W. Murray Thomson

A gradient of childhood self-control predicts health, wealth, and public safety

Policy-makers are considering large-scale programs aimed at self-control to improve citizens’ health and wealth and reduce crime. Experimental and economic studies suggest such programs could reap benefits. Yet, is self-control important for the health, wealth, and public safety of the population? Following a cohort of 1,000 children from birth to the age of 32 y, we show that childhood self-control predicts physical health, substance dependence, personal finances, and criminal offending outcomes, following a gradient of self-control. Effects of childrens self-control could be disentangled from their intelligence and social class as well as from mistakes they made as adolescents. In another cohort of 500 sibling-pairs, the sibling with lower self-control had poorer outcomes, despite shared family background. Interventions addressing self-control might reduce a panoply of societal costs, save taxpayers money, and promote prosperity.

Association between children's experience of socioeconomic disadvantage and adult health: a life-course study

BACKGROUND Research into social inequalities in health has tended to focus on low socioeconomic status in adulthood. We aimed to test the hypothesis that childrens experience of socioeconomic disadvantage is associated with a wide range of health risk factors and outcomes in adult life. METHODS We studied an unselected cohort of 1000 children (born in New Zealand during 1972-73) who had been assessed at birth and ages 3, 5, 7, 9, 11, 13, and 15 years. At age 26 years, we assessed these individuals for health outcomes including body-mass index, waist:hip ratio, blood pressure, cardiorespiratory fitness, dental caries, plaque scores, gingival bleeding, periodontal disease, major depression, and tobacco and alcohol dependence, and tested for associations between these variables and childhood and adult socioeconomic status. FINDINGS Compared with those from high socioeconomic status backgrounds, children who grew up in low socioeconomic status families had poorer cardiovascular health. Significant differences were also found on all dental health measures, with a threefold increase in adult periodontal disease (31.1% vs 11.9%) and caries level (32.2% vs 9.9%) in low versus high childhood socioeconomic status groups. Substance abuse resulting in clinical dependence was related in a similar way to childhood socioeconomic status (eg, 21.5% vs 12.1% for adult alcohol dependence). The longitudinal associations could not be attributed to life-course continuity of low socioeconomic status, and upward mobility did not mitigate or reverse the adverse effects of low childhood socioeconomic status on adult health. INTERPRETATION Protecting children against the effects of socioeconomic adversity could reduce the burden of disease experienced by adults. These findings provide strong impetus for policy makers, practitioners, and researchers to direct energy and resources towards childhood as a way of improving population health.

Female and male antisocial trajectories: from childhood origins to adult outcomes

This article reports on the childhood origins and adult outcomes of female versus male antisocial behavior trajectories in the Dunedin longitudinal study. Four antisocial behavior trajectory groups were identified among females and males using general growth mixture modeling and included life-course persistent (LCP), adolescent-onset, childhood-limited, and low trajectory groups. During childhood, both LCP females and males were characterized by social, familial and neurodevelopmental risk factors, whereas those on the adolescent-onset pathway were not. At age 32, women and men on the LCP pathway were engaging in serious violence and experiencing significant mental health, physical health, and economic problems. Females and males on the adolescent-onset pathway were also experiencing difficulties at age 32, although to a lesser extent. Although more males than females followed the LCP trajectory, findings support similarities across gender with respect to developmental trajectories of antisocial behavior and their associated childhood origins and adult consequences. Implications for theory, research, and practice are discussed.

