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Drumond VZ, de Arruda JAA, Bernabé E, Mesquita RA, Abreu LG. Burden of dental caries in individuals experiencing food insecurity: a systematic review and meta-analysis. Nutr Rev 2023; 81:1525-1555. [PMID: 37040617 DOI: 10.1093/nutrit/nuad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
CONTEXT Food insecurity affects approximately 2.37 billion people worldwide. Individuals experiencing food insecurity are more likely to exhibit poor health-related endpoints. Dental caries, a highly prevalent noncommunicable disease, is modulated by an interplay between biological, behavioral, and environmental factors. OBJECTIVE This systematic review and meta-analysis aimed to assess whether individuals experiencing food insecurity were more likely to exhibit dental caries than individuals facing food security. DATA SOURCES The Web of Science, PubMed, Scopus, Embase, Ovid, CINAHL, LILACS, and APA PsycINFO databases were checked from inception to November 2021. Grey literature and Google Scholar were also examined. An updated search was conducted in August 2022. Observational studies were included if they evaluated the association between dental caries and food insecurity status. DATA EXTRACTION Data extraction was performed by two reviewers. DATA ANALYSIS Random-effects meta-analyses were conducted using R language. In total, 514 references were retrieved from databases, of which 14 articles were included in qualitative synthesis and 7 were merged into meta-analysis. The results of an inverse-variance meta-analysis (OR = 1.62; 95%CI, 1.01-2.60) and a meta-analysis of binary data (OR = 1.66; 95%CI, 1.36-2.02) demonstrated that food-insecure individuals were more likely to exhibit dental caries than food-secure individuals. Inverse-variance meta-analyses appraising multiple strata of food security also showed that individuals experiencing marginal food security (OR = 1.48; 95%CI, 1.28-1.72), individuals experiencing low food security (OR = 1.26; 95%CI, 1.01-1.57), and those experiencing very low food security (OR = 1.33; 95%CI, 1.04-1.71) were more likely to exhibit dental caries than individuals experiencing full food security. CONCLUSION Dental caries is associated with food insecurity. Individuals living with food insecurity are more likely to exhibit dental caries than those who have food security. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42021268582.
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Affiliation(s)
| | - José Alcides A de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo Bernabé
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ricardo A Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas G Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Sanjeevi N, Monsivais P. Association of Food Insecurity Status with Resolution of Mental Health Conditions in Children and Adolescents. J Dev Behav Pediatr 2023; 44:e536-e542. [PMID: 37796631 DOI: 10.1097/dbp.0000000000001212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/06/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE Adverse consequences related to unresolved mental health issues underscore the importance of identifying factors that impede resolution of mental health conditions. Although studies have identified food insecurity as a risk factor for the diagnosis of mental health conditions, its impact on unresolved mental health issues is not understood. The objective of this study is to investigate the association of food insecurity status with resolution of depression, anxiety, and behavioral/conduct problems in children and adolescents. METHODS Using National Survey of Children's Health 2016 to 2019, logistic regression analyses examined the relationship of food insecurity status with the diagnosis and resolution of depression, anxiety, and behavioral/conduct problems in children (aged 5-11 years) and adolescents (aged 12-17 years). RESULTS Mild, moderate, and severe food insecurity were significantly associated with higher odds of being diagnosed with depression, anxiety, and behavioral/conduct problems. Severe food insecurity was significantly associated with higher odds of unresolved behavioral/conduct problems in children (adjusted odds ratio [aOR], 10.09; 95% confidence interval [CI], 2.99-34.04), after adjustment for demographic covariates. In adolescents, severe food insecurity was significantly related to greater odds of unresolved depression (aOR, 6.64; 95% CI, 2.13-20.70), anxiety (aOR, 3.27; 95% CI, 1.31-8.14), and behavioral/conduct problems (aOR, 5.57; 95% CI, 2.09-14.85). These associations of severe food insecurity with unresolved mental health conditions were significant even after adjustment for the receipt of mental health care. Mild and moderate food insecurity were not significantly associated with unresolved mental health conditions. CONCLUSION The findings suggest that severe food insecurity is associated with increased odds of unresolved mental health conditions in children and adolescents. This study highlights the importance of tailoring interventions to provide appropriate mental health services for children and adolescents from severely food insecure households.
