Trajectories and clustering of adverse childhood experiences and caries treatment experience among British young adults

Abstract

Objectives: To examine the associations of the trajectory (changes over time) and clustering (co-occurrence) of exposure to adverse childhood experiences (ACEs) with caries treatment experience among British young adults. Methods: Data from 4244 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. Eight ACEs were assessed via questionnaires completed by mothers and their partners at nine time points from birth to age 17 years. Mixture modelling was used to identify distinctive trajectories and clusters of exposure to ACEs. Caries treatment experience was indicated by the number of missing and filled teeth (MFT score), which was determined via participant-reported questionnaires at age 17 and 23 years. Mixed-effects Poisson regression was used to test the associations of ACE trajectories and clustering with the MFT score adjusting for covariates. Results: Four ACE trajectories were identified. Participants in the always-high trajectory had higher MFT score than those in the always-low trajectory (Rate ratio: 1.22, 95%CI: 1.07-1.38). No differences were found between participants in the increasing and decreasing trajectories and those in the always-low trajectory. Three clusters of ACEs were identified: unexposed, simultaneous experience of parental mental illness and parental separation and simultaneous experience of physical abuse, emotional abuse and parental mental illness. No differences in MFT score were found between clusters after adjustment for covariates. Conclusion: This longitudinal study showed that a trajectory of high exposure to ACEs was associated with greater caries treatment experience in young adulthood. Clustering of ACEs was not associated with caries treatment experience.