Relationship Between Factors Associated with Toxic Stress and Child Behavior in the Dental Office
Year: 2016
Type: article
Study design: Observational Study
Abstract: Purpose:To determine the relationship between toxic stress from negative social determinants of health and behavior of children at the initial dental visit.Methods:Using a 17-state sample of children 4-5 years-old, behavior ratings, using a 4point scale, applied by trained dental professionals at initial dental visits were analyzed using bivariate and multivariate logistic regression models as well as Naïve Bayes classification and chi-squared tests.Each child's behavior rating was correlated with social determinants using geographic mapping for racial/ethnic status, violence, education level, income, living conditions and other factors known to influence health.Results: Behavior ratings for 4-year-old (n=17,486) and 5-year-old (n=19,613) children were obtained for first dental visit over a five year period (2009)(2010)(2011)(2012)(2013).Behavior was good (n=11,999) and not good (n=25,100).The odds ratio correlating individual socioeconomic factors to behavior showed that children with more negative behavior were more likely to experience violent crime (P=.0004), parental unemployment (P=.0002), less parental education (P=.0006), high expense on food and transportation per capita income (P=.0005),living in a more densely populated area (P=.028), nonhomeowner (P=.0001), with a greater amount spend on housing per capita income (P=.0009),African-American (P=.0008), and a lower median household age (P=.0003).Children with good behavior rating were more likely to be of Latino or white ethnicity iii (P=.0002), come from homes owned by parents (P=.007), having a male to female ratio closer to 1:1 (P=.031), spent a greater amount on health related expenses (P=.015), and a larger average home size (P=.0002).Conclusion: This study of 37,099 4-and-5-year-old children, found poorer behavior at initial dental examination for children exposed to violence crime, parental unemployment, less parental education, high expense on food and transportation per capita income, non-homeowners with a short length of residence in the current domicile, African-American, in a more densely populated area, with a lower median household age.Children of Latino or white ethnicity, greater parental income, parents owning current residence, greater home size, and a male to female ratio approaching 1:1, were more likely to be rated "good" at the initial dental visit.
Author: Gabriel M Dawson
Institution: The Ohio State University
Language: English
Subfield: General Dentistry
Field: Dentistry
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2624966012