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Affiliation(s)
- Namrata Sanjeevi
- Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA
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Testa A, Mungia R, van den Berg A, C Hernandez D. Food deserts and dental care utilization in the United States. J Public Health Dent 2023; 83:389-396. [PMID: 38073040 DOI: 10.1111/jphd.12593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/15/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVES Although food deserts are known to impact health and healthcare utilization, no research has investigated the relationship between food deserts and dental care utilization. This study aimed to fill this gap by assessing the relationship between living in a food desert and self-reported dental care utilization in the past year. METHODS Data are from the National Longitudinal Study of Adolescent to Adult Health (N = 10,495). The association between food deserts and dental care utilization was assessed using covariate-adjusted multiple logistic regression. RESULTS Living in a food desert was associated with higher odds of not utilizing dental care in the past year. This association was concentrated among high-poverty areas (≥20% poverty rate). CONCLUSIONS The current study is the first to assess the relationship between living in a food desert and dental care utilization. The findings demonstrate that individuals living in low-income urban food deserts may be at increased risk for not utilizing dental care.
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Affiliation(s)
- Alexander Testa
- School of Public Health, Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Rahma Mungia
- School of Dentistry, Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Alexandra van den Berg
- School of Public Health, Department of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Daphne C Hernandez
- Cizik School of Nursing, Department of Research, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Bhaumik D, Wright CD, Marshall TA, Neiswanger K, McNeil DW, Jones AD, Shaffer JR, Marazita ML, Foxman B. Food insecurity and consumption of cariogenic foods in mothers and their two-year-old children in Appalachia. J Public Health Dent 2023; 83:127-135. [PMID: 36695472 PMCID: PMC10257733 DOI: 10.1111/jphd.12559] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To describe the association between household food insecurity and intake of cariogenic foods that increase risk of dental caries. METHODS Cross-sectional analysis of 842 mothers in Appalachia and their children participating in the Center for Oral Health Research Cohort 2 between 2011 and 2017 when their children were ~ 24 months of age. Mothers completed a telephone interview regarding cariogenic food consumption and food insecurity. Associations between food insecurity and daily food intake were adjusted for education, income, state residence, and daily snacking. RESULTS After adjustment for household income, state residence, daily snacking, and maternal education, mothers from moderately/severely food insecure households drank on average ½ more sugar-sweetened beverage servings per day (p = 0.005) and children drank almost 1/3 servings more (p = 0.006). Further, mothers and children from moderately/severely food insecure households had lower, but not statistically significant, daily average consumption of vegetables (mothers: 1/5 less of a vegetable serving per day, children: ~1/10 less) and fruits (mothers: 1/5 less of a fruit serving per day, children: ~ 1/10 les) and elevated consumption of sweets (mothers: ~ 1/25 more sweet servings per day, children: ~ 2/25 more); differences based on state residence were noted. CONCLUSIONS Food insecurity is associated with higher consumption of foods that increase risk of dental caries, but this association is modified by maternal education, income, and state residence. Food insecurity, and its socioeconomic determinants, should be considered when designing and implementing interventions to prevent dental caries.
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Affiliation(s)
- Deesha Bhaumik
- School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Casey D. Wright
- School of Dentistry, Department of Developmental Sciences, Marquette University, Milwaukee, WI 53201, USA
| | - Teresa A. Marshall
- College of Dentistry, Department of Preventive & Community Dentistry, University of Iowa, Iowa City, IA 52242 USA
| | - Katherine Neiswanger
- School of Dental Medicine, Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Center for Oral Health Research in Appalachia (COHRA) University of Pittsburgh, Pittsburgh, PA 15219, USA; West Virginia University, Morgantown, WV, 265506, USA
| | - Daniel W. McNeil
- School of Dentistry, Department of Developmental Sciences, Marquette University, Milwaukee, WI 53201, USA
- Center for Oral Health Research in Appalachia (COHRA) University of Pittsburgh, Pittsburgh, PA 15219, USA; West Virginia University, Morgantown, WV, 265506, USA
- School of Dentistry, Department of Dental Practice & Rural Health, West Virginia University, Morgantown, WV 26506, USA
| | - Andrew D. Jones
- School of Public Health, Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - John R. Shaffer
- School of Dental Medicine, Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Center for Oral Health Research in Appalachia (COHRA) University of Pittsburgh, Pittsburgh, PA 15219, USA; West Virginia University, Morgantown, WV, 265506, USA
- Graduate School of Public Health, Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Mary L. Marazita
- School of Dental Medicine, Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Center for Oral Health Research in Appalachia (COHRA) University of Pittsburgh, Pittsburgh, PA 15219, USA; West Virginia University, Morgantown, WV, 265506, USA
- Graduate School of Public Health, Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Betsy Foxman
- School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
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Brochier A, Messmer E, Wexler MG, Rogers S, Cottrell E, Tripodis Y, Garg A. A cross-sectional study of relationships between social risks and prevalence and severity of pediatric chronic conditions. BMC Pediatr 2023; 23:115. [PMID: 36890502 PMCID: PMC9992899 DOI: 10.1186/s12887-023-03894-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/06/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND To examine the differential relationships between seven social risk factors (individually and cumulatively) with the prevalence and severity of asthma, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and overweight/obesity in children. METHODS Using the 2017-2018 National Survey of Children's Health, we examined associations between social risk factors (caregiver education, caregiver underemployment, discrimination, food insecurity, insurance coverage, neighborhood support, and neighborhood safety) and the prevalence and severity of asthma, ADHD, ASD, and overweight/obesity. We used multivariable logistic regression to assess the relationship between individual and cumulative risk factors with each pediatric chronic condition, controlling for child sex and age. RESULTS Although each social risk factor was significantly associated with increased prevalence and/or severity of at least one of the pediatric chronic conditions we investigated, food insecurity was significantly associated with higher disease prevalence and severity for all four conditions. Caregiver underemployment, low social support, and discrimination were significantly associated with higher disease prevalence across all conditions. For each additional social risk factor a child was exposed to, their odds of having each condition increased: overweight/obesity (aOR: 1.2, 95% CI: [1.2, 1.3]), asthma (aOR: 1.3, 95% CI: [1.2, 1.3], ADHD (aOR: 1.2, 95% CI: [1.2, 1.3]), and ASD (aOR: 1.4, 95% CI: [1.3, 1.5]). CONCLUSIONS This study elucidates differential relationships between several social risk factors and the prevalence and severity of common pediatric chronic conditions. While more research is needed, our results suggest that social risks, particularly food insecurity, are potential factors in the development of pediatric chronic conditions.
