Bullying may affect dental health, say researchers

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Lena Myran, an expert psychologist and researcher, said: “The more negative experiences you carry with you in your emotional baggage, the greater the impact on brushing habits and tooth decay. Image: Elin Korsmo

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Lena Myran, an expert psychologist and researcher, said: “The more negative experiences you carry with you in your emotional baggage, the greater the impact on brushing habits and tooth decay. Image: Elin Korsmo

Young people who experienced adverse childhood experiences are at greater risk for poor dental health.This is important knowledge for dental health services, according to new research published in the Journal of Dentistry BMC Oral Health.

Most teenagers brush their teeth every day, but not all. More than 6% of young people aged 13 to 17 years completely or partially do not brush their teeth. Research now shows that adverse childhood experiences, including bullying, are linked to poor dental cleaning habits.

“We can't be sure if one causes the other, but we do know there is a link,” says Lena Myran, PhD, candidate at the NTNU Kompetansesenteret Tannhelse Midt and an expert in psychology.

She is studying how adverse childhood and adolescent experiences affect dental health.

Young people taking part in the Young-HUNT survey were asked if they had experienced anything bad during their childhood, such as bullying, abuse, violence or a parent with a serious alcohol problem. They were also asked about their dental cleaning habits. The answers were checked against data from the public dental health service.

“We conducted a study that combined self-reported answers with clinical dental health data. That makes this study unique, and we were a little surprised by what we found,” Mylan said.

Vulnerable Groups

A total of 6,351 teenagers participated in the survey. The results showed that young people who had had adverse childhood experiences were more likely to report not brushing their teeth every day. In addition to this, 16- to 17-year-olds who experienced bullying were more likely to report poor dental cleaning habits.

Poor dental health is also associated with feelings of shame.

“That doesn't mean everyone who is bullied doesn't clean their teeth every day. Most people brush their teeth every day.

The vast majority of people do a good job of taking care of their teeth and have very few cavities. However, there is one group that is more vulnerable and we need to pay attention to,” Mylan said.

Poor dental hygiene habits can lead to tooth decay (the medical term is “caries”), which increases the risk of cavities and causes pain.

“Toothache may cause people to give up on dental treatment, which in turn can make people fear going to the dentist,” Mylan said.

“The correlations we found provide us with important knowledge about young people. Experiences of violence, abuse and bullying are harmful in many areas of life, and we are now seeing that this is also true in dental health.

The more adverse experiences you have in childhood, the greater the impact on brushing habits and tooth decay.

Dentin caries (commonly known as decay) causes tooth decay and can be treated with a filling. The researchers found that the majority of survey participants with dental caries were the oldest young adults, aged between 16 and 17 years old.

“On average, our data show that in this age group, people who have experienced bullying, violence and abuse have more dentin cavities than people who have not experienced bullying, violence and abuse,” Mylan said. The proportion is higher.

A holistic approach is needed

Researchers also found a correlation between dose and response.

“The more different types of adverse experiences experienced in childhood, the greater the impact on toothbrushing habits and dental caries. For example, many people have experienced abuse and have parents with alcohol-related problems. These young people are more likely to have similar experiences with those who only experienced Their dental health is worse than people who live with one of these two conditions,” Mylan said.

Mylan emphasized that a large proportion of young people with adverse childhood experiences have good dental health. However, some young people do not clean their teeth well, and it is important to develop this habit early in life.

“These findings suggest that dental health clinics need to take a comprehensive approach. When a young person comes to the clinic with extensive caries, the clinic may be more curious about whether the person has experienced any difficulties in life that may have contributed to poverty. Diet or Poor dental hygiene habits.

root cause

Mylan wants dental health professionals to ask themselves what the possible causes of poor dental health are. When trying to identify vulnerable populations and the underlying reasons for the need for dental treatment, it is important to ask patients about their adverse experiences.

“Instead of saying, 'You need to brush and floss better,' you might ask, 'Why is it harder for you to clean your teeth?' We can also ask ourselves the question: 'What did the patient go through that caused them to Is your dental health deteriorating?

Mylan sees this as a more holistic approach.

“There are many reasons why a person may develop cavities or dental hygiene problems. No one actively neglects their teeth, but good advice and instructions on the importance of brushing are not always adequately heeded. By some people,” Mylan explain.

In contrast, a holistic approach can lead to earlier, more targeted preventive measures.

“This may include measures such as providing additional support to teach people about dental hygiene or referring them to other relevant support services,” Mylan said.

Need more time with patients

Mylan's background as a psychologist means she recognizes the importance of focusing on communication and building trust when interacting with young patients. She wishes dental health professionals would focus more on building positive and supportive relationships with young people.

“Creating an environment where young people feel safe enough to be honest about their habits and share their experiences is a prerequisite to helping some vulnerable patients.”

Mylan said many dentists and dental hygienists already do a good job of building good relationships with their patients.

“By continually prioritizing and further developing trust alliances, we can contribute to better treatment plans. But these tasks take up precious dentist time.”

Therefore, policymakers in public dental care services must facilitate this.

“Good collaboration can not only improve young people's dental health, but also make a positive contribution to their overall quality of life,” Mylan said.

More information:
Lena Myran et al. Associations of adverse childhood experiences with dental caries and toothbrushing in adolescents. Young-HUNT4 Survey, BMC Oral Health (2023). DOI: 10.1186/s12903-023-03492-z

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