Impact of Adverse Childhood Experiences on Oral Health Among Women in the United States: Findings From the Behavioral Risk Factor Surveillance System

Abstract

It is well established that adverse childhood experiences (ACEs) negatively impact physical and mental health. There is a paucity of research examining the impact of ACEs on oral health. Therefore, the aim of this study was to better understand how ACEs may impact oral health utilizing a nationally representative sample of females. Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were utilized. The sample comprised 36,249 females. Chi-square tests were used to examine associations between multiple forms of ACEs and oral health, mental health, smoking, and health-related quality of life. Logistic regression models were generated for the outcomes of interest: last dental cleaning, significant tooth loss, smoking, and health-related quality of life. Post-hoc analyses were conducted to examine whether smoking and dental cleaning moderated the relationship between ACEs and significant tooth loss. All ACE categories were significantly associated with poor health-related quality of life, being a current or former smoker, last dental cleaning >1 year, and significant tooth loss even after adjusting for demographic variables. Last dental cleaning and being a current or former smoker moderated the relationship between ACEs and significant tooth loss. This study affirms other findings that women with a history of ACEs were more likely to engage in health-risk behaviors, specifically cigarette smoking, which has been strongly associated with ACEs. These findings underscore the importance of including oral health in future studies given it has implications for disease development. Furthermore, dental visits may provide a window of opportunity for trauma-informed care.