Exposure to Adverse Childhood Experiences and Oral Health Measures in Adulthood: Findings from the 2010 Behavioral Risk Factor Surveillance System

Abstract

Introduction: Adverse childhood experiences (ACEs) are negative life events occurring before the age of 18 y. ACEs are risk factors for heart disease and diabetes in adult life. Furthermore, individuals who experience ACEs are more likely to smoke and become obese-factors associated with poor oral health. Objective: This study investigated likely associations between ACEs and the oral health measures of the 2010 Behavioral Risk Factor Surveillance System (BRFSS). Methods: Data from 16,354 participants of the 2010 BRFSS were analyzed with SAS 9.4. ACE scores were calculated in 2 domains: abuse (emotional, physical, or sexual) and household challenges (parental separation or divorce, intimate partner violence, household substance abuse, household mental illness, and incarceration). ACE scores, ranging from 0 to 8, were categorized into 0, 1, 2, 3, and ≥4. The 2010 BRFSS oral health measures included >1 y since last dental visit, ≥6 teeth extracted, and ≥2 y since last dental cleaning. Survey logistic regression estimated prevalence odds ratios and 95% CIs, adjusted for age, sex, race/ethnicity, and educational attainment. Results: The weighted mean ACE score was 1.74 (95% CI = 1.68 to 1.81), and the weighted and agestandardized percentages of study participants with ACE scores of 0, 1, 2, 3, and ≥4 were 33.1%, 24.3%, 14.9%, 9.69%, and 18.1%, respectively. There appeared to be a dose-response association between categories of ACE scores and the oral health measures.

Dental care of patients exposed to sexual abuse: Need for alliance between staff and patients

“…The negative consequences for both psychic and somatic wellbeing are welldocumented [3][4][5][6]. With reference to dental care, Akinkugbe et al [7] reported that a history of childhood sexual abuse was associated with postponement of appointments, extraction of ≥6 teeth, and a reported time lapse of at least two years since the last dental visit. Moreover, extreme dental fear is reported to be more common among survivors of sexual abuse than in non-abused individuals [8,9].…”

Architecture-Promoted Biomechanical Performance-Tuning of Tissue-Engineered Constructs for Biological Intervertebral Disc Replacement

“…Having shown that the effects of architectural design were more pronounced than the effects of the choice of materials, the next question was whether a confining outer ring is necessary for a potential final design. In the human body, the compressive forces exerted on the IVD are converted into tensile stress on the collagen fibers in the AF through the swelling of the NP [2,57,64]. Here, the compressive load was exerted on circular lamellar constructs consisting of softer and stiffer rings.…”

“…The mechanical properties of the architecture rings could be further improved by reinforcing the stiffer rings through fiber re-enforcement [57,64,65] and mimicking a multiply architecture as seen in the native AF [5]. Focusing on incorporating fibers into a given AF design is promising because several studies demonstrated that the mechanical properties are highly dependent on AF fiber orientation [36,56,66,67].…”

Adaptation measures in dental care for children with history of Adverse Childhood Experiences: A practical proposal

“…Child maltreatment is an act of physical, sexual, psychological, and/or emotional violence that occurs during the developmental stage of pediatric individuals. It constitutes a form of Adverse Childhood Experience (ACE) 1,2 . It may include the neglect of infants, children, and adolescents by parents or caregivers and may involve other authority figures (Table 1).…”

“…However, in environments where neglect or abuse exists, such a fundamental relationship is seldom established, thus putting the child at risk. Thus, it has been commonly reported that the oral health status in victims of child abuse presents a higher incidence of decayed and missing primary teeth, and more filled permanent teeth 2 …”