Adverse Childhood Experiences and Dental Care Utilization During Pregnancy: Findings from the North and South Dakota PRAMS, 2017–2021

BACKGROUND: Research demonstrates adverse childhood experiences (ACEs)—i.e., experiences of abuse, neglect, and household dysfunction—adversely impact healthcare utilization over the life course. Several studies demonstrate that ACEs are related to lower dental care utilization in childhood and adolescence. However, limited research has explored the connection between ACEs and dental care utilization in adulthood, and no research has examined this relationship during pregnancy. The current study extends existing research by investigating the relationship between ACEs and dental care utilization during pregnancy. DATA: Data are from the 2017–2021 Pregnancy Risk Assessment Monitoring System (PRAMS) North Dakota and South Dakota (n = 7,391). Multiple logistic regression is used to examine the relationship between the number of ACEs and dental care utilization. FINDINGS: Relative to respondents with 0 ACEs, those with 4 or more ACEs were significantly less likely to report having dental care during pregnancy (OR = 0.745, 95% CI = .628, .883). By racial and ethnic background, the results showed that the significant associations are concentrated among White and Native American respondents. CONCLUSIONS: The results suggest that exposure to 4 or more ACEs is associated with a significantly lower likelihood of dental care utilization in adulthood, and this relationship is concentrated among White and Native American respondents. Further investigations are necessary to understand the mechanisms underlying the relationship between ACEs and dental care utilization and replicate the findings in other geographic contexts.