Dental cavities are more common in children whose mothers suffer from chronic stress, according to a new study by researchers at King’s College London and the University of Washington. Maternal chronic stress was also found to be associated with a lower probability of breastfeeding and dental visits by children.

“We know that low socioeconomic status is associated with chronic exposure to adverse living circumstances. These take a toll on a person biologically and also affect behavior,” said first author Erin E. Masterson from the Schools of Public Health and Dentistry at the University of Washington.

“This study uniquely highlights the importance of considering the influence of socioeconomic status and maternal stress on children’s oral health through mothers’ struggles to adopt healthy patterns that are major predictors of dental cavities, such as brushing her children’s teeth regularly, maintaining healthy dietary habits, and taking regular visits to the dentist for preventive care.”

For the study, researchers analyzed data from 716 mother-child pairs in the U.S. taken from the Third National Health and Nutrition Examination Survey. Children were between the ages of two and six.

The findings revealed that dental cavities were more common among children whose mothers had two or more biological markers of chronic stress, an incident known as allostatic load (AL) or the “wear and tear” of the body. Specifically, 44.2 percent of children whose mothers exhibited AL had cavities compared to 27.9 percent of children whose mothers did not.

Further analyses investigated any potential links between maternal AL and care-taking behaviors, such as breastfeeding, dental visits, and eating breakfast daily. The findings showed that cavities were more common among children whose mothers did not breastfeed them, compared to those who did: 62.9 percent vs. 37.1 percent respectively. Mothers who had one and two or more markers of AL were significantly less likely to breastfeed than those with a normal AL level.

“Policy that aims to improve dental health, particularly the prevalence of cavities among children, should include interventions to improve the quality of life of mothers,” said study coauthor Dr. Wael Sabbah from the Dental Institute at King’s College London.

“Chronic maternal stress as a potential risk factor is something we need to consider, in addition to the wider implications of maternal well-being, social, and psychological environment on dental health.”

“Our study indicated that mothers with lower income were significantly less likely to breastfeed or to have taken their child to the dentist in the prior year. They were also less likely to feed their child breakfast than higher income counterparts. It is important to better understand the dynamics of these links, so that we might develop effective public health programs and interventions,” added Sabbah.

The study is the first to examine the link between maternal stress and cavities using biological markers: serum triglycerides; serum HDL cholesterol; plasma glucose; serum C-reactive protein; systolic or diastolic blood pressure; and waist circumference.

The authors note that the observed associations do not indicate a direct cause and effect.

The findings are published in the American Journal of Public Health.

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