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Affiliation(s)
- Annelise Brochier
- Department of Pediatrics, Boston Medical Center, 801 Albany St. Floor 2N, Boston, MA, 02119, USA.
| | - Emily Messmer
- Quality and Patient Experience, Mass General Brigham, 399 Revolution Dr., Somerville, MA, 02145, USA
| | - Mikayla Gordon Wexler
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl., New York, NY, 10029, USA
| | - Stephen Rogers
- Department of Pediatrics, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 9104, USA
| | - Erika Cottrell
- OCHIN, Inc., PO Box 5426, Portland, OR, 97228, USA.,Oregon Clinical & Translational Research Institute, Oregon Health & Science University, 3250 Southwest Sam Jackson Park Rd., Portland, OR, 97329, USA
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Ave., 3rd Floor, Boston, MA, 02118, USA
| | - Arvin Garg
- Child Health Equity Center, Department of Pediatrics, UMass Chan Medical School, UMass Memorial Children's Medical Center, 55 N Lake Ave., Worcester, MA, 01655, USA
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Weigel MM, Armijos RX. Food insecurity is associated with self-reported oral health in school-age Ecuadorian children and is mediated by dietary and non-dietary factors. Public Health Nutr 2023; 26:23-32. [PMID: 36172927 PMCID: PMC11077448 DOI: 10.1017/s1368980022002166] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 08/15/2022] [Accepted: 09/23/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The main objective was to investigate the association of household food insecurity (HFI) with child oral health. A secondary objective was to explore potential dietary and non-dietary mediators of the HFI-child oral health relationship. DESIGN Cross-sectional data from the nationally representative Ecuadorian National Health and Nutrition Survey (2018) were analysed. The data included self-reported child oral health, HFI (Food Insecurity Experience Scale), diet (FFQ) and oral care behaviours (toothbrushing frequency, toothpaste use). The association of HFI with the reported number of oral health problems was examined with stereotype logistic regression. Parallel mediation analysis was used to explore potential dietary (highly fermentable carbohydrate foods, plain water) and non-dietary (toothbrushing) mediators of the HFI-oral health relationship. Bias-corrected standard errors and 95 % CI were obtained using non-parametric bootstrapping (10 000 repetitions). Effect size was measured by percent mediation (PM). SETTING Ecuador. PARTICIPANTS 5-17-year-old children (n 23 261). RESULTS HFI affected 23 % of child households. 38·5 % of children have at least one oral health problem. HFI was associated with a greater number of oral health problems: 1-2 problems (adjusted odds ratio (AOR) = 1·37; 95 % CI (1·15, 1·58); P = 0·0001), 3-4 problems (AOR = 2·21; 95 % CI (1·98, 2·44); P = 0·0001), 5-6 problems (AOR = 2·57; 95 % CI (2·27, 2·88); P = 0·0001). The HFI-oral health relationship was partially mediated by highly fermentable carbohydrate foods (PM = 4·3 %), plain water (PM = 1·8 %) and toothbrushing frequency (PM = 3·3 %). CONCLUSIONS HFI was associated with poorer child oral health. The HFI-oral health relationship was partially mediated by dietary and non-dietary factors. Longitudinal studies are needed to replicate our findings and investigate the role of other potential mediators.
