title: Experience of childhood abuse and later number of remaining teeth in older Japanese: a life-course study from Japan Gerontological Evaluation Study project.
abstract: From a life-course perspective, adverse childhood experiences (ACEs) such as childhood abuse are known risk factors for adult diseases and death throughout life. ACEs could also cause poor dental health in later life because they could induce poor dental health in childhood, initiate unhealthy behaviors, and lower immune and physiological functions. However, it is not known whether ACEs have a longitudinal adverse effect on dental health in older age. This study aimed to investigate the association between experience of childhood abuse until the age of 18 and current number of remaining teeth among a sample of older Japanese adults.
  
  
  
  A retrospective cohort study was conducted using the data from the Japan Gerontological Evaluation Study (JAGES), a large-scale, self-reported survey in 2013 including 27 525 community-dwelling Japanese aged ≥65 years (response rate=71.1%). The outcome, current number of remaining teeth was used categorically: ≥20, 10-19, 5-9, 1-4, and no teeth. Childhood abuse was defined as having any experience of physical abuse, psychological abuse, and psychological neglect up until the age of 18 years. Ordered logistic regression models were applied.
  
  
  
  Of the 25 189 respondents who indicated their number of remaining teeth (mean age: 73.9; male: 46.5%), 14.8% had experience of childhood abuse. Distributions of ≥20, 10-19, 5-9, 1-4, and no teeth were as follows: 46.6%, 22.0%, 11.4%, 8.2%, and 11.8% among respondents with childhood abuse, while 52.3%, 21.3%, 10.3%, 6.6%, and 9.5% among respondents without childhood abuse. Childhood abuse was significantly associated with fewer remaining teeth after adjusting for covariates including socioeconomic status (odds ratio=1.14; 95% confidence interval: 1.06, 1.22).
  
  
  
  Childhood abuse could have a longitudinal adverse effect on later dental health in older age. This study emphasizes the importance of early life experiences on dental health throughout later life.
authors.affiliation: Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan. matsuyama-thk@umin.org.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsuyama
authors.affiliation: Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Fujiwara
authors.affiliation: Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Aida
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Watt
authors.affiliation: Department of Health and Social Behavior, Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Bunkyo-ku, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kondo
authors.affiliation: Division of Dental Sociology, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.|National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kondo
authors.affiliation: Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Osaka
mesh_terms: D054523:Adult Survivors of Child Abuse / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016388:Tooth Loss / Q000453:epidemiology* / Q000209:etiology
keywords:  Public health; Dental Health; Epidemiology; Tooth loss