Cannabis Smoking and Periodontal Disease Among Young Adults

CONTEXT Tobacco smoking is a recognized behavioral risk factor for periodontal disease (through its systemic effects), and cannabis smoking may contribute in a similar way. OBJECTIVE To determine whether cannabis smoking is a risk factor for periodontal disease. DESIGN AND SETTING Prospective cohort study of the general population, with cannabis use determined at ages 18, 21, 26, and 32 years and dental examinations conducted at ages 26 and 32 years. The most recent data collection (at age 32 years) was completed in June 2005. PARTICIPANTS A complete birth cohort born in 1972 and 1973 in Dunedin, New Zealand, and assessed periodically (with a 96% follow-up rate of the 1015 participants who survived to age 32 years). Complete data for this analysis were available from 903 participants (comprising 89.0% of the surviving birth cohort). MAIN OUTCOME MEASURE Periodontal disease status at age 32 years (and changes from ages 26 to 32 years) determined from periodontal combined attachment loss (CAL) measured at 3 sites per tooth. RESULTS Three cannabis exposure groups were determined: no exposure (293 individuals, or 32.3%), some exposure (428; 47.4%), and high exposure (182; 20.2%). At age 32 years, 265 participants (29.3%) had 1 or more sites with 4 mm or greater CAL, and 111 participants (12.3%) had 1 or more sites with 5 mm or greater CAL. Incident attachment loss between the ages of 26 and 32 years in the none, some, and high cannabis exposure groups was 6.5%, 11.2%, and 23.6%, respectively. After controlling for tobacco smoking (measured in pack-years), sex, irregular use of dental services, and dental plaque, the relative risk estimates for the highest cannabis exposure group were as follows: 1.6 (95% confidence interval [CI], 1.2-2.2) for having 1 or more sites with 4 mm or greater CAL; 3.1 (95% CI, 1.5-6.4) for having 1 or more sites with 5 mm or greater CAL; and 2.2 (95% CI, 1.2-3.9) for having incident attachment loss (in comparison with those who had never smoked cannabis). Tobacco smoking was strongly associated with periodontal disease experience, but there was no interaction between cannabis use and tobacco smoking in predicting the conditions occurrence. CONCLUSION Cannabis smoking may be a risk factor for periodontal disease that is independent of the use of tobacco.

Determinants of early-vs late-onset dental fear in a longitudinal-epidemiological study

A longitudinal investigation of risk factors for early- and late-onset dental fear was conducted. Early-onset dental fear was related to conditioning experiences (indexed via caries level and tooth loss), service use patterns, stress reactive personality and specific beliefs about health professionals. Late-onset dental fear was related to aversive conditioning experiences, irregular service use and an external locus of control. In contrast to recent findings for dental anxiety, personality factors were not strongly related to the onset of dental fear in young adulthood. The key role played by conditioning events in the development of both early- and late-onset dental fear was confirmed. Conditioning events appear to play a different role in the development of dental fear vs dental anxiety. This may reflect important, but largely ignored differences between these two closely-related constructs. Interventions for early-onset dental fear should aim to modify both the dental fear and the personality vulnerabilities that may contribute to the development of dental fear early in the life-course.

Mandibular single‐implant overdentures: preliminary results of a randomised‐control trial on early loading with different implant diameters and attachment systems

OBJECTIVES To determine surgical and prosthodontic outcomes of mandibular single-implant overdentures, opposing complete maxillary dentures, using a wide diameter implant and large ball attachment system compared with different regular diameter implants with standard attachment systems. MATERIALS AND METHODS Thirty-six edentulous participants (mean age 68 years, SD 9.2) were randomly assigned into three treatment groups (n=12). A single implant was placed in the mandibular midline of participants to support an overdenture using a 6-week loading protocol. The control group received Southern regular implants and standard ball attachments. One group received Southern 8-mm-wide implants and large ball attachments. Another group received Neoss regular implants and Locator attachments. Parametric and non-parametric tests of a statistical software package (SPSS) were used to determine between groups differences in marginal bone loss, implant stability, implant, and prosthodontic success (P<0.05). RESULTS Implant success after 1 year was 75% for Southern regular implant (control) group; and 100% for the Southern wide and Neoss regular implant groups (P=0.038). Mean marginal bone loss at 1 year was 0.19 mm (SD 0.39) without significant differences observed. Implant stability quotient (ISQ) at baseline was significantly lower for the Southern regular (control) group than the other two groups (P=0.001; P=0.009). At 1 year, no significant difference in implant stability was observed (mean ISQ 74.6, SD 6.1). The change in implant stability from baseline to 1 year was significant for the control group (P=0.025). Prosthodontic success was comparable between the groups but the maintenance (41 events overall, mean 1.2) was greater for the Locator and the standard ball attachments. CONCLUSIONS Mandibular single-implant overdentures are a successful treatment option for older edentulous adults with early loading protocol using implants of different diameters and with different attachment systems.

