There is emerging evidence that secondhand smoke exposure is associated with oral disease in non-smokers. A systematic review and meta-analysis of the association between secondhand smoke exposure and periodontitis in non-smokers found a moderate association between secondhand smoke exposure and objective clinical markers of periodontitis including tooth loss.1 This review included three studies that used cotinine levels as an indicator of secondhand smoke exposure and these studies demonstrated stronger associations between exposure and perionditis than studies that used self-reported measures of secondhand smoke exposure. Further research is needed to determine is this association is causal.
There is limited evidence that secondhand smoke exposure is associated with other changes in oral health including increasing gingival pigmentation2 and dental caries.3
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1. Akinkugbe AA, Slade GD, Divaris K, and Poole C. Systematic review and meta-analysis of the association between exposure to environmental tobacco smoke and periodontitis endpoints among nonsmokers. Nicotine and Tobacco Research, 2016; 18(11):2047–56. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27083214
2. Moravej-Salehi E, Moravej-Salehi E, and Hajifattahi F. Relationship of gingival pigmentation with passive smoking in women. Tanaffos, 2015; 14(2):107–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26528364
3. Avşar A, Darka O, Topaloğlu B, and Bek Y. Association of passive smoking with caries and related salivary biomarkers in young children. Archives of Oral Biology, 2008; 53(10):969–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18672230