Broadbent JM, Zeng J et al. J Dent Res 2016; 95: 808–813

The onset and progression of dental diseases can be steered by structural factors including social and economic factors, whereas diet and home oral care are behavioural drivers. Then there are life course models that recruit modifiers for disease risk. The investigators used generalised structural equation modeling to investigate the relationship between oral health-related beliefs and behaviours in childhood and early adulthood, and dental health outcomes including quality of life in adulthood. The participants were members of the Dunedin Study. This ground breaking study has followed the health, including oral health, the development and behaviour of 1,037 people since birth for now over 40 years. The key finding from this paper is that factors affecting oral health in childhood influence oral health quality of life in adulthood. This would support the 'accumulation of risk' model rather than a critical or sensitive period (for seminal paper on this subject see J Epidemiol Community Health 2003; 57: 778–783, cited by 825).