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Impact of Passive Smoking on Vital Signs, Motor Activity, and Agitation in Children Undergoing Dental Extractions

Elif Buse Kaplan1, Aysun Avşar1

  • 1Department of Pediatric Dentistry, Faculty of Dentistry, Ondokuz Mayıs University, 55280 Samsun, Türkiye.

Healthcare (Basel, Switzerland)
|June 12, 2026
PubMed

Insights

Passive smoking exposure in children undergoing dental sedation negatively impacts oxygen saturation, prolongs recovery, and increases agitation and delirium. Preoperative assessment should include environmental tobacco smoke exposure. Keywords: passive smoking, dental sedation, pediatric recovery, emergence delirium.

Area of Science:

  • Pediatric Anesthesiology
  • Environmental Health
  • Dental Public Health

Background:

  • Passive smoking (PS) is linked to systemic and oral health issues in children.
  • Its impact on perioperative stability during pediatric dental sedation is not well understood.

Purpose of the Study:

  • To investigate the association between passive smoking exposure and perioperative physiological stability, recovery, and emergence behavior in children undergoing dental sedation.

Main Methods:

  • Prospective cohort study of 100 children (4-6 years) undergoing dental extraction under sedation.
  • Stratified groups based on passive smoking exposure levels.
  • Monitored vital signs (HR, BP, SpO2) and assessed recovery using MASS, RASS, and PAED scales.

Main Results:

  • Passive smoking exposure correlated with significantly lower SpO2 levels (p < 0.001).
  • Prolonged recovery time (p = 0.002) and increased agitation/emergence delirium (higher RASS and PAED scores, p < 0.001) were observed in exposed children.
  • No significant differences in cardiovascular parameters were noted.

Conclusions:

  • Passive smoking adversely affects perioperative oxygenation and recovery in children undergoing dental sedation.
  • It exacerbates emergence neurobehavioral disturbances, including agitation and delirium.
  • Environmental tobacco exposure should be part of preoperative risk assessments.
Abstract

Keywords:
dental sedationemergence deliriumoxygen saturationpassive smokingpediatric dentistryperioperative monitoringrecovery time

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