Thesis Format
Integrated Article
Degree
Master of Clinical Dentistry
Program
Orthodontics
Supervisor
Tassi, Ali
2nd Supervisor
Jessani, Abbas
Co-Supervisor
Abstract
Introduction: Adverse Childhood Experiences (ACEs) are stressful events such as abuse or neglect that may occur before age 18. The prevalence of ACEs amongst orthodontic patients and its correlation with malocclusion severity is yet to be explored.
Objective: To examine the prevalence of ACEs in an orthodontic population and its link to orthodontic treatment need.
Methods: A validated ACE survey was adapted for use in an orthodontic clinic. Orthodontic treatment need was assessed via pre-treatment records and the Index of Orthodontic Treatment Need (IOTN).
Results: Of 334 participants, 68.0% (n=227) reported one or more ACEs and 29.4% (n=98) reported four or more ACEs. Ordinal regression revealed ACE score and IOTN grade are correlated (p=0.0488). Each 1-point increase in ACE score raised the odds of having a higher IOTN grade by 8.2% (OR=1.082, 95% CI [1.001, 1.172]).
Conclusions: Most orthodontic patients (68%) in this sample have experienced one or more ACEs, highlighting the relevance of trauma-informed care in a Canadian orthodontic clinic setting. ACEs are associated with increased odds of orthodontic treatment need, helping to identify potential at-risk communities for intervention.
Summary for Lay Audience
Introduction: Adverse Childhood Experiences (ACEs) are stressful events such as abuse, neglect, or household dysfunction that may occur before the age of 18. ACEs have been linked to multiple health issues, including asthma, stroke, cancer, and oral disease. ACEs also lead to biological changes associated with chronic toxic stress exposure, such as altered hormonal and molecular signalling. Orthodontics is a field within dentistry that addresses malocclusion, or the improper alignment of teeth and jaws. The process of normal development and alignment of the teeth and jaws is influenced by biological and environmental signals, including those also affected by ACEs. The prevalence of ACEs amongst orthodontic patients and its correlation with the severity of misaligned teeth and jaws is yet to be explored in research.
Objective: To examine the prevalence of ACEs in an orthodontic population and its relationship with the need for orthodontic treatment.
Methods: A validated ACE survey was adapted for use in an orthodontic clinic. Orthodontic treatment need was assessed via pre-treatment records and the Index of Orthodontic Treatment Need (IOTN), a widely used index to grade the severity of tooth and jaw misalignment.
Results: Of 334 participants, the majority (68.0%) reported having experienced one or more ACEs and more than a quarter (29.4%) reported having experienced four or more ACEs. Correlation analyses revealed that ACE score and IOTN grade are significantly associated. Each 1-point increase in ACE score raised the odds of having a higher IOTN grade by 8.2%.
Conclusions: ACEs have affected most participants in this sample, highlighting the relevance of trauma-informed care in an orthodontic clinic setting. ACEs are associated with increased odds of orthodontic treatment need, helping to identify potential at-risk communities for intervention.
Recommended Citation
Seo, Jennifer N., "The Relationship Between Adverse Childhood Experiences (ACEs) and Malocclusion" (2025). Electronic Thesis and Dissertation Repository. 10842.
https://ir.lib.uwo.ca/etd/10842
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License