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Association between exposure to secondhand smoke and sleep bruxism in children: a randomised control study
  1. Luisa Montaldo1,
  2. Paolo Montaldo2,
  3. Elisabetta Caredda2,
  4. Anna D'Arco3
  1. 1Department of Dentistry, Second University of Naples, Naples, Italy
  2. 2Department of Paediatrics, Second University of Naples, Naples, Italy
  3. 3Department of Dentistry, University of Naples “Federico II”, Naples, Italy
  1. Correspondence to Dr Luisa Montaldo, Department of Dentistry, Second University of Naples, Via L. De Crecchio 4, Naples 80131, Italy; lmontaldo{at}


Background Exposure to secondhand smoke (SHS) is a serious public health threat and represents a preventable cause of morbidity among children. Sleep bruxism is characterised by teeth grinding or clenching movements during sleep and may begin in adulthood as well as in childhood.

Objectives To investigate the association between SHS exposure and sleep bruxism in children.

Methods Sleep bruxism was investigated in 498 children (mean age: 9.2±1.9). Family members were interviewed and asked whether they smoked in the presence of their children. Children were classified according to their exposure to SHS into heavily, moderately, lightly and occasionally exposed. Children with sleep bruxism and exposed to SHS were randomly divided into two groups: children in group 1 were not exposed to SHS for 6 months, whereas children in group 2 were.

Results Thirty-one per cent of the children under investigation suffered from bruxism. Among them, 116 children (76%) were exposed to SHS. Exposed children showed a higher risk of sleep bruxism (p<0.05). After 6 months, sleep bruxism was found in 38% and in 90% of children, in the first and in the second group, respectively, this difference was statistically significant (p<0.05). In group 1, changes were statistically significant in those who were heavily and moderately exposed (p<0.05) but not in those lightly and occasionally exposed (p>0.05). In group 2, changes were not statistically significant (p>0.05).

Conclusion The findings showed that high and moderate exposure to SHS is associated with sleep bruxism in children.

  • Environment
  • secondhand smoke
  • smoking-caused diseases
  • prevention
  • primary healthcare

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  • See Editorial, P 383

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Second University of Naples.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The proposed research includes data from 498 children and their families recruited from a school project related to the risks of secondhand smoke exposure. Two elementary schools in Naples, Italy, were considered. Most data were published. However, because of the relatively restricted area from which we recruited the children and because of their age, although further data will be stripped of identifiers prior to release for sharing, we believe that there remains the possibility of deductive disclosure of subjects. We think that it is important to protect minors' privacy; therefore, we will make the data and associated documentation available upon request only under a data-sharing agreement that provides for (1) a commitment to using the data only for research purposes and not to identify any individual participant; (2) a commitment to securing the data using appropriate computer technology and (3) a commitment to destroying or returning the data after analyses are completed.

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