Abstract
BACKGROUND: Many believe women’s oral health deteriorates as a result of having children.
OBJECTIVES: This research aimed to investigate whether social and behavioural risk factors common to both parity (number of times a woman has given birth) and dental disease (periodontal attachment loss (AL), and caries) may account for any association between oral health and parity.
METHODS: The Dunedin Multidisciplinary Health and Development study is a longitudinal study of 1037 individuals (48.4% female) born from April 1972 to March 1973 in Dunedin, New Zealand. Logistic and negative binomial regression models were used to examine associations between the number of children born to female participants and their periodontal AL, dental caries experience, and tooth loss. Models controlled for confounders, including educational achievement, oral hygiene, dental service use and smoking.
RESULTS: Data were available for 433 women (96.4% dentally assessed, aged 45). Of these, 76.2% had given birth to one or more children. Low educational attainment was significantly associated with having more children at all ages assessed. Parity by age 38 was not associated with periodontal AL, untreated dental caries, or prevalence of missing at least one tooth, but was associated with mean tooth loss and DMFS. Women who had children by age 26 experienced poorer dental health outcomes by age 45 than nulliparous women, or women entering motherhood later in life. Parity by age 26 was associated with the number of tooth surfaces with untreated caries at age 45 (IRR 1.69, 95% CI 1.22-2.35) and teeth missing due to caries (IRR 1.62, 95% CI 1.27- 2.08).
CONCLUSION: The biological effects of pregnancy appear less important for the development of dental disease than the social factors associated with having children. Level of education attained appeared to influence both a woman’s reproductive patterns and health behaviours, which may in turn influence the risk of dental disease and how it is managed.