Department of Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA.
Department of Epidemiology, School of Public Health, Robert C Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA.
J Public Health Dent. 2022 Mar;82(2):194-203. doi: 10.1111/jphd.12450. Epub 2021 Mar 9.
Adverse childhood experiences (ACEs) often have consequences beyond the immediacy of any specific event. The purpose of this study is to identify if ACEs in children with special healthcare needs (CSHCN) are associated with oral problems and dental care utilization.
The data source for this cross-sectional, secondary data analysis study was the 2017-2018 National Survey of Children's Health. Children were categorized as CSHCN or children with no special healthcare needs (CNSHCN) who had no, 1, 2, or ≥3 ACEs. Rho-Scott Chi-Square tests and bivariate and multivariable logistic regression analyses were conducted.
CSHCN who have had 1, 2, or ≥3 ACEs were significantly more likely to have had an oral problem or dental caries within the previous year as compared with CNSHCN who did not have any ACE. For no dental visits for any reason and no preventive visits, CSHCN at all levels of ACE were not significantly different from CNSHCN and no ACE in adjusted analyses. However, CNSHCN who had ≥3 ACEs were significantly more likely to not have had a preventive dental or any dental visit within the previous year.
In this nationally representative study of children and adolescents in the United States, CSHCN who have had ACE were more likely to have oral health problems within the previous year as compared with CNSHCN who did not have ACE.
儿童期逆境（ACE）的影响往往不仅局限于特定事件发生的当下。本研究旨在确定有特殊医疗需求的儿童（CSHCN）的 ACE 是否与口腔问题和牙科保健利用有关。
本横断面、二次数据分析研究的数据来源是 2017-2018 年全国儿童健康调查。儿童分为 CSHCN 或无特殊医疗需求的儿童（CNSHCN），他们有无、1 项、2 项或≥3 项 ACE。进行 Rho-Scott 卡方检验以及单变量和多变量逻辑回归分析。
与没有 ACE 的 CNSHCN 相比，有过 1 项、2 项或≥3 项 ACE 的 CSHCN 更有可能在过去一年中出现口腔问题或龋齿。对于任何原因的无牙科就诊和无预防就诊，所有 ACE 水平的 CSHCN 在调整分析中与无 ACE 的 CNSHCN 没有显著差异。然而，≥3 项 ACE 的 CNSHCN 更有可能在过去一年中没有进行预防性牙科或任何牙科就诊。
在这项针对美国儿童和青少年的全国代表性研究中，与没有 ACE 的 CNSHCN 相比，有 ACE 的 CSHCN 更有可能在过去一年中出现口腔健康问题。
