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Noxious family environments in relation to adult and childhood caries
Affiliation:1. Dental Public Health Resident, Boston;2. Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston;3. Chief of Quality, Harvard Dental Center, Boston;4. Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston;5. Undiagnosed Diseases Coordinator Center, Center for Biomedical Informatics, Harvard Medical School, Boston
Abstract:
BackgroundThe authors tested hypotheses that more noxious family environments are associated with poorer adult and child oral health.MethodsA community sample of married or cohabiting couples (N = 135) and their elementary school–aged children participated. Dental hygienists determined the number of decayed, missing and filled surfaces via oral examination. Subjective oral health impacts were measured by means of questionnaires completed by the parents and children. The parents completed questionnaires about interparental and parent-to-child physical aggression (for example, pushing) and emotional aggression (for example, derision), as well as harsh discipline. Observers rated the couples’ hostile behavior in laboratory interactions.ResultsThe extent of women's and men's caries experience was associated positively with their partners’ levels of overall noxious behavior toward them. The extent of children's caries experience was associated positively with the level of their mothers’ emotional aggression toward their partners.ConclusionsNoxious family environments may be implicated in compromised oral health. Future research that replicates and extends these findings can provide the foundation to translate them into preventive interventions.Practical ImplicationsNoxious family environments may help explain the limitations of routine oral health preventive strategies. Interprofessional strategies that also address the family environment ultimately may prove to be more effective than are single modality approaches.
Keywords:Caries  aggression  hostility  family environment  child  Child Oral Health Impact Profile  Decayed, missing and filled surfaces  Family Maltreatment  International Caries Detection and Assessment System  Oral Health Impact Profile (14-item version)  Parenting Scale  Rapid Marital Interaction Coding System
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