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Affiliation(s)
- M Margaret Weigel
- Department of Environmental & Occupational Health, Indiana University, School of Public Health, 1025 E. 7th Street, Bloomington, IN47403, USA
- Global Environmental Health Research Laboratory, School of Public Health-Bloomington, Bloomington, IN, USA
- Center for Latin American & Caribbean Studies, Indiana University, Bloomington, IN, USA
- IU Center for Global Health, Indianapolis, IN, USA
| | - Rodrigo X Armijos
- Department of Environmental & Occupational Health, Indiana University, School of Public Health, 1025 E. 7th Street, Bloomington, IN47403, USA
- Global Environmental Health Research Laboratory, School of Public Health-Bloomington, Bloomington, IN, USA
- Center for Latin American & Caribbean Studies, Indiana University, Bloomington, IN, USA
- IU Center for Global Health, Indianapolis, IN, USA
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Sabbagh S, Mohammadi-Nasrabadi F, Ravaghi V, Azadi Mood K, Sarraf Shirazi A, Abedi AS, Noorollahian H. Food insecurity and dental caries prevalence in children and adolescents: A systematic review and meta-analysis. Int J Paediatr Dent 2022. [PMID: 36511123 DOI: 10.1111/ipd.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/13/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Food insecurity (FI) is associated with dietary practices, which can act as a risk factor for dental caries. AIM This study aimed to investigate the relationship between FI and dental caries prevalence in children and adolescents. DESIGN MEDLINE (via PubMed), EMBASE, SCOPUS, ISI web of knowledge, Cochrane, and ProQuest Dissertations & Theses Global database (up to April 19, 2022) as well as reference lists were searched. Eligible studies compared dental caries prevalence in food-secure and food-insecure individuals younger than 19 years. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using a modified Newcastle-Ottawa Scale. Meta-analysis was performed, and the pooled odds ratio (OR) was calculated at 95% confidence interval (95% CI). RESULTS Among the 1350 retrieved records, 10 cross-sectional reports were selected for systematic review. Six studies involving 8631 participants were included in the meta-analysis. More than half of the reports were published within the period 2019-2021. All studies except one were judged as low risk of bias. Overall, the prevalence of dental caries was greater among the food-insecure children and adolescents (OR: 2.01, 95% CI: 1.52-2.65, p < .001, I2 : 73.5%). Similarly, all three categories of FI were significantly associated with caries experience (marginal FI: OR: 1.88, 95% CI: 1.56-2.27, p < .001, I2 : 0.0%; low FI: OR: 2.42, 95% CI: 1.42-4.14, p = .001, I2 : 74.4%; very low FI: OR: 2.37, 95% CI: 1.88-3.00, p < .001, I2 : 0.0%). CONCLUSION The results showed a significant association between FI status and dental caries in both childhood and adolescence; however, there was a lack of longitudinal studies for a better understanding of this association. Health policies leading to reduction in FI may also aim to reduce dental caries.
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Affiliation(s)
- Sedigheh Sabbagh
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Mohammadi-Nasrabadi
- Research Department of Food and Nutrition Policy and Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Ravaghi
- School of Dentistry, University of Birmingham, Birmingham, UK
| | | | - Alireza Sarraf Shirazi
- Department of Pediatric Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdol-Samad Abedi
- Department of Research Deputy, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa Noorollahian
- Department of Pediatric Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Testa A, Ganson KT, Jackson DB, Bojorquez-Ramirez P, Weiser SD, Nagata JM. Food insecurity and oral health care experiences during pregnancy: Findings from the Pregnancy Risk Assessment Monitoring System. J Am Dent Assoc 2022; 153:503-510. [PMID: 35303979 DOI: 10.1016/j.adaj.2021.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/11/2021] [Accepted: 12/10/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Food insecurity has emerged as a salient risk factor for poor oral health in adult populations. A separate area of research also details that both poor oral health and food insecurity during pregnancy can have adverse consequences for maternal and infant well-being. The authors examine the connection between food insecurity and women's oral health care experiences during pregnancy. METHODS Data from 2016 through 2019 came from the Pregnancy Risk Assessment Monitoring System (N = 21,080). Multivariable logistic regression analyses were used to assess the association between food insecurity and 6 indicators of oral health care experiences during pregnancy. RESULTS Food-insecure women reported worse oral health care experiences during pregnancy, including being more likely to need to see a dentist for a problem, going to see a dentist for a problem, not receiving dental prophylaxis, not talking with an oral health care provider about dental health, not knowing it was important to care for teeth, and having unmet oral health care needs. CONCLUSIONS Food-insecure women exhibit worse overall oral health outcomes and unmet oral health care needs during pregnancy. PRACTICAL IMPLICATIONS Considering the risk that both food insecurity and oral health problems pose for maternal and infant health, interventions that can reduce food insecurity and improve oral health and oral health care access among pregnant women are important steps in promoting greater health equity.
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