Adverse childhood experiences (ACEs) are associated with poor health at all ages. Several mechanisms linking adversities to poor health outcomes later in life have been proposed, including the adoption of health risk behaviours, a leading cause of morbidity. This link is yet to be fully understood in the context of oral health.
By including adolescents’ self-reports on ACEs from the The Young-HUNT4 Survey, and merging these data with clinical measures of caries from the Public Dental Health Service, we were able to investigate the associations for these 8 specific and cumulative ACEs:
The adverse experiences of parental separation and parental alcohol problems were both associated with increased dentine caries experience when compared with no exposure to the specific ACE.
Several specific ACEs were associated with non-daily toothbrushing and a higher mean number of teeth with caries experience. Further, we found dose-response relationships of increasing numbers of adversities with higher caries experience and with infrequent toothbrushing.
ACEs may have lasting effects on oral health and oral health behaviours.
As ACEs pose a major risk for developing illness in adulthood through the adoption of health risk behaviours, identifying adolescents at risk in the dental setting is important for preventing an unfortunate oral health trajectory.
A history adverse childhood experiences is associated with a higher likelihood of learning difficulties; dental
health professionals should recognize that these adolescents may require individualized education and support on oral hygiene practises.
Experiencing adversities may also manifest in a lack of trust. In a patient-dentist relationship, it is therefore important to be aware that addressing poor oral hygiene habits in vulnerable adolescents requires an empathic approach. A safe and non-judgmental environment can be crucial for receiving care.