Paternal Physical Punishment and Neglect: Does It Increase the Odds of Toothache in Children and Adolescents?

Background: Physical punishment by caregivers affects approximately 60% of children between the ages of 2 and 14 worldwide. Aim: To evaluate the association between physical punishment and paternal neglect of children and adolescents and toothache. Design: This cross-sectional study included all schoolchildren between the ages of 9 and 19 from a small Brazilian town in 2016 (n = 329). Toothache was assessed through a structured questionnaire using the question: "In the last six months, have you experienced a toothache?" (yes/no). The main exposures consisted of six validated questions about negligence and six about physical punishment, both with three potential answers: Always (2 points), sometimes (1 point) or never (0 points). Logistic regression models were fitted to estimate the association between paternal physical punishment/neglect and toothache, adjusted for sex, age, family equivalent income and parents' level of education. Results: Thirty-seven percent of the children reported no physical punishment, while 19% reported no negligence. The odds ratio (OR) of toothache for every 1 point increase on the abuse or negligence scale was OR = 1.27 (95% Confidence Intervals (CI) = 1.08-1.50) and OR = 1.10 (95%CI = 0.96-1.26), respectively. If the child's mother had started and/or finished university, the OR of toothache is lower. Conclusions: Paternal physical punishment is associated with toothache.