Dental health effects adverse childhood experiences on U.S. adults: BRFSS 2010-2012
Embargo Date
2020-06-12
OA Version
Citation
Abstract
OBJECTIVE: To examine association between Adverse Childhood Experiences (ACE) and
teeth extracted due to dental caries or periodontitis among young and middle-aged US
adults.
METHODS: Study sample included 15,474 and 17,430 respondents aged 18-64 completing
2010 and 2012 Behavioral Risk Factor Surveillance System (BRFSS) survey
respectively. Outcome was any self-reported tooth extraction due to caries or
periodontitis. Primary predictor were self-reported 11 ACE answers (categorized into
none, 1, 2, and 3+) before 18 years of age. Covariates included smoking, heavy alcohol
consumption, diabetes, health coverage and access to dental care. Odds ratios were
computed from unadjusted and adjusted logistic regression models.
RESULTS: Overall ACE prevalence was 66.5% and 64.9% in BRFSS 2010 and 2012 study
sample respectively. In unadjusted models we observed a graded association wherein
adults reporting experienced 2 and 3+ ACE were more likely to experience tooth
extractions compared to those reporting no ACE exposure. (BRFSS 2010 OR =
1.47,1.48; BRFSS 2012 OR = 1.33, 1.54 respectively; p<0.05). We found similar results
in multivariate models after adjusting for covariates (BRFSS 2010 OR = 1.56,1.34;
BRFSS 2012 OR = 1.36, 1.42 respectively; p<0.05).
CONCLUSIONS: This study suggests potential long lasting impact of early adverse life
events on oral health in young and middle adulthood. Young and middle-aged adults
experiencing multiple ACE had significantly more extractions compared to adults who
reported not experiencing any ACE. Multidisciplinary efforts between dentists,
physicians and social therapists are needed to raise awareness about ACE as means of
identifying and reducing dental health inequities.