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Childhood stress associated with the early appearance of permanent molars




Neuroscientist Alison Mackey began thinking about molars early in his career. As a researcher studying brain development, she wanted to know when these teeth grew, indicating early maturity in her child.

I’ve long been worried that if a child grows too fast, the brain will mature too quickly and lose plasticity early on. After that, they go to school and have a hard time learning at the same speed as their peers. Of course, I feel stressed [is] Low income will show this pattern of accelerated development. “

Allison Mackie, Associate Professor, Faculty of Psychology, University of Pennsylvania

She found that an extensible and objective way of showing how children embodied and responded to stress in their world was a kind of physical manifestation. It turned out that the timing of the eruption of the first molar was exactly that timing.

In Proceedings of the American Academy of SciencesDr. McKee and Dr. Cassidy McDermott of the University of Pennsylvania School of Medicine and their colleagues have shown that the first permanent premolars of low-income children and those who have experienced greater adversity can be made faster. Findings generated from large-scale studies and replicated using nationally representative datasets are consistent with the broader pattern of accelerated development commonly found under stress conditions in early childhood. ..

“It’s very important to understand how to detect early maturation faster,” says Mackey. “Currently, we rely on determining when children will reach puberty, but this may be too late for meaningful intervention. Children experience this early maturity. If we can cheaply know what we are doing, we may be able to direct more intervention resources to our children. “

Innovative evaluation system

Broadly speaking, McKee’s lab is studying how the brain changes and grows as people learn. It is well established that children with early childhood stress maturation and early puberty are at increased risk of physical and mental health problems in adulthood.

In addition, in primate species studies, molar eruption has been used to measure childhood length and correlates with many other developmental events. Similarly, in humans, the timing of dental events often influences the estimation of biological age.

“All of this has made molar eruption a compelling indicator of development,” says McDermott, who is trained to become a clinical psychologist.

This helped more than 100 children between the ages of 4 and 7 participate in two-pen brain development studies, including structural and functional MRI scans. “There is a type of MRI scan called the T2-enhanced scan that gives a very good visualization of tooth morphology,” says McDermott. These scans are commonly used to examine the brain, but researchers have shown how close these molars are to breaking through the gum border.

After noticing this, McKee and McDermott partnered with Pennsylvania Dental School student Catherine Hilton and Oral Medicine professor Muralidar Mupalapu to develop a new scale that accurately assesses tooth position.

“The scale range is from 1 to 4,” says McDermott. “The lower limit of the scale is 1, before the tooth actually develops. There is an intermediate stage before the tooth appears, and the highest rating of 4 is that the tooth fits completely in the mouth and with other teeth. In parallel. ”Each of the four molars was scored and the scores were averaged, leaving one score per person.

Researchers investigated the association between the initial environment and molar rash, controlling factors such as age and gender. “We found that both income and childhood adversity were individually associated with the condition of the molar rash,” says McDermott.

Reproduction of survey results

The correlation was clear, as these findings were from only 117 participants, but McKee and McDermott wanted to recreate what they saw.

University of Missouri-Kanzas City collaborators talked about a large data set representing the population called the National Health and Nutrition Examination Survey (NHANES). NHANES is publicly available and contains measurements such as dental data, demographic data and family income.

“Our sample is from one city, much less than a survey representing such a population,” says McDermott. “I thought it was an opportunity to make sure that the findings weren’t what we collected in Philadelphia,” says McDermott.

Some aspects were different, for example, NHANES measured tooth development in a slightly different way, but the model showed similar results, with low family income and early first molars. Indicates that it is related to.

McKee wants to study further whether this overall trend is new or just recently revealed. She is also interested in when the maturity rate is set. “Is it early in the womb or is it dynamically adjusted based on global stressors?” She says. “In the latter case, we have more opportunities to intervene.”

Current impact, future work

McKee says there are still important unclear points, as well as discoveries that need further investigation. For example, the research team saw racial differences at this time, with black children growing their first molars earlier than white children.

“These racial differences in molar rashes have long been known, but no one has critically considered where they came from,” she says. “This is consistent with the high levels of stress from structural racism. It is not just speculation that the experience of racism can cause stress and premature aging. It’s clearly shown. They have a non-negligible effect on children. “

For all children, a year or more of grief and social isolation caused by a pandemic will definitely increase stress levels and make it even more important to understand who is at greatest risk of premature maturity. , Says McKee.

Still, she and McDermott emphasize that the timing of the molars does not become another fear of the parent. “What I really don’t want is that parents are worried and happy based solely on when their children have molars,” says McKee. “We don’t have those data yet. . “

Pen researchers are working on it. In the future, we would like to work with the dentist’s office to get children involved in the study based on the condition of the eruption of the molars. The goal is to track them up to adulthood and get more information about exactly what the first first molars show. “If this is a meaningful discovery I think, I hope many scientists will come in and test these hypotheses,” McKee says.


Journal reference:

McDermott, CL, Et al. (2021) Early life stress is associated with the early appearance of permanent molars. PNAS.


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