The intersection of stress, childhood adversities, and oral health

Aim: The physiological stress response is shaped in childhood and the intensity, frequency, and duration of stressful stimuli determine it. Adverse emotions experienced in early childhood can have profound and lasting physiological and psychological consequences. Therefore, it is important to understand how dental treatment can be a significant stressful in a child’s life and recognize the potential lifelong impact. It is also crucial to comprehend how chronic stress can negatively affect oral health over time. Methods: In the present study, a critical review was conducted by analyzing scientific articles related to stress, salivary cortisol levels, child neurodevelopment, and the association of these factors during pediatric dental care, from 1981 to 2024, in databases such as PubMed and SciElo. Results: Across 69 studies, the review emphasizes the connections between adverse childhood experiences (ACEs), dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, and their cumulative effect on pediatric oral health. The findings illustrate how ACEs can disrupt normal brain functioning, leading to chronic stress, poor oral health outcomes, and altered behavior during dental care. Conclusion: Dental professionals must approach pediatric care with a deep understanding of the child’s emotional and psychological state. By doing so, they can contribute to healthier oral outcomes and help mitigate the long-term impact of childhood adversities on oral health.