Association between adverse childhood experiences, bullying, self-esteem, resilience, social support, caries and oral hygiene in children and adolescents in sub-urban Nigeria

Abstract

Background: Adverse childhood experiences (ACE) and bullying have negative effects on oral health. Promotive assets (resilience, self-esteem) and resources (perceived social support) can ameliorate their negative impact. The aim of this study was to determine the association between oral diseases (caries, caries complications and poor oral hygiene), ACE and bully victimization and the effect of access to promotive assets and resources on oral diseases. Methods: This was a secondary analysis of data collected through a cross-sectional school survey of children 6-16years-old in Ile-Ife, Nigeria from October to December 2019. The outcome variables were caries, measured with the dmft/DMFT index; caries complications measured with the pufa/PUFA index; and poor oral hygiene measured with the oral hygiene index-simplified. The explanatory variables were ACE, bully victimization, resilience, self-esteem, and social support. Confounders were age, sex, and socioeconomic status. Association between the explanatory and outcome variables was determined with logistic regression. Results: Of the 1001 pupils with complete data, 81 (8.1%) had poor oral hygiene, 59 (5.9%) had caries and 6 (10.2%) of those with caries had complications. Also, 679 (67.8%) pupils had one or more ACE and 619 (62.1%) pupils had been bullied one or more times. The median (interquartile range [IQR]) for ACE was 1(3), for bully victimization was 1(5), and for self-esteem and social support scores were 22(5) and 64(34) respectively. The mean (standard deviation) score for resilience was 31(9). The two factors that were significantly associated with the presence of caries were self-esteem (AOR: 0.91; 95% CI: 0.85-0.98; p = 0.02) and social support (AOR: 0.98; 95% CI: 0.97-1,00; p = 0.02). No psychosocial factor was significantly associated with caries complications. Self-esteem was associated with poor oral hygiene (AOR: 1.09; 95% CI: 1.09-1.17; p = 0.03).

Association of Adverse Childhood Experiences with Oral Health Status of children living in Rural Areas of Alexandria, Egypt: A household Survey

“…It also showed no signi cant association with DMFT score and gingival score. These ndings are consistent with Folayan et al (11) who clinically examined Nigerian children, in schools, from ages 6-16, and revealed that less than 4% of the sample developed caries and had dental complications. Furthermore, this was the only study with similar sample selection and examination methodology that showed no association between tooth decay and ACE which; supports the current ndings.…”

“…These ndings suggest that ACEs may act as a risk indicator for dental caries and periodontal disease (9,10). However, among 6 to 16 years old Nigerian pupils, there was no association between dental caries, poor oral hygiene, oral disease complications and ACE (11). Nevertheless, little to scarce research assessed the link between ACE and oral health status of Egyptian children whose level of oral diseases and ACE may be different from western countries and who have high level of caries.…”

Individual and familial factors associated with caries and gingivitis among adolescents resident in a semi-urban community in South-Western Nigeria

“…The available evidence on caries in Nigeria indicates that the prevalence in adolescents 10–16 years old varies by settlement type. Caries prevalence ranges from 5.9% in sub-urban Nigeria [ 20 ], to 12.2% in a rural population [ 21 ] and from 11.2% to 15.5% in urban populations [ 21 – 23 ]. Gingivitis however appears far more prevalent, with 95% of 11–16-year-old students in an urban secondary school showing evidence of periodontitis [ 24 ].…”

“…Although there is some oral health data in Nigeria that may include the 10–19-year adolescent demographic, these data are often generated to reflect children under 10 or under 15 years of age. Some data are available on the epidemiology of caries in the 10–16-year age group [ 20 – 23 , 41 – 43 ]; however, there is no data on caries and periodontal diseases in older adolescents 17–19-year-old, and limited data on periodontal diseases among 10–16-year-olds [ 24 ].…”

Understanding Children’s Attention to Dental Caries through Eye-Tracking

“…Furthermore, the consequences of bullying can range from physiological to psychological, and victims are considered anxious, insecure, sensitive, withdrawn, and with low self-esteem as adolescents [Barasuol et al, 2017]. Conversely, good oral health can facilitate healthy smiles and less bully victimization [Folayan et al, 2020]. Although this statement sounds logical, there is no scientific evidence to support this notion.…”