Gender differences in dentists' working practices and job satisfaction

OBJECTIVES To describe the working practices and level of job satisfaction of male and female dentists. METHODS A nationwide postal survey of all dentists holding an annual practising certificate in New Zealand (response rate 78.1%). RESULTS The mean number of hours worked per week was 29.1 for female and 36.0 for male dentists. The main reason for part-time practice given by women was caring for children (cited by 67.2%) and for men was personal choice (cited by 63.6%). A greater proportion of females than males were employed on a salary or as an associate in practice rather than owning their own practice. Male dentists were more active in continuing education than females. The mean career satisfaction score for male respondents was 7.6 and for females 7.1 (P<0.001). Relatively more women than men had taken a career break, usually for child rearing. Two-thirds of women and one-third of men planned to retire from dentistry before 60 years of age. CONCLUSIONS Male and female dentists differ in their working patterns and career satisfaction. There is a need for ongoing monitoring of the workforce, particularly as the gender distribution (and societal trends and expectations) continues to change.

Good teeth, bad teeth and fear of the dentist.

Studies of dental fear and oral disease suggest that conditioning processes are important in the acquisition of dental fear. At this time, however, definitive conclusions are premature as all research on the etiology of dental fear has been retrospective in design, with most confined to analogue or clinic samples. This study redressed these limitations by prospectively investigating the relationship between oral health (i.e. caries experience) at age 5 and 15 yr and the report of dental fear at age 18 in a large, unselected birth cohort. Caries experience at age 5 was not related to the development of dental fear in late adolescence. In contrast, caries experience at age 15 was significantly, and specifically, related to the report of dental fear at age 18. A ratio of caries severity at age 15, indicating the extent of multi-surface involvement, was inversely related to dental fear at age 18. This intriguing finding suggests that relatively brief dental treatment occasioned by low levels of dental disease may result in the incubation of dental fear in some individuals and that longer episodes of treatment may facilitate fear habituation. Theoretical and practical implications of these findings are discussed.

Fluctuating asymmetry and physical health among young adults

Abstract Fluctuating asymmetry (FA), the random deviations from perfect symmetry found in the bilateral structures of bilaterally symmetric organisms, has been inconsistently linked to health. In this study, the association between FA and an array of health measures was determined for a large ( n =965) general population sample of 26-year-old men and women. FA was significantly associated with two health measures: body mass index (BMI), but only for females (more asymmetric=greater BMI), and number of medical conditions (asymmetric subjects were more likely to report they had two or more medical conditions). FA was not associated with waist/hip ratio, systolic blood pressure (BP), blood cholesterol, cardiorespiratory fitness, and periodontal disease. Two suggestions are offered for these results. The first is that, as a consequence of the association between developmental stability and low metabolism [Evol. Hum. Behav. 18 (1997) 15.], stable and unstable groups will differ on some health measures (e.g., BMI), but not those related to body maintenance (e.g., BP). The second is that because of the minimization of environmental stressors in Westernized societies, there is too much homogeneity in asymmetry among the population to detect differences within samples.

Changes in young children’s OHRQoL after dental treatment under general anaesthesia

OBJECTIVE To use the Parental-Caregivers Perceptions Questionnaire (P-CPQ) and Family Impact Scale (FIS) to determine whether dental treatment of young Auckland children under general anaesthesia (GA) improved oral-health-related quality of life (OHRQoL) for them and their families. DESIGN A pretest/post-test design, with a consecutive clinical sample of parents/caregivers of children (10 years or younger) treated under GA. More than half of the children were Māori or Pacific Islanders. RESULTS Of the 157 children in the baseline sample, 144 (91.7%) were followed up. The overall P-CPQ score showed a large decrease following treatment, along with an increase in the number scoring 0 (no impact). Similar relative changes were observed in the oral symptoms and emotional well-being subscales, whereas the other two subscales showed moderate decreases. All post-treatment FIS scores were lower than pre-treatment ones; all showed moderate effect sizes. The greatest relative changes were seen in the parental/family activity and parental emotions subscales. CONCLUSIONS The dental treatment of young children under GA is associated with considerable improvement in their OHRQoL. The P-CPQ and the FIS are valid and responsive to treatment-associated changes in young children with early childhood caries (ECC).