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PREDICTING CARIES RISK IN UNDERSERVED CHILDREN, FROM TODDLERS TO THE SCHOOL-AGE YEARS, IN PRIMARY HEALTHCARE SETTINGS

预测初级医疗保健机构中从幼儿到学龄儿童的龋齿风险

基本信息

批准号：
10361268
负责人：
Margherita R Fontana
金额：
$ 0.76万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-01 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10361268
关键词：
5 year old 8 year old Academy Age Age-Years American Area Assessment tool Biological Child Childhood Chronic Disease Cohort Studies Data Data Analyses Dental Dental Care Dental caries Dentists Development Disease Dyes Early treatment Enrollment Environment Expenditure Experimental Designs Follow-Up Studies Funding Goals Grant Health Health Care Costs Health Personnel Health Services Accessibility Healthcare Incidence Interdisciplinary Study Intervention Lesion Life Cycle Stages Medical Methods Minority Groups Mixed Dentition Monitor National Institute of Dental and Craniofacial Research Oral Oral health Participant Patients Pattern Pediatrics Policies Population Group Population Heterogeneity Predictive Value Prevalence Prevention Preventive Preventive therapy Primary Dentition Primary Health Care Process Provider Publishing Questionnaires Research Research Personnel Resources Risk Risk Assessment Risk Factors School-Age Population Schools Specialist Strategic Planning Temperament Therapeutic Time Toddler Tooth structure Triage Visit Work aged base care providers clinical risk cohort cost cost effective craniofacial deciduous tooth design disorder prevention early childhood ethnic minority population evidence base experience health assessment health care delivery health care settings innovation low socioeconomic status multidisciplinary neglect parent grant permanent tooth prevent primary caregiver programs racial and ethnic racial minority sex tool tooth surface

项目摘要

SUMMARY OF FUNDED PARENT GRANT: Dental caries, one of the most common chronic diseases of childhood, is a largely preventable disease, yet approximately 23% of U.S. children 2-5 years-of-age experience dental caries, and this number more than doubles to 56% among those aged 6-8. In the current environment of escalating healthcare costs and resource constraints, the large disparities in caries experience and access to care that exist in the U.S., especially among low socioeconomic status (SES) and minority population groups, call for a greater focus on targeted (at the patient and tooth surface level), risk-based caries preventive and therapeutic strategies to be delivered through interprofessional partnerships, including primary healthcare settings. Our team has just finished following 1,326 children from age 1 to age 4, and we have started data analyses to validate a caries risk questionnaire for use by medical providers to accurately identify high caries risk toddlers. The problem is that, while caries experience more than doubles from ages 2-5 to 6-8, caries in primary teeth during mixed dentition is a largely neglected area of research and prevention, there is no validated caries risk tool for medical settings to easily help triage 5-8 year old children, and there have been almost no studies following the life-course progression of caries in children 1-8. This information is critically important, as designing and targeting efficacious and cost-effective preventive therapies that can adapt to changes in the life-course from toddlers to school-age children is dependent on accurate risk factor and tooth surface assessment. Thus, the objectives of this innovative continuation renewal study are: 1) to develop a practical and easily-scored caries risk tool for use in primary medical healthcare settings to identify high caries risk children, expanding from the toddler (1-4) to the school-age years (5-8); and 2) to determine the relationships between caries risk profiles and caries disease patterns (e.g., occlusal vs. proximal) in the mixed dentition. This will be accomplished by following a cohort of 876 primary caregiver (PCG)-child pairs from our ongoing U01’s enrolled pairs. This cohort represents a diverse population, including ethnic/racial minorities and low SES groups. The PCG will complete a caries risk questionnaire and the child will have caries examinations at baseline (child’s age 6.5 years old + 3 months), and again at 18 months (child’s age 8 years + 3 months) and 36 months after baseline (child’s age 9.5 years + 3 months) to monitor the caries disease process. Longitudinal caries risk data and caries disease prevalence/incidence and tooth surface pattern information collected from age 1-4 (ongoing U01) and 5-8 (proposed continuing renewal) will be used to assess risk of caries in children ages 5-8. A great strength of this proposal is that it involves four experienced medical and dental investigator groups, who have successfully worked together for the past 5.5 years and can facilitate follow-up of the study cohort. The significance is that identification of high caries risk children in primary healthcare settings will allow cost- effective preventive and/or referral strategies to be developed, targeted and used in interprofessional settings to prevent caries development from the toddler to the school-age years. This will have immediate broad impact and influence on existing and/or new policies and programs to be delivered by non-dental professionals in medical settings and other non- healthcare settings (e.g., school-based), as well as by dental professionals in dental healthcare settings.

受资助父母补助金摘要：