Childhood dental caries are influenced by a variety of factors, including diet, oral hygiene habits, socioeconomic conditions, and environmental exposures. Among these, maternal smoking has been identified as a particularly strong contributor compared to paternal or other household smoking. This study investigated how exposure to environmental tobacco smoke (ETS) relates to the occurrence of dental caries in children aged 5–10 years attending both private and public schools. A cross-sectional study was carried out involving schoolchildren, with data collected from caregivers through a structured questionnaire addressing five domains of ETS exposure: during pregnancy, early life, around schools, in eateries/roadside locations, and at public transport areas. Dental caries were diagnosed according to WHO 1997 criteria. Associations between ETS exposure and caries were quantified using prevalence ratios (PRs) and 95% confidence intervals (CIs). Among 211 participants (60.2% in private schools, 39.8% in government schools), nearly half (49.3%; 95% CI: 42.5–56.1%) had dental caries. Exposure to ETS emerged as a significant risk factor for developing caries. While variations in maternal education and high sugar intake influenced the adjusted prevalence ratio (APR), these differences were not statistically significant. Dental caries affected a moderate proportion of children, consistent with national estimates. Prenatal ETS exposure was associated with a 41% higher risk of caries after accounting for other factors, highlighting the importance of raising awareness among parents about the harmful impact of tobacco smoke on children’s oral health.
