangkan risiko mempunyai karies gigi lebih
daripada satu pertiga (36%) berbanding dengan mereka yang menerima rawatan
pergigian daripada perkhidmatan pergigian sekolah (SDS) dan rawatan tambahan
diluar SDS untuk menyelesaikan masalah pergigian (Adjusted OR=0.64 dan 95% CI=0.50,
0.90). Kesimpulannya, pendedahan kepada HHS untuk tempoh yang panjang (> 10 tahun)
meningkatkan risiko untuk mendapat karies gigi kekal dalam kalangan
kanak-kanak.
Kata kunci: Asap rokok di rumah; faktor risiko;
kanak-kanak; karies gigi
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*Pengarang
untuk surat-menyurat; email: asmar@um.edu.my
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