Methods: Mothers with an alcohol-related diagnosis (using International Classification of Disease), a proxy for alcohol-use disorder, recorded on health datasets were identified through the Western Australian data-linkage system. Exposed mothers were frequency-matched by maternal age, Aboriginal status and child’s birth year to randomly selected comparison mothers without an alcohol diagnosis. Linkage with the Midwives Notification System (1983-2002) identified all births of these mothers; 19,316 ‘exposed’ and 49,227 comparison children. Dental hospital admissions were identified through linkage with Hospital Morbidity Data (1983-2007) which includes data from all hospitals. Linkage with the Western Australian Register of Developmental Anomalies identified cases of FAS. Odds ratios (OR) and 95% Confidence Intervals (CI) for having a dental admission (ICD9 520-529; ICD10 K0-14) were generated using generalised estimating equations, adjusting for potential confounding factors.
Results: There were 2,609 (3.8%) children with a dental admission occurring by five years of age, with around 80% having only one dental admission. The most frequently occurring diagnoses were dental caries which occurred in around 2.6% of children, and pulp and periodontal diseases in around 1% of children. Children of mothers with an alcohol-related diagnosis were significantly more likely to have a dental admission related to gingivitis and periodontal diseases, diseases of the lip and oral mucosa, and diseases of the salivary glands. Children diagnosed with FAS had increased odds ratio of any dental admission (OR 2.58;95% CI 1.30;5.11).
Conclusions: Maternal alcohol-use disorder was associated with dental admissions related to disorders of the soft tissues, but questions remain regarding social inequalities and perinatal influences on dental admissions and disease.