{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:00:16Z","timestamp":1790708416709,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Public Health Dent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the association between cumulative adverse childhood experiences (ACEs) and oral health outcomes among US children and adolescents in the post\u2013COVID\u201019 period, specifically examining preventive dental care receipt and caregiver\u2010reported tooth decay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed nationally representative data from the 2022\u20132023 National Survey of Children's Health (NSCH), using a cross\u2010sectional study design. The analytic sample included 44,489 children aged 6\u201317\u2009years with complete geographic data. Multivariable logistic regression models estimated associations between cumulative ACE exposure and two outcomes: receipt of a preventive dental visit in the past year and parent\u2010reported tooth decay. Models adjusted for sociodemographic, household, and health\u2010related factors, including language, income, insurance type, special healthcare needs, and rural residence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Children exposed to four or more ACEs had significantly higher odds of experiencing tooth decay (aOR 1.60; 95% CI 1.33\u20131.94) compared with those with less than four ACEs. After adjustment, cumulative ACE exposure was not associated with reduced receipt of preventive dental care. Other predictors of tooth decay included low household income, public insurance, special healthcare needs, speaking a non\u2010English language at home, and rural residence. Children with high ACE exposure continued to exhibit disproportionate oral health burdens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that childhood adversity is associated with poorer oral health status, while preventive dental care utilization may be influenced by broader socioeconomic and contextual factors. Given the cross\u2010sectional design and reliance on caregiver\u2010reported measures, longitudinal studies are needed to clarify temporal relationships and better understand the pathways linking childhood adversity and oral health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jphd.70083","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:29:40Z","timestamp":1790692180000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Examining Adverse Childhood Experiences as a Risk Factor for Preventive Dental Care and Tooth Decay: National Survey of Children's Health 2022\u20132023"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5380-8391","authenticated-orcid":false,"given":"Elizabeth","family":"Crouch","sequence":"first","affiliation":[{"name":"University of South Carolina Rural Health Research Center, Department of Health Services Policy and Management, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Frattaroli","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Division of Population Oral Health Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3380-4835","authenticated-orcid":false,"given":"Zachary","family":"Brian","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill, School of Dentistry  Chapel\u2010Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0075-6863","authenticated-orcid":false,"given":"Cassie","family":"Odahowski","sequence":"additional","affiliation":[{"name":"University of South Carolina Rural Health Research Center, Department of Health Services Policy and Management, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3949-2749","authenticated-orcid":false,"given":"Amy","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Division of Population Oral Health Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8824-869X","authenticated-orcid":false,"given":"Joni","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Division of Population Oral Health Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Oral Health Surveillance Report: Dental Caries, Tooth Retention, and Edentulism, United States, 2017\u2013March 2020","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2019.01.045"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2022.02.008"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/idh.12808"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.53567"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2020.09.001"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182312313"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2025.105966"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010023\u201003492\u2010z"},{"key":"e_1_2_10_11_1","unstructured":"Data Research Center \u201cNational Survey of Children's Health 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