182 - Early childhood caries risk factors differ between children with prenatal opioid exposure and unexposed controls

Publication Number: 2175.182

Nicole Mack, RTI International, Chicago, IL, United States; Kimon Divaris, UNC-Chapel Hill, Chapel Hill, NC, United States; Carla M. Bann, RTI International, Apex, NC, United States; Jamie E. Newman, RTI International, Research Triangle Park, NC, United States; Sara DeMauro, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Namasivayam Ambalavanan, University of Alabama School of Medicine, Birmingham, AL, United States; Scott A. Lorch, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States; Deanne Wilson-Costello, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Brenda Poindexter, Children's Healthcare of Atlanta, Atlanta, GA, United States; Myriam Peralta-Carcelen, University of Alabama at Birmingham, Birmingham, AL, United States; Jonathan M. Davis, Tufts University School of Medicine, Boston, MA, United States; Catherine Limperopoulos, Children's National Health System, Washington DC, DC, United States; Stephanie L. Merhar, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: Understanding oral health practices at an early age is crucial to prevention of early childhood dental caries (ECC) and other oral diseases as children grow. Exploring whether such practices differ for children prenatally exposed to opioids is even more important given other health challenges they may face.

Objective: To explore differences in risk factors contributing to ECC between children with prenatal opioid exposure and unexposed controls after accounting for sociodemographic factors and parenting stress.

Design/Methods: Infants born at ≥37 weeks gestation with prenatal opioid exposure and unexposed controls were enrolled at 0-1 months of age in the prospective longitudinal Outcomes of Babies with Opioid Exposure (OBOE) study. At the 2-year visit, caregivers responded to questions on frequency of sugary snacks, water sources, tooth brushing frequency, dental visits, and general oral health and completed the Parenting Stress Index. Chi-square tests were used to compare oral health practices between exposure groups. Generalized linear regression models were conducted to identify risk factors associated with putting the child to bed with liquids other than water, a major risk factor for ECC.

Results: Oral health data were collected on 196 participants (Table 1). Most oral health practices (e.g., frequency of sugary snacks, tooth brushing) did not differ between groups. However, opioid-exposed infants were more likely to have been put to bed with something other than water (p=0.018) compared to unexposed infants. Additionally, primary water sources differed significantly, with opioid-exposed children more likely to receive municipal water (32% vs 15%, p=0.012) and less likely to receive filtered water (25% vs 46%, p=0.003). Adjusting for sociodemographic factors, opioid-exposed children were more likely to have been put to bed with a bottle containing something other than water (OR: 3.1, 95% CI [1.2,7.8]) (Table 2).

Conclusion(s): After accounting for sociodemographic factors and parenting stress, children with prenatal opioid exposure were more likely to experience nighttime bottle-feeding patterns that increase their risk for ECC. Interventions to increase caregiver awareness of best practices could prevent longer-term oral health diseases among this vulnerable population.

Table 1. Oral Health Practices at 24 months by Prenatal Opioid Exposure
PAS_Abstract_Oral_Health_2025_Table_1.pdf

Table 2. Adjusted Odds Ratios for bedtime liquids other than water
PAS_Abstract_Oral_Health_2025_Table_2.pdf