RISK FACTORS ASSOCIATED WITH EARLY CHILDHOOD CARIES

幼儿龋病是一种复杂的多因素疾病 这对儿童福利构成了严重威胁。 虽然有些风险 风险因素和风险指标已经确定，但尚未 在特定的种族群体或非常年轻的 学龄前儿童 ECC的特征在于 乳牙，在某些情况下，它与不适当的 喂养方法。 Iis的患病率从5%到72%不等 百分比取决于诊断标准、年龄、种族和人口。 这项研究将集中在ECC的最早表现， 四颗上颌前切牙 拟进行病例对照研究 比较12至48个月有龋和无龋的儿童 上颌前切牙的位置 研究人群将 从旧金山弗朗西斯科的牙科和儿童诊所招募 综合医院，它提供了一个种族多样，经济 弱势群体，城市人口。 将选择具有以下特征的病例 在至少一个上颌前切牙中未治疗的龋齿。 控制 将选择上颌前部无龋的患者 门牙 儿童的父母或监护人将接受采访 以确定可能与早期 ECC的表现。 将收集儿童的唾液样本 并测定致龋标志物（变形链球菌和 乳酸杆菌水平;钙、磷酸盐和氟化物浓度; 和氟磷灰石过饱和）。 具体目标是：（1） 描述和比较人口统计学、行为学、家庭学和 环境因素在一个种族多样的群体服务不足 儿童上颌前切牙有龋与无龋; (2)评估同一人群唾液中的致龋标志物; （3）估计各变量之间的关联强度， 具体目标1和2的调查结果以及是否存在 上颌骨龋 确定的因素可在以后用于 前瞻性纵向研究，以制定全面的风险 青年ECC早期表现评估模型 孩子 这种模式将有助于早期发现， 监测有风险的儿童， 干预和预防方案， 使人衰弱的状况。

Early childhood caries (ECC) is a complex, multifactorial disease that poses a serious threat to child welfare. Although some risk factors and risk indicators have been identified, they have not been adequately investigated in specific ethnic groups or in very young preschool children. ECC is characterized by severe decay of primary teeth and in some cases, it is associated with inappropriate feeding practices. Iis prevalence varies from 5 percent to 72 percent depending on diagnostic criteria, age, race, and population. This study will focus on the earliest manifestations of ECC in the four maxillary anterior incisors. A case-control study is proposed to compare children aged 12 to 48 months with and without caries in the maxillary anterior incisors. The study population will be recruited from the dental and well-child clinics at San Francisco General Hospital, which serves an ethnically diverse, economically disadvantaged, urban population. Cases will be selected who have untreated caries in at least one anterior maxillary incisor. Controls will be selected who are caries-free in the maxillary anterior incisors. Parents or guardians of the children will be interviewed to identify factors that may be associated with the early manifestations of ECC. Children's saliva samples will be collected and assayed for cariogenic markers (mutans streptococci and lactobacilli levels; calcium, phosphate, and fluoride concentrations; and fluorapatite supersaturation). The specific aims are (1) to characterize and compare demographic, behavioral, familial, and environmental factors in an ethnically diverse group of underserved children wiht and without caries in the maxillary anterior incisors; (2) to assess cariogenic markers in saliva in the same population; and (3) to estimate the strength of the associations between the findings in specific aims 1 and 2 and the presence or absence of maxillary caries. Factors identitied can later be used in a prospective longitudinal study to develop a comprehensive risk assessment model for early manifestations of ECC in young children. Such a model would enable early detection and monitoring of at-risk children and lead to cost-effective intervention and prevention programs for this expensive and debilitating conditions.