Abstract
Prevention of childhood caries is an ongoing public health challenge, but the possibility of an association with maternal mental disorders has received limited attention. We estimated the extent to which maternal mental disorders are associated with an increased risk of hospitalization due to dental caries. We conducted a longitudinal cohort study of 790,758 infants born in Quebec, Canada between 2006 and 2016, with follow-up extending to 2018. We identified women with mental disorders before or during pregnancy and computed the incidence of dental caries in their children. We estimated HR and 95% CI for the association of maternal mental disorders with the risk of dental caries, adjusted for personal characteristics. Infants of women with mental disorders before or during pregnancy had a higher incidence of dental caries compared to children of women with no mental disorder (56.1 vs. 27.2 per 10,000 person-years). Maternal stress and anxiety disorders (HR = 1.73; 95% CI 1.60–1.86), depression (HR = 1.81; 95% CI 1.60–2.03), schizophrenia and delusional disorders (HR = 1.69; 95% CI 1.29–2.22), and personality disorders (HR = 1.89; 95% CI 1.70–2.11) were associated with the risk of dental caries. The associations were present throughout childhood, including after 7 years (HR = 1.65; 95% CI 1.38–1.96). Maternal mental disorders were associated with caries of the enamel, dentin, and cementum and caries that reached the dental pulp. Maternal mental disorders before or during pregnancy, especially stress and anxiety, depression, schizophrenia, and personality disorders, are associated with the risk of childhood caries. Women with a history of mental disorders may benefit from enhanced strategies for prevention of dental caries in their children.
References
1.
ADA Division of Communications
; Journal of the American Dental Association
; ADA Council on Scientific Affairs
. For the dental patient. Tooth eruption: the primary teeth
. J Am Dent Assoc
. 2005
Nov
;136
(11
):1619
.
[PubMed]
0002-81772.
Ayoub
A
, Fraser
WD
, Low
N
, Arbour
L
, Healy-Profitós
J
, Auger
N
. Risk of central nervous system defects in offspring of women with and without mental illness
. Arch Women Ment Health
. 2018
Aug
;21
(4
):437
–44
.
[PubMed]
1434-18163.
Collège des médecins du Québec [Internet]. La Tenue Des Dossiers Par Le Médecin En Centre Hospitalier De Soins Généraux Et Spécialisés [cited 2019 June 11]. Available from: http://www.cmq.org/publications-pdf/p-1-2005-12-01-fr-tenue-des-dossiers-par-medecin-en-centre-hospitalier-de-soins-generaux-et-specialises.pdf
4.
Correia
PN
, Alkhatrash
A
, Williams
CE
, Briley
A
, Carter
J
, Poston
L
, et al. What do expectant mothers need to know about oral health? A cohort study from a London maternity unit
. BDJ Open
. 2017
Mar
;3
(1
):17004
.
[PubMed]
2056-807X5.
Costa
FS
, Silveira
ER
, Pinto
GS
, Nascimento
GG
, Thomson
WM
, Demarco
FF
. Developmental defects of enamel and dental caries in the primary dentition: A systematic review and meta-analysis
. J Dent
. 2017
May
;60
:1
–7
.
[PubMed]
0300-57126.
Dos Santos Pinto
G
, de Ávila Quevedo
L
, Britto Correa
M
, Sousa Azevedo
M
, Leão Goettems
M
, Tavares Pinheiro
R
, et al. Maternal depression increases childhood dental caries: a cohort study in Brazil
. Caries Res
. 2017
;51
(1
):17
–25
.
[PubMed]
0008-65687.
Foster
H
, Fitzgerald
J
. Dental disease in children with chronic illness
. Arch Dis Child
. 2005
Jul
;90
(7
):703
–8
.
[PubMed]
0003-98888.
Ghanim
A
, Manton
D
, Bailey
D
, Mariño
R
, Morgan
M
. Risk factors in the occurrence of molar-incisor hypomineralization amongst a group of Iraqi children
. Int J Paediatr Dent
. 2013
May
;23
(3
):197
–206
.
[PubMed]
0960-74399.
Hooley
M
, Skouteris
H
, Boganin
C
, Satur
J
, Kilpatrick
N
. Parental influence and the development of dental caries in children aged 0-6 years: a systematic review of the literature
. J Dent
. 2012
Nov
;40
(11
):873
–85
.
[PubMed]
0300-571210.
Ismail
AI
, Sohn
W
. The impact of universal access to dental care on disparities in caries experience in children
. J Am Dent Assoc
. 2001
Mar
;132
(3
):295
–303
.
[PubMed]
0002-817711.
Kavanaugh
M
, Halterman
JS
, Montes
G
, Epstein
M
, Hightower
AD
, Weitzman
M
. Maternal depressive symptoms are adversely associated with prevention practices and parenting behaviors for preschool children
. Ambul Pediatr
. 2006
Jan-Feb
;6
(1
):32
–7
.
[PubMed]
1530-156712.
Kisely
S
. No mental health without oral health
. Can J Psychiatry
. 2016
May
;61
(5
):277
–82
.
[PubMed]
0706-743713.
