Child externalizing behavior problems linked to genetic and non-genetic variation in dental caries

Michael F. Lorber, Amy M.Smith Slep, Richard E. Heyman, Walter A. Bretz

Research output: Contribution to journalArticlepeer-review


The association of environmental and genetic variation in caries with child externalizing behavior problems (inattention, hyperactivity, impulsivity, and defiance) was studied in a sample of 239 pairs of 3- to 8-year-old impoverished Brazilian twins. It was hypothesized that externalizing problems would show a stronger positive association with environmental than genetic variation in caries. Univariate twin models were estimated to parse variation in caries into three components: additive genetic (A), shared environment (C) and non-shared environment/error (E). Age-adjusted associations between externalizing problems and each variance component were tested. Contrary to the hypothesis, modest but very consistent negative associations were found between externalizing problems and both genetic and environmental variation in caries. Mutans streptococci and sweetness preference did not explain the negative associations of caries and externalizing problems. Externalizing problems in non-medicated children were associated with less dental decay that could be explained by both genetic and environmental factors.

Original languageEnglish (US)
Pages (from-to)475-481
Number of pages7
JournalCaries research
Issue number5
StatePublished - Apr 16 2014


  • Attention deficit
  • Childhood caries
  • Environment
  • Externalizing
  • Genetic
  • Hyperactivity
  • Impulsivity
  • Oppositional-defiant
  • Twins

ASJC Scopus subject areas

  • General Dentistry


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