Family Resilience and Connection Is Associated with Dental Caries in US Children

Abstract

Family resilience is a family‐level construct that has been defined by Walsh (2011) as the family’s ability to “withstand and rebound from disruptive life challenges, strengthened and more resourceful.” Family resilience is associated with connection, which is the body of social relationships that the family possesses. It is from these social connections that the family may receive support when faced with adversity. Family resilience and connection are associated to thriving and improved mental health outcomes; but less is known about the impact of family resilience and connection on children’s oral health. This study examined the association between family resilience and connection and the probability of a child having caregiver‐reported dental caries using a nationally representative sample. We hypothesized that the odds of caregiver‐reported child dental caries would be lower among children with higher levels of family resilience and connection.We performed a cross‐sectional analysis of the 2016 National Survey of Children’s Health among US children ages six to 17 years. Family resilience and connection was assessed using the family resilience and connection index, a valid and reliable measure for children ages six to 17 years in which the six‐point score is analyzed as a three‐level categorical variable. Caregivers reported whether their child had “decayed teeth or cavities” during the past 12 months. We used logistic regression controlling for child (age, gender, race/ethnicity, insurance, preventive dental use) and family (education and federal poverty level) characteristics.In the 2016 National Survey of Children’s Health, 35,167 children were age six to 17 years.Among the 35,167 children in our sample, 3,661 (10.4%) children had caregiver‐reported dental caries. The prevalence of dental caries decreased in a graded fashion with increasing levels of family resilience and connection (12.5, 10.5 and 8.8%, respectively, P < 0.001). Compared to children with the lowest level of a family resilience and connection, those with the highest level had lower odds of caregiver‐reported dental caries after adjusting for child and family covariates (adjusted odds ratio [OR] = 0.63; 95% confidence interval [CI] = 0.58, 0.69).Using a nationally representative sample, we found that children with higher levels of family resilience and connection had significantly lower odds of caregiver‐reported dental caries compared to children with lower levels of family resilience and connection.This finding is consistent with previous research on the relationships between family resilience and health outcomes. Further study is needed to identify the mechanisms through which families with low resilience and connection experience higher rates of adverse health outcomes. In light of growing body of literature on effective interventions for building resilience, policies and programs that prioritize family health and increase family resilience and connection have the potential to decrease dental caries in school‐aged children, though this should be definitively established through a randomized controlled trial.The Robert Wood Johnson Foundation.