Lamster
IB
, Lalla
E
, Borgnakke
WS
, Taylor
GW
. The relationship between oral health and diabetes mellitus
. J Am Dent Assoc
. 2008
Oct
;139
Suppl
:19S
–24S
.
[PubMed]
0002-817714.
Masterson
EE
, Sabbah
W
. Maternal allostatic load, caretaking behaviors, and child dental caries experience: a cross-sectional evaluation of linked mother–child data from the Third National Health and Nutrition Examination Survey
. Am J Public Health
. 2015
Nov
;105
(11
):2306
–11
.
[PubMed]
0090-003615.
Mouradian
WE
, Wehr
E
, Crall
JJ
. Disparities in children’s oral health and access to dental care
. JAMA
. 2000
Nov
;284
(20
):2625
–31
.
[PubMed]
0098-748416.
Needleman
HL
, Allred
E
, Bellinger
D
, Leviton
A
, Rabinowitz
M
, Iverson
K
. Antecedents and correlates of hypoplastic enamel defects of primary incisors
. Pediatr Dent
. 1992
May-Jun
;14
(3
):158
–66
.
[PubMed]
0164-126317.
Pampalon
R
, Hamel
D
, Gamache
P
, Philibert
MD
, Raymond
G
, Simpson
A
. An area-based material and social deprivation index for public health in Québec and Canada
. Can J Public Health
. 2012
Apr
;103
(8
Suppl 2
):S17
–22
.
[PubMed]
0008-426318.
Quiñonez
RB
, Keels
MA
, Vann
WF
Jr, McIver
FT
, Heller
K
, Whitt
JK
. Early childhood caries: analysis of psychosocial and biological factors in a high-risk population
. Caries Res
. 2001
Sep-Oct
;35
(5
):376
–83
.
[PubMed]
0008-656819.
Rabb-Waytowich
D
. Water fluoridation in Canada: past and present
. J Can Dent Assoc
. 2009
Jul
;75
(6
):451
–4
.
[PubMed]
1488-215920.
Rowan-Legg
A
; Canadian Paediatric Society, Community Paediatrics Committee
. Oral health care for children - a call for action
. Paediatr Child Health
. 2013
Jan
;18
(1
):37
–50
.
[PubMed]
1205-708821.
22.
Seow
WK
, Clifford
H
, Battistutta
D
, Morawska
A
, Holcombe
T
. Case-control study of early childhood caries in Australia
. Caries Res
. 2009
;43
(1
):25
–35
.
[PubMed]
0008-656823.
Silva
MJ
, Scurrah
KJ
, Craig
JM
, Manton
DJ
, Kilpatrick
N
. Etiology of molar incisor hypomineralization - A systematic review
. Community Dent Oral Epidemiol
. 2016
Aug
;44
(4
):342
–53
.
[PubMed]
0301-566124.
Simmer
JP
, Hu
JC
. Dental enamel formation and its impact on clinical dentistry
. J Dent Educ
. 2001
Sep
;65
(9
):896
–905
.
[PubMed]
0022-033725.
Slack-Smith
L
, Colvin
L
, Leonard
H
, Kilpatrick
N
, Bower
C
, Brearley Messer
L
. Factors associated with dental admissions for children aged under 5 years in Western Australia
. Arch Dis Child
. 2009
Jul
;94
(7
):517
–23
.
[PubMed]
0003-988826.
Slack-Smith
L
, Colvin
L
, Leonard
H
, Kilpatrick
N
, Read
A
, Messer
LB
. Dental admissions in children under two years—a total-population investigation
. Child Care Health Dev
. 2013
Mar
;39
(2
):253
–9
.
[PubMed]
0305-186227.
Stein
A
, Pearson
RM
, Goodman
SH
, Rapa
E
, Rahman
A
, McCallum
M
, et al. Effects of perinatal mental disorders on the fetus and child
. Lancet
. 2014
Nov
;384
(9956
):1800
–19
.
[PubMed]
0140-673628.
Tang
C
, Quinonez
RB
, Hallett
K
, Lee
JY
, Whitt
JK
. Examining the association between parenting stress and the development of early childhood caries
. Community Dent Oral Epidemiol
. 2005
Dec
;33
(6
):454
–60
.
[PubMed]
0301-566129.
Textor
J
, Hardt
J
, Knüppel
S
. DAGitty: a graphical tool for analyzing causal diagrams
. Epidemiology
. 2011
Sep
;22
(5
):745
.
[PubMed]
1044-398330.
Vargas-Ferreira
F
, Salas
MM
, Nascimento
GG
, Tarquinio
SB
, Faggion
CM
Jr, Peres
MA
, et al. Association between developmental defects of enamel and dental caries: A systematic review and meta-analysis
. J Dent
. 2015
Jun
;43
(6
):619
–28
.
[PubMed]
0300-571231.
Vesga-López
O
, Blanco
C
, Keyes
K
, Olfson
M
, Grant
BF
, Hasin
DS
. Psychiatric disorders in pregnant and postpartum women in the United States
. Arch Gen Psychiatry
. 2008
Jul
;65
(7
):805
–15
.
[PubMed]
0003-990X© 2020 S. Karger AG, Basel
2020
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