{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T18:16:01Z","timestamp":1779214561861,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T00:00:00Z","timestamp":1558396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG051142"],"award-info":[{"award-number":["R01AG051142"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["U01AG009740"],"award-info":[{"award-number":["U01AG009740"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007234","name":"University of Chicago","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007234","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007270","name":"University of Michigan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007270","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Childhood socio\u2010economic status (SES) has long been associated with later\u2010life oral health, suggesting that childhood is a sensitive period for oral health. Far less attention has been given to the long\u2010term impact of childhood trauma, abuse, and smoking on later\u2010life oral health. This study fills the gap in the literature by examining how adverse childhood experiences\u2014social, psychological, and behavioral\u2014shape total tooth loss over the life course, with an assessment of the sensitive period, accumulation, and social mobility models from life course research.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data are drawn from the 2012 Health and Retirement Study (HRS) merged with multiple HRS data sources to obtain childhood information (N\u00a0=\u00a06,427; age\u00a0&gt;\u00a050). Adverse childhood experiences include childhood financial hardship, trauma, abuse, and smoking. Total tooth loss is measured to assess poor oral health in later life. Educational attainment and poverty status (since age 51) are measured as adult adversity. Current health conditions and health behaviors are assessed to reflect the correlates of oral health in later life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The sensitive period model indicates that childhood trauma such as parental death or divorce (odds ratio [OR]\u00a0=\u00a01.37, 95% confidence interval [CI]\u00a0=\u00a01.04, 1.80), physical abuse (OR\u00a0=\u00a01.17, 95% CI\u00a0=\u00a01.03, 1.34), and low educational attainment (\u2264 high school; OR\u00a0=\u00a01.52, 95% CI\u00a0=\u00a01.04, 2.22) are associated with higher odds of total tooth loss in later life. Poverty status was not associated with the outcome. There was a clear graded relationship between accumulation of adverse experiences and oral health, which supports the accumulation model. In the social mobility model, older adults who occupied a stable disadvantageous position were more likely to be toothless (OR\u00a0=\u00a01.77, 95% CI\u00a0=\u00a01.08, 2.90) compared to those who did not face adversity in any case. Neither upward nor downward mobility mattered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Failing oral health in older adults, especially total tooth loss, may have its roots in adverse experiences such as childhood trauma, abuse, and low educational attainment. Findings also suggest that oral health in later life may be more influenced by accumulation of adversity rather than changes in social and economic position over the life course.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cdoe.12463","type":"journal-article","created":{"date-parts":[[2019,5,22]],"date-time":"2019-05-22T06:00:10Z","timestamp":1558504810000},"page":"333-339","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["A life course approach to total tooth loss: Testing the sensitive period, accumulation, and social mobility models in the Health and Retirement Study"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5061-2564","authenticated-orcid":false,"given":"Haena","family":"Lee","sequence":"first","affiliation":[{"name":"Survey Research Center, Institute for Social Research University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,21]]},"reference":[{"issue":"9","key":"e_1_2_5_2_1","first-page":"661","article-title":"The global burden of oral diseases and risks to oral health","volume":"83","author":"Petersen PE","year":"2005","journal-title":"Bull World Health Organ"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2011.00640.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02788.x"},{"issue":"3","key":"e_1_2_5_5_1","first-page":"382","article-title":"Oral health\u2014a neglected aspect of subjective well\u2010being in later life","volume":"73","author":"Rouxel P","year":"2018","journal-title":"J Gerontol Ser B"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-10-386"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2003.00205.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx059"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2005.76.11.1910"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.301918"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12351"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11602-3"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1525602113"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2007.01123.x"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/intjepid\/31.2.285"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0708473"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.1998.3.1.288"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2010.07.045"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2011.00611.x"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/58.6.S327"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(03)00344-7"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12404"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2010.01647.x"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyu067"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67728-8"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14036"},{"key":"e_1_2_5_27_1","unstructured":"National Institute on Alcohol Abuse and Alcoholism.Alcohol & Your Health: Older Adults. 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