BMC public health · 2025
Associations between childhood adversity and adult oral health-related quality of life, the HUNT4 Survey.
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Dahllöf Göran, Sørbø Marie Flem, Feuerherm Astrid Jullumstrø, Myran Lena, Havnen Audun, Willumsen Tiril, Kvist Therese, Rønneberg Anne, Sun Yi-Qian, Høvik Hedda
Аннотация
BACKGROUND: Adverse childhood experiences (ACEs) negatively impact health outcomes, including oral health. However, the relationship between ACEs and oral health-related quality of life (OHRQoL) has not been thoroughly explored in adult populations. This study aimed to assess the association between ACE exposure and OHRQoL in a population-based sample of adults.
METHODS: The study sample was drawn from the fourth Trøndelag Health Study (HUNT4) in Norway and included 6156 adults who answered questions on ACEs and OHRQoL, assessed using the validated 14-item Oral Health Impact Profile (OHIP-14). Six types of ACEs were evaluated: sexual, physical, and psychological abuse, bully victimization, parental divorce, and parental death. The relationship between ACE exposure and OHIP-14 was estimated using negative binomial regression models, adjusting for potential confounders, and presented as a ratio of means (RM) with 95% confidence intervals (CIs).
RESULTS: A total of 36.6% of participants reported experiencing at least one ACE. Those exposed to any ACE had worse OHRQoL, with higher mean OHIP-14 scores than those without ACE (3.46 vs. 2.28, p < 0.001). Exposure to any ACE was linked to higher mean scores across all four subdimensions: oral function, orofacial pain, orofacial appearance, and psychosocial impact. A dose-response relationship was observed, where one additional ACE was associated with an increase in mean OHIP-14 total score (RM 1.21, 95% CI 1.15-1.27). Specific ACEs, excluding parental death, were associated with a 15-58% higher mean total score, indicating a reduced OHRQoL.
CONCLUSIONS: The findings suggest that exposure to ACEs is linked with poorer OHRQoL in adulthood. These results emphasize the long-lasting association of childhood adversity with oral health and highlight the importance of considering ACEs in the prevention and management of oral health issues among vulnerable populations.
METHODS: The study sample was drawn from the fourth Trøndelag Health Study (HUNT4) in Norway and included 6156 adults who answered questions on ACEs and OHRQoL, assessed using the validated 14-item Oral Health Impact Profile (OHIP-14). Six types of ACEs were evaluated: sexual, physical, and psychological abuse, bully victimization, parental divorce, and parental death. The relationship between ACE exposure and OHIP-14 was estimated using negative binomial regression models, adjusting for potential confounders, and presented as a ratio of means (RM) with 95% confidence intervals (CIs).
RESULTS: A total of 36.6% of participants reported experiencing at least one ACE. Those exposed to any ACE had worse OHRQoL, with higher mean OHIP-14 scores than those without ACE (3.46 vs. 2.28, p < 0.001). Exposure to any ACE was linked to higher mean scores across all four subdimensions: oral function, orofacial pain, orofacial appearance, and psychosocial impact. A dose-response relationship was observed, where one additional ACE was associated with an increase in mean OHIP-14 total score (RM 1.21, 95% CI 1.15-1.27). Specific ACEs, excluding parental death, were associated with a 15-58% higher mean total score, indicating a reduced OHRQoL.
CONCLUSIONS: The findings suggest that exposure to ACEs is linked with poorer OHRQoL in adulthood. These results emphasize the long-lasting association of childhood adversity with oral health and highlight the importance of considering ACEs in the prevention and management of oral health issues among vulnerable populations.