The mouth and maltreatment: safeguarding issues in child dental health

Harris, Jenny

doi:10.1136/archdischild-2017-313173

Cited by 16 publications

(18 citation statements)

References 60 publications

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“…Dental caries is among the most common preventable diseases in children, yet surgery for advanced dental caries remains the most frequent hospital procedure performed in preschool children (Rowan-Legg 2013). Maternal substance use may be an important risk factor for advanced childhood caries, as substance use has been linked with dental neglect (Harris 2018). However, studies of the association of maternal substance use with the risk of dental caries in children are scant.…”

Section: Introductionmentioning

confidence: 99%

Prenatal Substance Use Disorders and Dental Caries in Children

et al. 2020

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Substance use is common in women of reproductive age, but limited data exist on the dental health of their children, including risk of caries. We conducted a longitudinal cohort study of 790,758 infants born between 2006 and 2016 in Quebec, Canada. We identified women with substance use disorders before or during pregnancy. The main outcome measure was hospitalization for dental caries in offspring up to 12 y after birth. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for the association of maternal substance use with pediatric dental caries, adjusted for potential confounders. Children exposed to maternal substance use had a higher incidence of hospitalization for dental caries than unexposed children (105.2 vs. 27.0 per 10,000 person-years). Maternal substance use was associated with 1.96 times the risk of childhood dental caries (95% CI, 1.80–2.14), including a greater risk of caries of enamel, dentin, or cementum (HR, 2.00; 95% CI, 1.82–2.19) and dental pulp (HR, 2.36; 95% CI, 2.07–2.70), relative to no substance use. Associations were elevated for alcohol (HR, 2.31; 95% CI, 2.03–2.64) but were also present for cocaine, cannabis, opioids, and other substances. Substance use during pregnancy was more strongly associated with dental caries hospitalization than prepregnancy substance use. Associations were stronger in early childhood. Maternal substance use is associated with the future risk of dental caries hospitalization in children. Targeting substance use early in the lives of women may contribute to dental caries prevention in offspring.

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Section: Introductionmentioning

confidence: 99%

Prenatal Substance Use Disorders and Dental Caries in Children

et al. 2020

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“…The findings from this study are relevant to policy that aims to achieve better oral health for children. Oral health is an important part of a child's overall health status and a marker of wider health and social care issues [43,44]. Improving child dental health requires a lifelong and whole-systems approach, of which the prevention of ACEs is part of.…”

Section: Discussionmentioning

confidence: 99%

Understanding the association between self-reported poor oral health and exposure to adverse childhood experiences: a retrospective study

et al. 2020

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Background: Adverse childhood experiences, including physical, sexual or emotional abuse, can have detrimental impacts on child and adult health. However, little research has explored the impact that such early life experiences have on oral health. This study examines whether experiencing adverse childhood experiences before the age of 18 years is associated with self-reported poor dental health in later life. Methods: Using stratified random probability sampling, a household survey (N = 5307; age range 18-69 years) was conducted in the South of England (Hertfordshire, Luton and Northamptonshire). Data were collected at participants' homes using face-to-face interviews. Measures included exposure to nine adverse childhood experiences, and two dental outcomes: tooth loss (> 8 teeth lost due to dental caries or damage) and missing or filled teeth (direct or indirect restorations; > 12 missing or filled teeth). Results: Strong associations were found between exposure to childhood adversity and poor dental health. The prevalence of tooth loss was significantly higher (8.3%) in those with 4+ adverse childhood experiences compared to those who had experienced none (5.0%; p < 0.05). A similar relationship was found for levels of missing or filled teeth (13.4%, 4+ adverse childhood experiences; 8.1%, none; p < 0.001). Exposure to 4+ adverse childhood experiences was associated with a higher level of tooth loss and restorations at any age, compared to individuals who had not experienced adversity. Demographically adjusted means for tooth loss increased with adverse childhood experience count in all age groups, rising from 1.0% (18-29 years) and 13.0% (60-69 years) in those with none, to 3.0% and 26.0%, respectively in those reporting 4+. Conclusions: Exposure to childhood adversity could be an important predictive factor for poor dental health. As oral health is an important part of a child's overall health status, approaches that seek to improve dental health across the life-course should start with safe and nurturing childhoods free from abuse and neglect. Given the growing role that dental professionals have in identifying violence and abuse, it seems appropriate to raise awareness in the field of dentistry of the potential for individuals to have suffered adverse childhood experiences, and the mechanisms linking childhood adversity to poor dental health.

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“…Failure or delay in seeking dental care, including for dental caries, is a cause for concern, all the more so in the UK where child dental care is available free-of-charge on the NHS and cost is not a barrier to access. It is only more recently that missed appointments for dentistry have been considered from a safeguarding perspective (Harris 2018 ). This study highlights the impacts of dental caries which will be experienced by children who have a delay in receiving treatment under GA, either from not being brought to appointments, or where there is a lack of GA service provision resulting in long waiting times for treatment, or where GA services are reduced for other reasons, as has been the case during the recent COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

The impact of dental caries and its treatment under general anaesthetic on children and their families

Knapp

Marshman

Gilchrist

et al. 2020

Eur Arch Paediatr Dent

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Objective To assess the impact of dental caries and treatment under general anaesthetic (GA) on the everyday lives of children and their families, using child-reported measures of quality of life (QoL) and oral health-related quality of life (OHRQoL). Method Participants, aged 5–16 years old having treatment for dental caries under GA, were recruited from new patient clinics at Charles Clifford Dental Hospital, Sheffield. OHRQoL was measured before and 3-months after treatment using the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC). Overall QoL was measured using the Child Health Utility 9D (CHU9D). Parents/caregivers completed the Family Impact Scale (FIS). Results Eighty five parent–child dyads completed the study. There was statistically significant improvement in OHRQoL (mean interval score difference in CARIES-QC = 4.43, p < 0.001) and QoL (mean score difference in CHU9D = 2.48, p < 0.001) following treatment, with moderate to large effect sizes. There was statistically significant improvement in FIS scores (mean score difference = 5.48, p = 0.03). Conclusions Treatment under GA was associated with improvement in QoL and OHRQoL as reported by children, and reduced impacts on the family. This work highlights the importance of GA services in reducing the caries-related impacts experienced by children. Further work is needed investigate the impact of clinical, environmental and individual factors.

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The mouth and maltreatment: safeguarding issues in child dental health

Cited by 16 publications

References 60 publications

Prenatal Substance Use Disorders and Dental Caries in Children

Prenatal Substance Use Disorders and Dental Caries in Children

Understanding the association between self-reported poor oral health and exposure to adverse childhood experiences: a retrospective study

The impact of dental caries and its treatment under general anaesthetic on children and their families

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