# Associations between cumulative exposure to potentially traumatic events and self-reported oral health in the Tromsø Study: Tromsø7

## TL;DR

Experiencing multiple traumatic events in life is linked to worse self-reported oral health, with dental-related trauma showing the strongest connection.

## Contribution

This study identifies the strongest association between adverse dental events and poor oral health, emphasizing psychological aspects in dental care.

## Key findings

- Higher cumulative exposure to traumatic events correlates with poorer self-reported oral health.
- Adverse dental events showed the strongest link to poor oral health compared to other traumatic events.
- Traumatic events occurring before age 18 consistently associate with worse oral health outcomes.

## Abstract

Potentially Traumatic Events (PTEs), such as accidents, childhood neglect or abuse, can affect mental and physical health. The study investigated the association between PTEs and self-reported oral health (SROH), focusing on cumulative exposure to multiple events, the types of events, and the timing of exposure.

Data were collected from the seventh survey of the Tromsø Study, which invited all residents over 40 in Tromsø, Norway. A total of 21,069 participants took part, comprising 47,5% male and 52,5% female respondents, who completed assessments of PTEs and SROH. Chi-square (Χ²) tests evaluated unadjusted associations, and a series of logistic regression models were employed to investigate the association of PTEs with poor SROH, controlling for sociodemographic variables, emotional distress, and oral health-related behaviours.

The likelihood of reporting poor SROH was higher among those who experienced more PTEs, and this relationship persisted after adjusting for sex, age, socioeconomic status, oral health-related behaviour, dental anxiety, emotional distress and adverse dental events. Subsequent analyses differentiated the associations by type and timing (before and after age 18) of events. Interpersonal events involve direct interactions with others (e.g., abuse, bullying), while impersonal events refer to broader circumstances (e.g., accidents, natural disasters). Adverse dental events, classified as impersonal events, demonstrated the strongest association with poor SROH. The associations between interpersonal events and poor SROH varied more depending on covariates than impersonal events. The association strengthened when adjusting for sociodemographic factors but weakened when accounting for oral health behaviours, dental anxiety, and emotional distress. Notably, impersonal events occurring before age 18 were consistently associated with poor SROH across all models.

Experiencing multiple PTEs throughout life is associated with poor SROH. Among the various PTEs, adverse dental events showed the strongest association with poor SROH, emphasising the importance of addressing dental care’s emotional and psychological aspects, particularly in paediatric settings, to support long-term oral health outcomes.

Not applicable.