ArticleCommunity dentistry and oral epidemiology2019
A life course approach to total tooth loss: Testing the sensitive period, accumulation, and social mobility models in the Health and Retirement Study.
Article in Community dentistry and oral epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 19 citations in OpenAlex.
- Adverse Childhood Experiences and the Co-occurrence of Poor Oral Health and Multimorbidity: Findings From the Canadian Longitudinal Study on Aging.Community dentistry and oral epidemiology · 2025Article
- Childhood and adult socioeconomic status influence on late-life healthy longevity: evidence from the Chinese longitudinal healthy longevity survey.Frontiers in public health · 2024Article
- Childhood Adversity and Passive Suicidal Ideation in Later Life in the United States: Does Religious Attendance Matter?Journal of religion and health · 2023Article
- Childhood Background Measures and Their Associations With Later-Life Physical, Mental, and Social Health in the National Social Life, Health, and Aging Project.The journals of gerontology. Series B, Psychological sciences and social sciences · 2021Article
- Multigenerational Households During Childhood and Trajectories of Cognitive Functioning Among U.S. Older Adults.The journals of gerontology. Series B, Psychological sciences and social sciences · 2021Article
- Intragenerational social mobility and self-rated oral health in the british cohort study.Health and quality of life outcomes · 2021Article
- Are Positive Childhood Experiences Linked to Better Cognitive Functioning in Later Life?: Examining the Role of Life Course Pathways.Journal of aging and health · 2021Article
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Abstract
objectivesChildhood socio-economic status (SES) has long been associated with later-life oral health, suggesting that childhood is a sensitive period for oral health. Far less attention has been given to the long-term impact of childhood trauma, abuse, and smoking on later-life oral health. This study fills the gap in the literature by examining how adverse childhood experiences-social, psychological, and behavioral-shape total tooth loss over the life course, with an assessment of the sensitive period, accumulation, and social mobility models from life course research.
methodsData are drawn from the 2012 Health and Retirement Study (HRS) merged with multiple HRS data sources to obtain childhood information (N = 6,427; age > 50). Adverse childhood experiences include childhood financial hardship, trauma, abuse, and smoking. Total tooth loss is measured to assess poor oral health in later life. Educational attainment and poverty status (since age 51) are measured as adult adversity. Current health conditions and health behaviors are assessed to reflect the correlates of oral health in later life.
resultsThe sensitive period model indicates that childhood trauma such as parental death or divorce (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.04, 1.80), physical abuse (OR = 1.17, 95% CI = 1.03, 1.34), and low educational attainment (≤ high school; OR = 1.52, 95% CI = 1.04, 2.22) are associated with higher odds of total tooth loss in later life. Poverty status was not associated with the outcome. There was a clear graded relationship between accumulation of adverse experiences and oral health, which supports the accumulation model. In the social mobility model, older adults who occupied a stable disadvantageous position were more likely to be toothless (OR = 1.77, 95% CI = 1.08, 2.90) compared to those who did not face adversity in any case. Neither upward nor downward mobility mattered.
conclusionsFailing oral health in older adults, especially total tooth loss, may have its roots in adverse experiences such as childhood trauma, abuse, and low educational attainment. Findings also suggest that oral health in later life may be more influenced by accumulation of adversity rather than changes in social and economic position over the life course.
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