Department of Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
BMC Oral Health. 2024 Aug 10;24(1):927. doi: 10.1186/s12903-024-04686-9.
BACKGROUND: Poverty negatively impacts beneficial aspects of mental development, such as resilience. Toothbrushing, an oral health behavior, has the potential to protect children's resilience through its anti-inflammatory and self-management effects and may be more effective for children, especially children in poverty. This study investigated whether toothbrushing boosts resilience among children, especially children under poverty, and modifies the association between poverty and resilience using a longitudinal population sample of school children. METHODS: Data from the Adachi Child Health Impact of Living Difficulty (A-CHILD Study) were analyzed. A baseline study was conducted in 2015 in which the children were in first grade and followed through fourth grade (N = 3459, response rate: 80%, follow-up rate: 82%). Poverty was assessed by material deprivation (life-related deprivation and child-related deprivation) and annual household income at baseline. Children's toothbrushing frequency was assessed at baseline and classified into less than twice a day or twice or more a day. Children's resilience was assessed at baseline and follow-up using the Children's Resilient Coping Scale (range 0-100). RESULTS: Children who brushed their teeth twice or more a day in first grade had 3.50 points greater resilience scores in fourth grade than those who brushed their teeth less than twice a day in first grade. After adjusting for confounders, including resilience in first grade, among underpoverty children, those who brushed their teeth twice or more a day in first grade had higher resilience scores [2.66 (95% CI = 0.53, 4.79)] than those who brushed their teeth less than twice a day. Among nonpoverished children, toothbrushing frequency in first grade did not significantly correlate with resilience in fourth grade. CONCLUSIONS: The beneficial effect of toothbrushing twice or more a day on resilience was more significant among children in poverty than among those without poverty in elementary school in Japan. Health policy focused on frequent toothbrushing may contribute to boosting resilience among children living in poverty.
背景：贫困对心理健康发展的有益方面产生负面影响，例如韧性。刷牙作为一种口腔健康行为，具有通过抗炎和自我管理作用来保护儿童韧性的潜力，并且对儿童，尤其是贫困儿童可能更有效。本研究使用学校儿童的纵向人群样本，调查了刷牙是否可以增强儿童，尤其是贫困儿童的韧性，并改变贫困与韧性之间的关联。
方法：对阿达奇儿童生活困难对健康影响（A-CHILD 研究）的数据进行了分析。在 2015 年进行了基线研究，当时孩子们上一年级，并在四年级进行了随访（N=3459，应答率：80％，随访率：82％）。在基线时，通过物质剥夺（与生活相关的剥夺和与儿童相关的剥夺）和家庭年收入评估贫困状况。在基线和随访时评估儿童的刷牙频率，并分为每天刷牙少于两次或每天刷牙两次或更多。在基线和随访时使用儿童适应力量表（范围 0-100）评估儿童的韧性。
结果：在一年级每天刷牙两次或更多次的儿童，在四年级的韧性评分比每天刷牙少于两次的儿童高 3.50 分。在调整了包括一年级的韧性在内的混杂因素后，在贫困儿童中，每天刷牙两次或更多次的儿童的韧性评分更高[2.66（95％CI=0.53，4.79）]比每天刷牙少于两次的儿童。在非贫困儿童中，一年级的刷牙频率与四年级的韧性评分无明显相关性。
结论：在日本的小学中，与非贫困儿童相比，贫困儿童每天刷牙两次或更多次对韧性的有益影响更为显著。关注频繁刷牙的健康政策可能有助于增强贫困儿童的韧性。
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